Amanda M.

About Amanda M.

Medical Reimbursement Specialist that leverages tools like EPIC, eClinicalWorks…

Experience

1. Billing Specialist

   Tribe513 The Onyx Group

   Nov 2022 — Present · Greenville, SC, US

   As a Medical Reimbursement Specialist, I specialize in managing the end-to-end reimbursement processwith a strong focus on reviewing medical claims, identifying coding issues, and resolving denials througheffective appeals.Denials Management- Identify denial trends through conducting chart audits and working directlywith payers to ensure accurate and timely reimbursement, increasing quarterly revenue by $50K bystreamlining claim appeal process.Medical Accounts Receivable- Interpret payer policies, submit reconsiderations/appeals to payerportals and Waystar Clearinghouse with supporting clinical documentation, and ensure claims arecompliant with coding and regulatory standards, helping to decrease outstanding balances by 30%in six months.Payment Posting- Identify underpayments for high-volume procedures, recouping over $150, inlost revenue annually.Revenue Cycle Enhancement- Collaborate with providers to address recurring coding and icd-10issues and offer education based on research, improving cash flow by 25%.Optimize Reimbursement- Stay current with healthcare policy updates- especially those related tocoding- as key priority each month, reducing claims error submission by 75%.Medical Insurance Plans- BCBS of SC, Aetna, Cigna, United Healthcare, Humana Standard SCMedicaid, Select Health Medicaid, Molina Medicaid, Absolute Total Care Medicaid, HumanaMedicaid, Blue Choice Medicaid.