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Click here or scroll down to respond to this candidateCandidate's Name
Address: Street Address
Phone: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLEProfessional SummaryTo maintain an effectively work flow and facilitate a Jobs ability to meet its goals and objectives. It's my job to uphold an position to utilize my knowledge and skills. I will perform my job successfully as an individual or as a team player. Education Altierus Career College Houston, TX March 2018 November 2018 Medical Billing and Coding Houston Community College Houston, TX Graduated, May 1994 GED ExperienceSAGIS PLLC Houston, TX Jan 2020 - PresentPosition: Customer Service Representative/Data Entry/Claims Specialist/Payment Poster/Medical Records Duties:Perform data entry login of patient demographics, clinical information and charges.Making sure medical records are completed in each patients chart for any email/fax request.Answer patient phone calls and assist patients on their accounts.Collected Payments, Refiling claims with in timely filing, Check claims on Availity /Insurance Provider PortalMaking calls to Insurance Payers to check eligibility/denial payments and claims.Completing A/R monthly spreadsheet by month end.Making sure to have all of my policies/contracts in order for Payers.Following up on unpaid claims within standard billing cycle timeframe.Checking each insurance payment for accuracy and compliance with contract discount.Setting up patient payment plans and work collection accounts.Receive medical records request and making sure they received them in timely manner. Radiology Partners Houston, TX Feb 2019 - Jan 2020 Position: Group/Payer Enrollment Specialist/Data Entry Duties:Implements the physician enrollment and credentialing process for clients who request provider enrollment services. Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.Maintains provider information and demographics for all providers.Responds to internal and external inquiries on routine enrollment and contract matters.Monitored and updated provider license and Insurance before expiration. Orion-MBS Healthcare Houston, TX April 2003 - November 2018 Position: Data Entry/Claim Specialist/Payment Poster Duties:Entering patient demographics and Insurance through the MEDFM system for over 200 Hospitals.Posting Physician/Dr. Billing, Patient/Insurance Payments to patient accounts.Applying Procedure (CPT) Diagnosis (DX) codes and Clinical edit (blood work) charges on patient accounts and making sure no charges are duplicatedIncoming/ Outgoing patient calls to update any patient information, insurance and payments.Provide weekly/monthly reports vie email on a public folder and analyzed all electronic spreadsheets to ensure all data was viewable to supervisors and managers.Verifying pending Addendum charges before applying to patients accounts.Identified duplicate reports in order to eliminate redundant maintenance for claims to be processed in a within a 24 hour turnaround and meeting Month End deadline.Verify and Update Referring Physicians Credentials.Responsible for handling, resolving and resubmitting all denial claims.Making sure the accession log is updated daily.Place calls to clients to verify any information.Answer departmental phone calls and assist clients as needed. Aetna/Prudential Healthcare Sugarland, TX August 1998 March 2003 Position: Data Entry SpecialistDuties:Entering patient demographics and Insurance information through our system for over 50 clinics.Posted patient payments to patient accounts.Verifying insurance for inpatient and outpatient procedures.Incoming/Outgoing patient calls to update any patient information, Insurance, payments and claims.Correct, Refile all rejected/denied claims by day end.Scanned, made photocopies, filed all Pathology/Radiology pending addendum charges until further reviewed and authorized for charging.Provide weekly/monthly reports via email on a public folder for all managers to view.Refiling denied/rejected claims after corrected.Backed up front desk by answering phones, copying, filing and helping co-workers. G.C. Services Houston, TX March 1992-August 1998Position: Data Entry/Charge Operator/Book KeepingDuties:Entered patient demographics on a daily basis.Answering heavy phone lines, filing claims, checks and correspondence. Posted checks and read all correspondence to narrow down to input on patients accounts.Made sure on daily basis, all books and deposit slips balanced before day end. Helping patients with any issues on accounts and applying payments.Mailing Claims out to patients by week end.Input Invoices for account receivables. |
