April Cato
Memphis
Summary
Medical Billing Manager with over 20 years of experience in healthcare management. Expertise in optimizing billing processes and ensuring coding accuracy, leading to improved revenue cycle efficiency. Proven leadership in training staff on best practices for medical coding and compliance management. Significant contributions to financial goals through effective communication with medical professionals and insurance companies.
Overview
26
26
years of professional experience
Work History
Financial Counselor
Lebonheur Children Medical Center
Memphis
08.2024 - Current
- Updated patient information in database regularly to ensure accuracy of records.
- Assisted patients with completion of forms needed for admission process.
- Greeted patients and answered questions regarding registration process.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Entered patient data into electronic medical record system accurately and efficiently.
- Processed payments for services rendered in a timely manner.
- Answered general questions about hospital policies and services provided.
- Created daily logs of discharged patients and maintained a list of available beds at all times.
- Utilized various software and tools to streamline processes and optimize performance.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Supervisor Revenue Services
University Clinical Health
Memphis
11.2022 - 04.2025
- Trained new employees in company policies, procedures and work ethics.
- Supervised and coordinated activities of staff to ensure compliance with established policies, procedures, and standards.
- Delegated tasks to team members according to individual strengths.
- Resolved conflicts between team members and departments.
- Set performance goals for staff members and helped teams meet important deadlines.
- Monitored workflow processes to ensure accuracy and timeliness of deliverables.
- Established policies and procedures for handling confidential patient information according to HIPAA regulations.
- Resolved denied claims in a timely manner by working directly with insurance companies.
- Reviewed claims submissions for accuracy prior to submitting to payers.
- Identified process improvements that would reduce costs associated with medical billing activities.
- Tracked reimbursements from insurance companies and managed follow-up procedures when needed.
- Advised senior management on best practices related to healthcare reimbursement rules and regulations.
- Resolved patient billing issues and communicated with insurance carriers.
- Performed claims research, appeals and related follow-up using medical systems and software.
- Prepared and reviewed claims for submission, resolving upfront claims edits and errors.
- Collaborated with other departments to resolve invoice disputes in a timely manner.
Patient Account Team Lead
LifeLinc Anesthesia
Memphis
01.2021 - 11.2023
- Responsible for posting all charges, payments, and adjustments.
- Responsible for processing all written orders and scheduling patients for surgery or diagnostic testing.
- Analyzes trends impacting charges, coding, collection and accounts receivable, ensuring appropriate action to align staff and revise policies and procedures.
- Appealing all claims that denied for medical necessity or unbundling claims.
- Responsible for performing a daily follow up on all claims that are listed on the aging report.
- Monitored trends in the healthcare industry related to billing practices and procedures.
Clinical Assistant/Patient Account Representative Lead
The Meyer Eye Group
Memphis
03.1999 - 11.2018
- Responsible for posting all charges, payments, and adjustments.
- Responsible for processing all written orders and scheduling patients for surgery or diagnostic testing.
- Analyzes trends impacting charges, coding, collection and accounts receivable, ensuring appropriate action to align staff and revise policies and procedures.
- Maintains contacts with other departments to obtain and analyze additional patient information to document and process billing.
- Responsible for completing disability and social security forms for patients.
- Responsible for obtaining pre-certifications, authorizations, and patient demographics.
Senior Reimbursement Manager
Physicians Financial and Management Services, LLC
Cordova
02.2013 - 09.2015
- Responsible for performing a daily follow up on all claims that are listed on the aging report.
- Contacts responsible party to resolve delinquent accounts; directs accounts to outside collection agency when needed.
- Maintains contacts with other departments to obtain and analyze additional patient information to document and process billing.
- Analyzes trends impacting charges, coding, collection and accounts receivable, ensuring appropriate action to align staff and revise policies and procedures.
- Responsible for keeping up to date carrier rule changes and distributing the information to the administrators.
- Responsible for analyzing and reporting the financial status for all 17 of our practices.
- Prepared monthly variance reports comparing actual versus expected revenues.
- Created reports summarizing financial data such as accounts receivable aging, cash flow projections, and patient charges and collections summaries.
- Established relationships with insurance providers to ensure timely reimbursement for services rendered.
Education
Medical office certification - Medical Office Professional
Concorde Career Health
Memphis, TN01.1999
Diploma -
Southside High School
Memphis, TN01.1996
Skills
- I'm an experienced manager, with over 17 years of patient account experience, seeking to take the next career step, with a highly respected organization
- Financial counseling
- Patient data management
- Medical billing
- Claims processing
- Microsoft Excel
- Team leadership
- Process improvement
- Effective communication
- Problem solving
- Time management
- Insurance verification
- Telephone etiquette
- Decision-making
Timeline
Financial Counselor
Lebonheur Children Medical Center
08.2024 - Current
Supervisor Revenue Services
University Clinical Health
11.2022 - 04.2025
Patient Account Team Lead
LifeLinc Anesthesia
01.2021 - 11.2023
Senior Reimbursement Manager
Physicians Financial and Management Services, LLC
02.2013 - 09.2015
Clinical Assistant/Patient Account Representative Lead
The Meyer Eye Group
03.1999 - 11.2018
Medical office certification - Medical Office Professional
Concorde Career Health
Diploma -
Southside High School
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