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Click here or scroll down to respond to this candidateCandidate's Name 840-58th ST west Birmingham, AL.35228 PHONE NUMBER AVAILABLE Cell Email: EMAIL AVAILABLE
OBJECTIVE: To obtain a challenging position within a company that will continue to enhance my knowledge, and give me the opportunity to advance, serve, and contribute my talents to the best of my ability. STRENGTHS: All Microsoft Applications Various Medical Billing Software ICD-9 & CPT/HCPCS Coding Computerized/Manual Accounting; Bookkeeping Experience with clinical and financial side or hospital services PERSONAL: Proven self-starter who takes the initiative to do what needs to be done without being asked. Work well (and competently) under stress Trustworthy, ethical proven tact & diplomacy in handling interpersonal relationships Excellent Leadership qualities & experience EDUCATION: CERTIFIED CODING CREDENTIALS OBTAINED JULY 2008 CPAR CERTIFICATION OBTAINED NOV 2005 Business Management-Minor (currently enrolled) Herding College, Madison Wisconsin (Health Information Management) (Graduated Dec 2006) Herzing College, Birmingham Alabama Business Administration (Graduated October 2002)
WORK
EXPERIENCE:
Pangetwo
Atherotech diagnostic lab Sept 2014-present
Patient Account/Insurance Follow Up Rep
Responsibilities:
Responsible for researching batch payments, auditing accounts, and knows the ins and outs of debits and credits as they apply to patient accounts.
Utilizing and Understanding of CPT and ICD9/ICD10 medical billing codes and guidelines.
Continuous Research of Medicare, Medicaid, and replacement Medicare Products regulations and guidelines.
Ability to follow up with insurance companies, make appeals, review reimbursements and unpaid claims on a daily basis in a high volume practice.
Analyze data and perform records maintenance as needed.
Efficiency and strong organization skills are a must.
Research for correct policy information and payer states to complete billing for payment.
UAB/UHSF - Birmingham, AL
THIRD PARTY MEDICARE/HOSPICE REP October 2011 to August 2014
Responsibilities include: Collecting, posting and managing account payments. Responsible for
Submitting claims and following up with insurance companies. Prepare and submit clean claims to various insurance companies wither electronically or by paper. Prepare, review and send patient statements. Perform various collection actions including contacting Insurance Companies by phone, correcting and resubmitting claims to third party payers. Participates in educational activities and attends monthly staff.
THE OUTSOURCE GROUP Oct 2008-Aug 2011 POSITION SUPERVISOR/TEAM LEAD MEDICAID/COMMERCIAL FOLLOW UP Responsibilities include: Assisting the Manager by giving staff day to day direction in performing daily responsibilities. Working with Manager to ensure staff is capable of handling current production goals within department as well as set an example for staff by meeting above quotas and 95% and above accuracy. Assist in training new staff by demonstration sound collection practices, monitoring new hire calls and providing feedback. Address any issues that should require immediate and necessary action to improve and maintain success. Review policies and procedures and ensure understanding with all staff. Assist and address and escalated call issues, research customer accounts and provide necessary feedback to staff. Perform weekly QA audits for staff, as well as the managing of problem accounts on a daily basis. Prepared daily and weekly reports as needed. Obtained claim status on insurance claims to resolve all outstanding balances. Analyze each patient account for accuracy in billing/follow-up/payment. Complete and log all outgoing calls to insurance companies to obtain claim status.
BEVERLY HEALTHCARE GOLDEN LIVING Jan. 2008-Oct 2008 POSITION: MEDICARE BILLING SPECIALIST Review all claims submitted for payment to Medicare for accuracy and completion. Billing services in accordance with Federal regulations; coordinate accumulation and verification of all necessary documentation required for billing; process correspondence and telephone calls from Medicare regarding all clients; timely resolution for all claims. Responsible for the timely billing and collections of Medicare account balances per policy and procedures. Follow up timely on claims and maintain daily log for account follow-up. Maintain compliance with all current Medicare guidelines. Resolve account discrepancies and uncollectible accounts and prepare adjustments or write-offs and refunds for approval as necessary. Maintain accurate and complete records concerning collection activity. Document all activity in chart or system notes. Address problems as they occur. Keep supervisor or manager advised of areas of concern or compliance issues which may lead to inaccurate or untimely payment of claims. Complete all weekly/monthly reports according to schedule.
TELETECH Oct.2007-Jan.2008 POSITION: TECHNICAL SUPPORT ANALYST FOR NOTEBOOK PC Answer all customers calls and acting independently to resolve customer issues that are technically complex in nature Using tact, diplomacy, and superior customer service skills to deal with challenging and complex customer interactions Providing first-level technical support on basic operational or maintenance of a personal computers and /or peripherals using documented procedures and available tools Identifying unique or recurring customer problems and providing input to management to prevent recurrence BROOKWOOD MEDICAL CENTER Sep. 2002-Oct.2007 POSITION: QUALITY ANALYST/PATIENT FINANCIAL SERVICES Responsibilities: Review every registration within corporate toolkit guidelines to ensure accuracy of registration data. Provide feedback to Patient Access Manager and Supervisors for training purposes. Update all inaccurate information within ADT and Financial Systems to assure billing is accurate during initial billing. Advanced knowledge of medical terminology and the ability to coordinate and perform the functions of the front office in an efficient and organized manner. Provide excellent customer service during the process of registration and scheduling of patients. Gather and document accurate patient and guarantor demographic, medical, employment and insurance/financial information in a timely manner, including collection of deposits for deductible and co-payments. Review and outline criteria used to define reporting distribution of QA results and employee performance. Assist staff supervisors to provide a plan of action to improve the accuracy of any employee's performing below a threshold of specific percentage of accuracy.
REFERENCES: Available upon request (remains updated |
