Deborah Buzainz Email & Phone Number | •30 years of experience in the healthcare industry working in various positions i.e. Claims Examiner, Customer Service Rep, Claims Auditor, Worker’s Comp. Adjustor, Medical Billing & Collections, Provider Contract Administrator, Financial Recovery Specialist, and Configuration Analyst for Physician Revenue Cycle Management • Extensive knowledge interpreting and configuring complex provider contractual agreements •Extensive knowledge in reviewing, processing and interpreting medical and hospital claims including a complete understanding of all claim forms, EOP’s and EOB’s •Experience in handling daily phone calls from provider regarding claim payments, denials, and negative balances •Knowledge of CMS coding and billing guidelnes, i.e., CPT’, HCPC, DRG, Revenue Codes, and Medical Terminology •Experience in Physician Revenue Cycle Management process •Knowledge in EDI and ERA set up for govermental and commercial payers i..e Emdeon, Availity, Navinet, and Human website knowledge •Knowledge in data mining, i.e., running system queries, and analyzing and manupilating large amounts of data in excel format to create specific reports for management •Knowledge in analyzing and configuring different types of benefit structures •Knowledge in the following systems and applications: CSP Facets, Amisys, MHS, Encoder, Macess, and Microsoft Outlook, Excel, Word, Access & Power Point •Experience in internal auditing of claims, provider contracts, and all facets of Policies and Procedures Excellent organizational and detail oriented skills

Deborah Buzainz

•30 years of experience in the healthcare industry working in various positions i.e. Claims Examine...
United States

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Deborah Buzainz’s Email deborah_buzainz@uhc.com

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Deborah Buzainz’s Location United States

Deborah Buzainz’s Current Industry Unitedhealth

Deborah Buzainz’s Prior Industry Avmed Health Plans | Avisena | Coventry Health Care

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Work Experience

Unitedhealth

Employer Installment Administrator

2012-10-01 00:00:00 - Present

Avmed Health Plans

Benefits Configuration Analyst

2011-07-01 00:00:00 - 2012-01-01 00:00:00

Avisena

Configuration Specialist

2010-06-01 00:00:00 - 2010-12-01 00:00:00

Coventry Health Care

Provider Contract Administrator

1992-11-01 00:00:00 - 2010-06-01 00:00:00

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Languages

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FAQ About Deborah Buzainz

Deborah Buzainz is located at
United States

Deborah Buzainz is a •30 years of experience in the healthcare industry working in various positions i.e. Claims Examiner, Customer Service Rep, Claims Auditor, Worker’s Comp. Adjustor, Medical Billing & Collections, Provider Contract Administrator, Financial Recovery Specialist, and Configuration Analyst for Physician Revenue Cycle Management • Extensive knowledge interpreting and configuring complex provider contractual agreements •Extensive knowledge in reviewing, processing and interpreting medical and hospital claims including a complete understanding of all claim forms, EOP’s and EOB’s •Experience in handling daily phone calls from provider regarding claim payments, denials, and negative balances •Knowledge of CMS coding and billing guidelnes, i.e., CPT’, HCPC, DRG, Revenue Codes, and Medical Terminology •Experience in Physician Revenue Cycle Management process •Knowledge in EDI and ERA set up for govermental and commercial payers i..e Emdeon, Availity, Navinet, and Human website knowledge •Knowledge in data mining, i.e., running system queries, and analyzing and manupilating large amounts of data in excel format to create specific reports for management •Knowledge in analyzing and configuring different types of benefit structures •Knowledge in the following systems and applications: CSP Facets, Amisys, MHS, Encoder, Macess, and Microsoft Outlook, Excel, Word, Access & Power Point •Experience in internal auditing of claims, provider contracts, and all facets of Policies and Procedures Excellent organizational and detail oriented skills