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Click here or scroll down to respond to this candidateCandidate's Name
Cell#PHONE NUMBER AVAILABLEPhiladelphia, PA Street Address
EMAIL AVAILABLETraining and Experience:Excellent Customer Service experience and supportEnrollment insurance verification experienceKnowledge of Medical TerminologyComputers skills, Medic systems, SMS, Citrix, Nextgen, Centricity, Emdeon, Epic, MedentExperience in medical claims procedures and terminology, specialities, hospitals, skilled nursing facility claims, BH claims, Worker Compensation/MVA knowledge, A/R hospital billing, physician billing, ICD-10 CM, CPT knowledge,abilty to meet productivity goals,strong problem solving, and research skills. Excellent interpersonal skills both written and verbal.Experience with Manage Care, Commerical, Medicare and MA Billing/medical claims and Self payWork Experience:Aerotek Inc,/PATHS LLC, CherryHill, NJ(Temp)Accounts Respresentative-08/2021-presentContact insurance companies to resolve unpaid balances on accountsReview assigned accounts for missing insurance paymentsAssist with the resolution of credit balances in a timely mannerObtain information from insurance companies to foster claim adjudicationInform management of issues with accounts that require client interventionConstellis Inc, Doylestown PA, Pittsburg PA, Bensalem PA,(Temp)COVID-19 Patient Administrator -03/2021- 07/2021The Patient Administrator interacts with individuals interested in registering to receive a COVIDensures all of the relevant paperwork is completed in full.enter patient data into the provided vaccination information system in an accurate and expeditious manner.responsible for maintaining and tracking electronic records and logs.Crozer Health Systems, Chester, PAReimbursement Specialist- 03/2020-08/2020Researched worker's comp/MVA claims for non payment or unprocessed claimsVerified eligiblity for compensation of work injuries and MVA accidentsContacted Auto claims departments spoke with claim adjustors for verification of injuriesSent necessary documentation for clams processing.Drexel University-Phila, PA (Contract Assigment)Accounts Receivables Specialist- 04/2019- 01/2020Provided Accounts reveivables servies fo physician billing practiceWorked with Family Medicine providers claimsIdentified the root cause of issues with claims deniedEnsure accurate payments of claims are receivedMade claim adjustments and write-offBatched all services according to billing areaCooper Health, Camden NJCollections Specialist II- 01/2018- 7/2018Edits claims for registration errorsProducing accurate first steps to clean a claimVerifying eligibility capturing as much patient information to ensure claim is sent to correct insurance carrierEnsuring valid CPT and DX codes are being billed for each claim and groupValidating physician information is correct using EPIC systemSend Appeals for denied claimsSIRRUS GroupAccounts Receivable Specialist 11/2016 -03/30/2017-(Temp) Oreland, PASpecialized in Workers Comp and Motor Vehicle claimsInvestigate workers compensation incidents, validate insurance, collected pertinent information pertaining to processing a claimCash postingClaims verificatonJefferson Hospital- Phila, PAAccounts Receivables Specialist- 10/2015- 6/2016Responsible for collections,analysis, and overall management of Accounts Receivables as well as assisting with account payable process to ensure healthy cash flow of the companyAnswer A/R inquires from staff and clientsFacilitate issue resolution with A/P invoicesThird party verificationWorked outpatient, inpatient and self-pay claimsUpdated patient demographicsFresenius Medical Care, Malvern, PABilling Specialist- 6/2013- 10/2015Researched and resolved claim issues by contacting the pertinent parties by telephone or insurance websiteMet productivity goals by working 95% of accounts within 45 days from bill dateManaged over 200-1500 accounts monthlySent patient invoices for self paymentsARC Group- Hatboro, PAAccounts Receivables Representative-01/2009- 6/2013Reviewed claim edited lists for missing or incorrect registration date and post patient third party payment to accounts in IDX Flow cast systemReviewed EOB received to ensure proper payment from the third party payors. Interact with clinical departments (internal) insurance carriers (external)Followed up on rejected or under paid outpatient facility claims. Re-submitted claims to third party carriers as necessar, ensuring all necessary paperwork was attached to claimsHandled billing inquires from patients and insurance companies as well as from physicians concerning patient accounts. |
