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Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL PROFILEWell-rounded professional who offers extensive medical industry experience. Pays attention to detail to review and correct errors and ensure high levels of accuracy. Develops effective communication in order to promote a positive work environment and optimal operational workflow. Maintains patient privacy and confidentiality.Academic Honors Recognition / Honor Roll.Experience in Microsoft Word and Excel; Typing Speed: 85 wpm & 10-by touch 15,000 ksphProblem solver; combines judgment and experience to create sound solutions. KEY QUALIFICATIONSPractice Structure Leadership & Management Medical Terminology Business Office Operations Medical Office Procedures HIPAA Compliance Anatomy & Physiology Human Resource Management Organizational Improvements Practice Management Software Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway Healthcare Computer Information Systems Medical Practice Management Systems Accounting, Payroll, and Banking Systems Healthcare Law Insurance Billing Procedures Healthcare Claim Cycle Insurance VerificationMaintaining Prescription Line Appointment Scheduling Charting Filing Processing Co-Payments EDUCATIONUltimate Medical Academy Associate of Science Degree Healthcare Management, 2016 Everest Institute of Technology Medical Insurance Billing and Coding Certificate, 2006 MEDICAL EXPERIENCEStartek/Medica Insurance, Mansfield, OH 12/2019 03/2020 Customer Service Billing RepresentativePost payments of premium for customersCall center setting explain Marketplace subsidies & credits, adjustmentsExplain monthly premium when different than estimated by government University Hospitals Good Samaritan, Ashland, OH 07/2018 10/2018 Customer Service Billing/Revenue Cycle SpecialistContact and follow up with patients via phone and/or letters to collect on self-pay balances through assigned work queues or reportsTake incoming phone calls from patients or others and assist in resolving accountsNegotiate payment arrangements with patientsTransfer accounts to collection agencies for bad debt and payment plansFax claims to insurance companies for processingSend letters to patients for info needed to process claimRe-bill claims that have been lost, rejected or erroredVerify insurance informationUse credit card machine to process patient paymentsFollow-up with insurance companiesAnswers emails on the same day or the next business day Centene Corporation, Buckeye Health Plan, Columbus, OH 06/2015 11/2016 Program Coordinator IUsed computer to enter data assessments and authorizations into the system.Initiated authorization requests and maintained prior authorization list.Screened eligibility and benefits; coordinated services with community-based organizations. Program Coordinator 1Worked with nurses to ensure a well-established health plan for members.Answered phones and assisted members with waiver services; updated member information.Managed reporting of patient information and provided to managers. Molina Healthcare, Columbus, OH 02/2015 06/2015Care Review ProcessorAbstracted clinical data to assign CPT, ICD-9, and HCPCS codes.Researched and made corrections to denied or rejected claims from third party payers. Columbus OBGYN, Columbus, OH 08/2013 11/2013Medical BillerEntered data electronically to process charges, payments, denials, and adjustments.Resolved routine billing issues and inquiries; followed-up on balances due from insurance companies. Contract Work for Nationwide Childrens Hospital/Firstsource Solutions/ Careworks/ HMS, Columbus, OH 03/2009 01/2013Medical Biller / Caseworker / Patient Account Representative/Account Resolution SpecialistEntered data into charge capture system for export to billing system.Posted payments, corrected errors, and re-submitted claims.Contact patients regarding accounts 30-90 days past due.Contact insurance companies regarding overdue payments.Worked with UB-04, UB-92 and CMS-1500 electronically and manually. |
