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Click here or scroll down to respond to this candidateEDUCATIONCandidate's Name
Street Address PresentUniversity of Maryland Global College, Adelphi, Maryland Diploma with Academic HonorsMay Street Address
Paul Lawrence Dunbar High School, Baltimore, Maryland LETITIABANKSADMINISTRATIVEPROFESSIONALOBJECTIVEIn pursuit of an employmentopportunity in a progressiveorganization that allows thescope to update my knowledgeand qualifications in theadministrative field to addvalue and be part of a diverseand dynamic team that adds toboth my personal andprofessional growth.CONTACTPHONE:PHONE NUMBER AVAILABLEEMAIL:EMAIL AVAILABLEWORK EXPERIENCEMedstar - Reimbursement SpecialistJune 2019PresentAssists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy- including updating account information and transferring charges to correct financial class. Liaison with other administrative teams. Assists with keeping the department organized and running smoothly overall. Train new employees. Collects and determines follow-up needed on outstanding accounts receivable with an invoice balance less than or equal to $3,000. Contacts insurance carriers directly to confirm receipt of claim(s). Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes and effective communication. Prepares and edits letters, reports, memos, and emails. Follows appeal procedures for denied claims and reimbursement below contractual fee schedule. Identifies patient/third party carrier complaints, resolves, and communicates these complaints to management. In accordance with operational policies and procedures, adjustment to patient accounts as necessary to facilitate timely reimbursement. Maintains collection follow-up notes utilizing GE IDXETM software. Meets the Performance ETM Production quota set at 100% of the established quota. Monitors assigned accounts receivable categories until payments are received and posted. Obtains necessary billing/appeal information fromprovider/division/electronic record/billing contact/patient to facilitate timely claim/appeal adjudication. Participates in educational/professional development activities. Provides supporting documentation at time of claim appeal to facilitate timely reimbursement. Reports status of delinquent accounts. Resolves billing issues if necessary. Sorts, distributes, and responds to incoming mail from insurance carriers. Uses support capabilities of accounts receivable billing system to obtain appropriate information and work product. Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations. Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees, and represents the department and hospital/facility in community outreach efforts as appropriate. Option Care - Revenue Cycle Management SpecialistNovember 2013February 2019Submitted timely, accurate invoices to payer for products and services provided. Understood the terms and fee schedule for all contracts for which invoices are submitted. Correctly determined quantities and prices for drugs billed. Verified that the services and products are correctly authorized, and that required documentation is on file. Ensured that invoices were submitted for services and products that were properly ordered and confirmed as provided. Evaluated payments received for correctness and applied payments accurately to the system. Verified that payments received were correct according to the fee schedule. Applied the payment correctly to the patient account. Ensured that secondary bills and patient invoices were mailed within 48 hours of receipt of payment. Notified the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service. Transferred payments belonging to other offices within 48 hours of receipt. Followed up on invoices submitted to ensure prompt and timely payment. Called to verify that claims submitted were received and were being processed. Sent letters to the patient or responsible party when their insurance carrier failed to make payment within a reasonable time frame. Generated and mailed statements and collection letters. Followed-up on all denials within 48 hours of receipt. Ensured compliance with policies and guidelines outlined in the contract terms and fee schedule. Followed HIPPA guidelines when accessed and shared patient information to maintain patient and business confidentiality. WUTB TV - Office AssistantMay 2013November 2013Performed various clerical tasks, such as sorting and sending mail. Maintained operations of the front desk. Answered and addressed viewers concerns. Assisted with accounts receivable. Coded and submitted invoices to accounts payable. Tracked and obtained payment for delinquent invoices. Handled incoming calls and other communications. Managed filing system. Recorded information as needed. Greeted clients and visitors as needed. Updated paperwork, maintained documents, and wordprocessing. Helped organize and maintain office common areas. Performed general office clerk duties and errands. Organized travel by booking accommodation and reservation needs as required. Coordinated events as necessary. Maintained office supply inventory. Maintained office equipment maintenance as needed. Aided with client reception as needed. Experience as a virtual assistant. Created, maintained, and entered information into databases.Baltimore Medical Systems - Billing SpecialistMarch 2013May 2013Managed patients account by obtaining and tracking insurance company payments. Submitted adjusted/revised and original claims. Posted payments and adjustments to accounts. Maryland Healthcare Clinics - Medical Billing Specialist May 2007August 2012Duties included scheduling patients, handling billing and collections, supervising front desk operations, checking patients vital signs, medical coding, medical clearance, as well as insurance verification. Ordered and charged office supplies as well as maintained inventory. Maintained and updated medical filing system and accurately delivered mail to all company departments as well as other assignments as needed.SKILLS Warm personality with strong written and oralcommunication skills Data entry Resourceful and strategic planning Management/Supervisor Ability to work well under limited supervision. Excellent customer service Organization and time-management Problem-solving Detail oriented Proficient in Microsoft OfficeReferences available upon request. |
