Karine SaintvilKS
Open to opportunities

Karine Saintvil

@karinesaintvil

Customer service-oriented professional with medical billing expertise.

United States
Message

What I'm looking for

I seek a role that values teamwork and offers opportunities for professional growth.

I am a dedicated professional with a strong background in medical billing and claims processing. My experience spans over a decade, during which I have honed my skills in managing accounts receivable, resolving discrepancies, and ensuring compliance with HIPAA regulations. I pride myself on my ability to communicate effectively with clients, providers, and insurance payers, facilitating a smooth billing process.

Throughout my career, I have successfully worked in various roles, including Denial Analyst and Claims Processor, where I have demonstrated my problem-solving abilities by addressing claim denials and appeals. My attention to detail and commitment to maintaining organized records have contributed to my success in achieving high-quality billing services. I am passionate about leveraging my expertise to support healthcare organizations in optimizing their revenue cycle management.

Experience

Work history, roles, and key accomplishments

SF

Claim Associate

State Farm

Aug 2019 - Dec 2021 (2 years 4 months)

Worked as part of a team and applied knowledge of medical terminology to handle simple and complex claims. Researched denials and entered data into computer systems. Finalized and posted payments for claims and completed Medicare and Medicaid compliance reporting.

MA

Appeals Coordinator

McBee Associates

Sep 2015 - Jul 2019 (3 years 10 months)

Oversaw various cases including provider payment disputes, medical appeals, and reversals. Completed data entry of all new denied cases and researched reasons for denials. Placed outbound phone calls to providers and followed up via email or letters.

HJ

Managed Care Coordinator

Horizon Blue Cross Blue Shield of New Jersey

Mar 2004 - Jul 2015 (11 years 4 months)

Prepared, documented, and routed cases in appropriate system for clinical review. Initiated call-backs and correspondence for members and providers to coordinate and clarify benefits. Handled Explanation of Benefits (EOB), processed claims accurately, resolved billing issues, and provided insurance providers with correct payments.

Education

Degrees, certifications, and relevant coursework

UA

Ultimate Medical Academy

Associate of Science Degree, Medical Billing and Coding

Completed an Associate of Science Degree in Medical Billing and Coding. Gained expertise in medical insurance claims, billing services, and revenue cycle management. Developed skills in problem-solving, communication, and compliance with healthcare regulations.

UA

Ultimate Medical Academy

Certificate, HIPAA Essentials for Healthcare Professionals

Obtained a HIPAA Essentials for Healthcare Professionals Certificate. Focused on understanding and adhering to HIPAA compliance standards in healthcare settings. Enhanced knowledge of patient privacy and data security.

Tech stack

Software and tools used professionally

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Karine Saintvil - Denial Analyst - Revecore | Himalayas