KAREN CULLIVER10700 Fuqua Street Apt #142, Houston, Texas 77089Cell: 832-407-9914 whoudini34@yahoo.com

Professional SummaryMedical Billing and Coding/Collection's Specialist with 20 years’ experience providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Organized Medical Billing Specialist with foundation in records management. Experienced in billing and collection procedures. Advanced medical terminology knowledge. Efficient Medical Administrative Assistant skilled in tackling administrative and patient-oriented tasks in a fast-paced environment. Skills billing and collection procedures expert. Follow and Appeals Reconciliations, Supervisory skills, Extensive Customer Service and Advance Collections. Applied Social Security Knowledge.

CertificationsAdvanced Collections Techniques

Core StrengthsMedical billing software Strong work ethicKnowledge of HMOs, Medicare and Medi-Cal Good written communication

Exercises good judgmentManaged care contract knowledge Internal Team player with positive attitudemedicine billing Strong planning skills

Maintains strict confidentialityICD-9 codingHIPAA complianceQuality assessment of coded data

Professional ExperienceInsurance Resolution SpecialistJanuary 2014 to CurrentGetix Health - Houston, TexasActed as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative. Thoroughly reviewed remittance codes from EOBS/AR’s. Submitted refund requests for claims paid in error. Performed quality control of the data entry system to verify that claims and payments were posted correctly. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Monitored shared email in-boxes and ensured inquiries were addressed. Thoroughly

investigated past due invoices and minimized number of unpaid accounts.Social Security Refund SpecialistFebruary 2007 to October 2013Lincoln Financial Group - Omaha, Nebraska

Lincoln Financial Group Omaha, Nebraska Appropriate claims paperwork, documentation and system entry.Claim review and calculation of overpayments due back to company Recovery and posting of refunds Research and resolve claim and recovery issue with claimants and vendors Review and placed awarded Social Security claims applied knowledge in escalated collection issues Verify benefits with third party entity.

Medical Billing SpecialistJanuary 2004 to January 2007

Alegent Health System - Omaha, NECompleted appropriate claims paperwork, documentation and system entry.Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.Reviewed and billed Workers Compensation claims with third party insurance company Researched and resolved escalated issues with claimants and employers Customer Service.

Lead Medical Billing SpecialistMay 2002 to December 2003Veterans Hospital - Omaha, NE

Completed appropriate claims paperwork, documentation and system entry.Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.Lead biller over staff of 5 Billed Champion's claims for disabled veterans Reviewed and resolved issues for claimants concerning benefits Verified insurance benefits.

Medical Billing SpecialistOctober 2000 to March 2002Dr. Nadim Zacca M.D - Houston, TX

Coded and billed medical claims for non-invasive cardiology procedures.Researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.Scheduled appointments, registered patients.Completed appropriate claims paperwork, documentation and system entry.Applied knowledge in Medical Record Filing Review medical records in order to determine correct billing and coding is applied Verify insurance benefits for cardiology patients applied knowledge in accounts receivable and payables.Resolved third party insurance questions issues with patients.

Medical Billing and Collection SpecialistSeptember 1993 to September 2000Nebraska Health System - Omaha, NE

Billed medical claims for Surgical Anesthesia, Medicare and Blue Cross and Blue Shield of Nebraska.Completed appropriate claims paperwork, documentation and system entry.Thoroughly researched medical procedures to expand skills and knowledge.Advanced collections of past due in and out patient balances.Financial Counseling Customer Service Insurance Verification.

Education and TrainingHigh School Diploma: Speech Pathology-Audiology, May 1986Burke High School - Omaha, NEBusiness ManagementUniversity of Nebraska at Lincoln - Lincoln, NEBellevue University - Omaha, NE