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Click here or scroll down to respond to this candidateCandidate's Name
REVENUE SPECIALISTA highly motivated and dedicated professional, seeking to utilize Street Address + yearsof healthcare billing, follow-up, and leadership experience to advancemy career.CONTACT INFO1522 Kirk RoadRainsville, AL 35986PHONE NUMBER AVAILABLEEMAIL AVAILABLEEXPERIENCESPECIALTY BILLING AND FOLLOW UP REP II TRINITY HEALTHSep 2023- CurrentBill Primary and secondary claims for specialty services and hospice patients.Documents account notes with billing notes, payment details, and follow up activities completed.Determines appropriate billing and follow up activities and escalates when appropriate.Performs follow up functions including investigation of overpayments, underpayments, credit balance and payment delays to maximize reimbursement for services rendered.Verify patient eligibility through online portals and resources.Research claim rejections and denials, submit corrected claims, and refer claims to appropriate colleagues as needed to ensure timely filing and claim resolution.REVENUE SPECIALIST ENABLE COMPJan 2023- Sep 2023Bill primary and secondary hospital and physician claims to out of state Medicaid payers.Review Explanation of benefits, remittance advices, and medical records for secondary billing, authorization requests, and/or appeals.Review claims for expected payment reimbursement amounts and DRG calculations.Verify patient eligibility through online portals and resources.Work directly with clients (hospitals) to keep their claims inventory up to date.BILLING LEAD WAYNE GENERAL HOSPITALAug 2018 Oct 2022Managed Medicaid claim inventory from verifying patient eligibility, submitting claims to payers within their timely filing limits, reviewed remits and worked denials, and processed insurance payments.Assisted front end with scheduling appointments and customer service tasks.Backup assistance for BCBS, Humana, and Commercial payer teams.Organized new hire orientations and training.Managed employee timecards and schedules.Oversaw employee interviews, conducted background/credit checks and assisted with hiring and termination process.Handled and investigated employee complaints.CUSTOMER SERVICE REPRESENTATIVE Farmers TelephoneJan 2016- Aug 2018Responsible for answering incoming calls and scheduling appointments and installations.Data entry.Sales.Process customer orders and payments.Process credit reports.Assist customers with trouble shooting.REGISTRATION SUPERVISOR/FINANCIAL COUNSELOR Dekalb Regional Hospital Medical CenterFeb 2006- January 2016Started out in registration and was promoted to supervisor and then promoted to financial counselor.Scheduled appointments and managed multi line phone system answering incoming patient calls.Verified patient insurances and conducted data entry into patient accounts.Set up patient payment agreements on self-pay accounts and accounts with patient responsibility balances after insurance payments.Set up accounts to process to charity.Oversaw collections on delinquent patient accounts and set up settlement agreements with patients.Managed employee timecards and schedules and lead orientation and training for new hire employeesConducted investigations of employee and patient complaints.EDUCATIONCollinsville High School-GraduateNortheast Community College-Criminal justice GPA 3.9SKILLSMicrosoft officeLeadershipTime managementCommunicationCritical thinkingOrganizationTeamworkProblem solvingAdaptabilityAttention to detailEpic |
