NIKOLINA GRUBNIC
Des Plaines
Summary
Results-driven Medicare Reimbursement Specialist at Option Care Health with expertise in HCPCS and ICD-10 coding. Demonstrated success in enhancing billing accuracy and compliance, while effectively resolving discrepancies. Strong attention to detail and collaborative skills led to improved departmental efficiency and training of new staff in billing procedures.
Overview
7
7
years of professional experience
Work History
Medicare Reimbursement Specialist
OPTION CARE HEALTH
12.2014 - 03.2017
- Assisted in processing reimbursement claims for accuracy and compliance with guidelines.
- Supported documentation efforts by organizing and maintaining accurate records for reimbursement requests.
- Learned to utilize reimbursement software to track claims and updates efficiently.
- Collaborated with team members to resolve discrepancies in patient billing information promptly.
- Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
- Trained department employees in proper billing and accounting procedures.
- Accurately assigned TPN, ENT, Drug codes and successfully submitting to the payer.
Medical Biller and Coder
PRIME SOURCE HEALTH CARE
06.2010 - 11.2014
- Managed patient billing processes ensuring timely and accurate submission.
- Utilized coding software to assign correct medical codes for insurance claims.
- Familiar with ZirMed (Clearing House) healthcare revenue cycle management platform that I used to streamline billing, claims processing, and payment management. It offers tools for eligibility verification, coding, and denial management, improving financial performance and operational efficiency.
- Collaborated with healthcare providers to verify diagnosis and procedure details.
- Resolved billing discrepancies by liaising with insurance companies and patients.
- Implemented coding updates to maintain compliance with regulatory standards.
- Trained new staff in billing procedures and documentation standards.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Assigned Evaluation and Management codes for podiatry specialty along with diagnosis and procedure codes which specifically include debridement of skin, tx of ulcers decubitus
- Medicare Reimbursement Supervisor hiring and training of new employees with keeping up to date with Medicare Guidelines and Regulations
Education
Associate of Science - Registered Health Information Technology
Oakton Community College
Des Plaines06-2012
Skills
- HCPCS coding
- HIPAA compliance
- ICD-10 coding
Timeline
Medicare Reimbursement Specialist
OPTION CARE HEALTH
12.2014 - 03.2017
Medical Biller and Coder
PRIME SOURCE HEALTH CARE
06.2010 - 11.2014
Associate of Science - Registered Health Information Technology
Oakton Community College
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