Summary
Overview
Work History
Education
Skills
Timeline
Generic

Amber L Krejsa

Lyons

Summary

In search pf a position within the medical field that will allow me to effectively demonstrate my skills, knowledge and passion for delivering high-quality work in a professional environment that offers structure and the opportunity for growth and advancement within a company.

Excellent customer service, interpersonal and communication skills High level of accuracy and efficiency Ability to handle high stress situations and come to a resolution Extensive medical billing background, patient focused, skilled at medical billing, coding and office management Strong analytical skills, proven track record of results in changing and improving companies processes Ability to effectively prioritize workload, manage multiple tasks, follow-up with minimal supervision Quick and accurate data entry. Skilled with medical software such as Medisoft, IMS, Brightree, I- Emphsys, Zirmed, & MRO. WPM 60-100 Knowledge of CPT, ICD-10, & medical terminology. Familiar with DME equipment & qualifications for CPAP, O2, Enteral, etc. Conduct meetings and team building exercisers to improve quality of work and ensure company wide processes are implemented with a proven track record of results

Experienced with managing comprehensive billing operations, ensuring accuracy and timely invoicing. Utilizes problem-solving skills to optimize billing processes and resolve discrepancies swiftly. Knowledge of financial analysis and team leadership.

Overview

15
15
years of professional experience

Work History

HME Billing Manager

Independence Plus
10.2023 - Current
  • Reviewing patient information, verifying insurance coverage, and accurately coding and submitting claims to payers
  • Monitoring claim status, identifying and addressing billing errors, and following up on outstanding claims
  • Tracking outstanding balances, following up with insurance companies for timely payments, and managing the aging of accounts receivable
  • Staying updated on billing regulations, ensuring adherence to coding guidelines, and implementing necessary compliance measures
  • Training and managing a team of billing specialists, assigning tasks, and monitoring performance
  • Generating reports on key billing metrics such as collection rates, denial rates, and revenue cycle performance

Revenue Qualifications Manager

LifeTech
11.2017 - 10.2023
  • Responsible for timely filing & accurate billing activities, including interactions with third party payers, Medicare, & Medicaid
  • Maintain current coverage status information
  • Resubmit rejected claims & reverse & rebill
  • Provide reports on billing activities as requested by the Billing Department Manager
  • Maintain expert knowledge of CMS/Medicare billing requirements relating to the submission of claims for DME
  • Perform insurance / billing clerical duties, including review and verification of patient account information against insurance program specifications
  • Understand and comprehend basic medical terminology
  • Process monthly resupply orders & confirm new patient equipment setups
  • Conduct weekly team meetings to ensure operations and numbers and being met
  • Collaborates with other managers and departments to ensure patients receive their monthly supply orders
  • Manage and motivates team to promote collaboration and keep employees on task
  • Staff and train new team members
  • Understands and has experience with billing, collections and negotiations

Billing Specialist

Option Care Inc.
04.2016 - 11.2017
  • Responsible for the timely processing of health insurance claims
  • Verify patient benefits and effective date of coverage, updating patient demographics as needed
  • Ensure all claims are submitted accurately for services provided based on payor guidelines
  • Verify all required documentation and authorization is completed prior to billing
  • Utilize tracking report to follow up on unpaid claims
  • Investigate denials when deemed a reimbursable service

Lead Patient Services Representative

Prism Healthcare Services Inc.
04.2015 - 04.2016
  • Accurately enters/updates patient information in practice management system
  • Identifies payer source, verifies insurance eligibility, financial status and assigns correct pay type
  • Schedules and re-schedules appointments as needed
  • Functions as a contact person between all members of the healthcare team to relay necessary information in order to coordinate patient needs
  • Manages a limited caseload of patients regarding the coordination of patient supplies & delivery needs
  • Generates delivery tickets for all deliveries & supplies

Patient Services Representative

Walgreens Sleep & Respiratory
06.2014 - 03.2015
  • In charge of receiving and processing telephone and fax requests from patients and referral sources to provide DME
  • Responsible for entering orders accurately and efficiently
  • Answer high volume calls using a multi-line phone system
  • Verify insurance and update patient files
  • Obtain initial prior authorizations as needed based on payor guidelines
  • Provide instructions on how to use the equipment

Senior Liability Case Manager

Prime Source Healthcare Systems
11.2012 - 05.2014
  • Made outbound phone calls to nursing homes, patients’ families, and facilities’ social services representatives to follow-up on approved claims and consent documents
  • Use the Medicaid website to confirm the status of patients and pending payments
  • Generate and distribute invoices to appropriate parties
  • Meet deadlines and monthly goals
  • Excel working independently and as part of a team
  • Work with supervisor and coworkers to obtain and direct delivery receipts to the appropriate recipients
  • Maintain and update daily reports tracking the status of cases outstanding on a daily, weekly, and monthly basis
  • Contribute to weekly team meetings by generating and presenting performance reports

Medical Biller/ Patient coordinator

Priority Medical Billing
05.2010 - 11.2012
  • Retrieve patient medical records for physicians, technicians, or other medical personnel
  • Post medical insurance billings
  • Review records for completeness, accuracy and compliance with regulations
  • Enter patient info into the database and audit existing files for accuracy
  • Create spreadsheets and other office documents for management as needed

Education

CNA certificate -

Morton College
Cicero, IL
01.2011

High School diploma -

Morton East HS
Cicero, IL
01.2003

Skills

  • Skillful in Microsoft Word, Excel and Outlook etc
  • Audit support
  • Data entry proficiency
  • Accounts receivable management
  • HIPAA compliance
  • Complex Problem-solving
  • Organization and multitasking
  • Billing systems and software
  • Training and mentoring
  • Month-end closing procedures

Timeline

HME Billing Manager

Independence Plus
10.2023 - Current

Revenue Qualifications Manager

LifeTech
11.2017 - 10.2023

Billing Specialist

Option Care Inc.
04.2016 - 11.2017

Lead Patient Services Representative

Prism Healthcare Services Inc.
04.2015 - 04.2016

Patient Services Representative

Walgreens Sleep & Respiratory
06.2014 - 03.2015

Senior Liability Case Manager

Prime Source Healthcare Systems
11.2012 - 05.2014

Medical Biller/ Patient coordinator

Priority Medical Billing
05.2010 - 11.2012

High School diploma -

Morton East HS

CNA certificate -

Morton College
Amber L Krejsa