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Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL SUMMARYExperienced call center agent with over ten years of experience in account management, telephone, email, and virtual customer service. Excited to bring my proven skills and customer enthusiasm to Dynata.Knowledge & Skills AreasCustomer SupportKPIs (AHT)Problem SolverTyping Speed 30wpmVoice of CustomerMS WordPROFESSIONAL EXPERIENCEMedical Biller/Collector, Addison Group05/2023 Current remoteResponsible for tracking all authorizations, including Individual Plan of Care (IPC) and Intellectual Disability/Related Condition Assessments (IDRC), reviewing them for accuracy, and ensuring they are submitted timely. Authorization Management Specialists will frequently engage with Operations and Billing to address issues related to authorizations, including pre-submission and upon rejection of services. Authorization Management Specialists are required to perform the tasks below independently and satisfactorily to effectively manage authorizations:Utilize the Sevita billing and reporting system (Avatar) and Texas Medicaid & Healthcare Partnership Portal (TMHP) to monitor upcoming IPC and IDRC expirations.Understand required fields and quality needed to successfully submit IPC and IDRCs in TMHP and Avatar (only IPCs)Manage receivable IPC from Clinical Specialists prior to IPC expiration date and coordinate with the Clinical Specialist for completeness and accuracy before submission to the state.Complete documentation of IDRCs upon expirationSubmit IPC and IDRCs to the state via TMHP.Research issues preventing authorizations from being billed, address issues, and update internal billing workflow (DWF) with corrections.Submit authorization into Avatar upon approval in TMHP (short-term)Communicate barriers/issues to UR Coordinator and respective Regional Director.Other systems used Waystar, Iserve, Slack and GoTo.Patient Account Rep Remote, Community Health Network 10/2016 02/2023 (Laid Off)Perform collection outreach to customers with outstanding bills, as well as setting up payment plans, documenting communications, and generating reports.Process refunds weekly on Microsoft excel spreadsheet.Apply/Deposit all DME, Infusion, Hospice and HomeCare cash and checks within one working day of receipt and track cash balances on a daily basis.Make necessary adjustments to customer demographics, billing status, and account balance information.Process pending items including charges, payments, and personal information updates via inbound calls.Month end closing and account reconciliation.Assist in educating teammates on new guidelines and cybersecurity protocols for current year.Collaborate with resource management group to administer collections on unpaid accounts.Identify trends/recurring issues and present to supervisor for further investigation and resolution.Maintain thorough knowledge of products, risks, policies, guidelines, and regulations to provide customers accurate responses.Training in Human Resource Operations, PeopleSoft, Waystar, Iserve, Onbase, Epic, Brightree, ARDashboard, Cerner, Fastrack & etc.Educated customers on privacy laws, data collection, and secure file transfer procedures during collection of payment.Provide weekly adhoc reports and data via excel spreadsheets, PowerPoints, and Word documents.Insurance Verification Specialists/Cash Poster, Eye Specialist of Indiana 08/2015 09/2016Collecting out of pocket cost and copays, posting payments to patients' accountsVerified Ids and checked insurance eligibility.Reviewed prints, research, and verify billing information to ensure a complete and accurate process.Assisted with the set up and maintenance of projects in the business system in accordance with accounting policies, pricing schedules, customer details, and billing standards.Prepared and maintain various reports to that provided value and understanding to the department.Contact referring doctors for prior authorizations for patients to receive treatment.Worked with customer to troubleshoot invoicing issues and verify accuracy.Posted charges from CMS-1500/UB04.Customer Service Rep, MDWise 04/2XXX-XX-XXXXProvided quality 1-on-1 customer service while ensuring I address all of the customers inquiries, concerns and issues in a fast-paced results driven environment.Provided astounding customer service through effective and timely resolution of various customer inquiries and concerns.Built customer loyalty and value through effective account management, identifying and providing offers for the appropriate healthcare plans.Used resource documentation for reference and the automated and training tools provided to deliver exceptional customer service.Met department productivity and quality standards. Appropriately disburses adjustments and account credits in accordance with the company policy.Recognized potential quality issues, such as grievances/complaints and appeals, and processed the information accordingly.Patient Service Assistant, Eskenazi Health01/2014-04/2015Verified Ids and checked insurance eligibility.Handled complaints, while still maintaining a professional and caring demeanor.Scheduled patients for appointments.Collected copays, and faxed documents to insurances companies.Explained HIPAA to each patient I encountered, and had them sign consent electronically.Direct Care, Options Behavioral Treatment06/2012-01/2014Helped care for mentally, substance abuse, and behaviorally individuals.Participated in social, and recreational activities designed to encourage achievements of treatment goals.Document timely, accurate and appropriate clinical information in patients medical record..Provided academic skill building, occupational training, grooming, and eating support.Took safety precautions when exposed to illnesses and diseases.Completed and maintained required documentation. Assist with follow-up and paperwork as required on incidents and events that took place in the facility.EDUCATIONWarren Central High School, Indiana 2007DiplomaGeneral StudiesMedtech College, Indiana 2015CertificateMedical Billing and Coding. |
