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Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEEXPERIENCEAmerican Pathology Partners Brentwood, TNA/R Account Representative (June 2017 - Current)Process payer claims for Blue Cross Blue Shield Florida and Blue Cross Blue Shield Texas.Work with payers to resolve denial issues that are returned for additional information. For example, claims that are returned by insurance company that are paid at a reduced rate.Work outstanding balances chronologically for opened accounts, ensuring that there are less than .055% outstanding.Present statistics at monthly departmental Accounts Receivable meeting.Process any needed adjustments to ensure the accuracy of the patient account.Follow-up with phone calls to payers to resolve any outstanding balances or other issues.Provide additional assistance to the Claims department by ensuring the correct ordering physician so that claims will be processed in a timely manner.Devote extensive time on daily conference calls with insurance companies working with payer to resolve outstanding claim issues.Provide accurate documentation of call logs to include actions and resolutions taken with each claim.Responsible for utilizing current knowledge of ICD-10 and CPT codes.American Pathology Partners Brentwood, TNPatient Account Representative (May 2016 June 2016)Processed high volume of incoming patient and provider calls in a timely manner.Provide accurate documentation of call logs to include actions and resolutions taken with each claim.Gained experience working with multiple health insurance carriers.Process verification of insurance eligibility on private and government payers.Update billing edits for accuracy before submission of billing claim.Submit corrective claims in accordance with timely filing guidelines.Ensure current carrier information is maintained in Xifin & Ligo, FrontRunnerHC software systems.Acquired the ability to interpret diagnosis and procedure coding on provider's requisition form.Collect payment on balances and/or resolve outstanding delinquent accounts.Awarded with "Top Collector" title for six months in a row.Adhere to all HIPAA and company compliance training.Stadium Inn Properties Nashville, TNProperty Manager (May 2014 March 2016)Provided all front desk responsibilities while also providing assistance with maintenance staff operations, and housekeeping requests as needed.Created monthly operating budget and increased sales from 78% annual profits to 99%.Posted daily and weekly financial transaction reports to upper management.Responsible for interviewing and hiring new staff and subsequent training for new employees.Ensured excellent customer surveys were properly recorded and tracked on behalf of management.LifeCare Family Services Pulaski, TNCase Manager (November 2009 March 2014)Maintained a caseload of twenty-five your and adult clients.Provided linkage resources for client's needs as housing.Acted as an advocate for clients.Remained compliant with documentation on all company and insurance guideline submissions.Held weekly consultations with various members of the treatment team.Centerstone Mental Health Fayetteville, TNRegional Coordinator (June 2006 November 2009)Provided cost analysis of center expenditures for the southern region of Middle Tennessee.Recruited members for center's growth and fulfillment for TN State requirements.Filled in where needed; driving, conducting group sessions.Coordinated monthly activities for each facility.Tracked and reported employee time cards in order to process payroll.Conducted HR duties by interviewing, hiring and training of new staff.REFERENCES: Available Upon RequestHR PROFESSIONALQuick thinking, and conflict resolution skills, with an appetite for continued education and achieving a positive work environment. I am seeking a position where my professional experience and education will allow me to make a positive contribution as an integral team player.TECHNOLOGICAL SKILLSLearning current edition of Microsoft Windows 10 and proficient with Windows 7 operating systems, Microsoft Office software including Outlook, Word, Excel, Adobe Reader, Xifin Revenue Solutions, Ligo Lab application, FrontRunnerHC Insurance Discovery application, with a typing speed of approximately 50 wpm.EDUCATIONAlabama A&M University Huntsville, AlabamaMaster of Science, Human ResourcesDegree received Dec 2003Tennessee State University
Nashville, TennesseeBachelor of Science, PsychologyDegree received - May 1997VOLUNTEER ACTIVITIESVanderbilt RehabilitationCenter - Nashville, TNNashville Rescue Mission -Nashville, TN |
