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Click here or scroll down to respond to this candidateCandidate's Name
Email:EMAIL AVAILABLEAddress: Street Address
Cel phone: PHONE NUMBER AVAILABLESummary Of QualificationsHighly experienced candidate with a strong track record in the medical field, with 10 years of experience in medical billing/collections and account receivable, 1 year as a Medical Assistant, and 6 years as a Customer Service Representative.With a proven history of successful revenue cycle management and excellent communication skills,Katherine is an ideal contender for any role in the healthcare industry.Proficient in software such as Excel, Outlook, and Salesforce, coupled with their multicultural communication skills, make them an asset to any organization.Excellent communication and organizational skills with fluency in English and Spanish.Proven interpersonal, multicultural communications skills.SkillsMedical TerminologyAnatomyPhlebotomy/ EKGExell office/ NaviNetEPIC/Medisoft/FRIST DATA/TelcorSalesforceEducationMedical Administrative Assistant Certificate, Drake College of Business 2012Microsoft Office Technology, Excel, Outlook, Universidad Del Caribe D, R 2010Work ExperienceSanofiReverse logistic and Claim Analyst March 2022 August 2023Responsible for timely and accurate and compliant processing of all expiration returns, deduction and claims.Ensure timely and accurate communication to business and customer when delayed or issues occurs and analyze claims, returns and deductions no less than a month to recognize trends,Identify opportunities and develop recommendations for improvement that will benefit the company and customers.Collaborative with AR and credit to compile well documented, accurate and relevant information required for customer specific decisions.Utilize a logical and systematic approach to identifying, analyzing and solving problems in both physical and data-based processes.Resolve claims, credits, and provide customer support for multiple programs.Maintain Customer Relationship Management (CRM) to ensure data is accurate for program support.Perform complex analyst on return and crediting data to ensure analyses in detailed and informative either daily or monthly or as needed.For work with team lead and warehouse, generalist to resolve discrepancies on shipment of finish goods, packaging component and customer return.Mainly work with expired return, deduction, and claims processing.Ammon Analytical laboratories. September 2019 throw January 2022Medical Billing Specialist and Revenue Cycle Management.Prepare daily reports for preprocessing edits listing errors and accessions count for team leads and supervisors.Create KPI reporting and tracking on weekly for the Ammon board of directors with Classification of errors, listing percentage, clearinghouse errors, provider errors and listing whether they are internal or external errors also reported on Medicaid weekly remittances and payment.Work Claim status rejection making proper adjustments and Resubmission as well as preprocessing errors.Made reports for new clients on their payors pool, integrating them into the life point data hub for our LIS system.Work account receivables and claim resolution and claim handling as well as patient and patient education accounts receivable, administrator.With a demonstrated history of working in the hospital /hospital outpatient surgery & health care industry.Work well under pressure and have the proven ability to learn, Skilled in Physician Relations, revenue cycle Management, Software Documentation, care coordination representative, Anesthesia Billing, Direct billing laboratory billing, Healthcare Management, Healthcare Knowledge of third-party reimbursement Knowledge of coding.Prope documentation requirementsMedi-Corp October 2017- September 2019Medical Biller/Revenue Cycle Account RepPrepare customer statements, bills and invoices, follow up on AR special project.Analyzed Patients account to make sure insurance companies are paying according to our fee schedule, made adjusted for accounts example coding correctio.Modifier use payment posting Insurance and patient policy verifications work on PIP cases and workman compensation answered phone calls from patients and insurance companies with outstanding charges.Worked claim appeals.Surgical Care Affiliates Inc November 2015-October 2017Medical Billing RepresentativeEntered Account charges, and anesthesia charges review account edits, generate claims to insurance companies for payment.Map Claims to Insurance, worked return mail and Insurance correspondence.Analyzed Patients account to make sure insurance companies are paying according to our fee schedule, answered phone calls from patients and insurance companies with outstanding charges, made proper adjustments.Assuring Patient-Insurance Transparency, consist of CPT codes, ICD-10 codes and modifiers.Verified insurance Benefits and made estimates based on our contracted Rate with insurance for patients.Responsibilities(Deductible and Co- insurance ) on line or over the phone Worked EDI rejections and collections, set up payments plans, print and processes secondary claims prepared for mailing in a timely manner.Run and maintain accounts receivable for medical Review cycle reports.Origin Healthcare Solutions April 2013-June2015Medical Billing RepresentativeReviewed claim registers and worked charge edits on a daily basis.Generated statements in IDX, enter anesthesia charges which consist of CPT codes, ICD-9 codes and modifiers, post payments and work EDI rejections, and collections, set up payment plans, print and process secondary payer claims.Prepare for mailing in a timely manner, process and follow up on workers compensation, no fault according to the fee schedule.Medicare and Medicaid claims, run and maintain account receivable reports,Analyze insurance contract summaries to verify accurate payments,Utilized EOB Manager to pull primary EOBs, review unbilled reports monthly and verified outstanding claims that should be billed to insurance, and respond to all correspondence from insurance carriers using Centricity software.Dr, De La Cruz May 2012-July 2013Medical AssistantSchedule and confirm daily appointments, responsible for vital checks and phlebotomy, assisted physicians with minor procedures and exams, filing and updating charts, handled specimens and sent to labs and verified insurance.Language Line Services February 2010-March 2011InterpreterInterpreted English to Spanish language for public service companies, government agencies and private physicians, conferred with Quality Assurance Department to ensure translations retained content and meaning of original materials listened to speakers statements to determine meanings.Prepared translations for clients utilizing electronic listening devices when required, compiled terminology and information to be used in translations including technical terms used for legal and/or medical materials,Checked translations of technical terms and terminology ensuring information remains accurate and consistent throughout translation revisions.Data Vimenca February 2009-April 2010Customer Service/Collections RepresentativeReceived telephone and/or email regarding delinquent accounts, verified confidential information; bank accounts and Check verifications name, Date of birth, and SSN numbers (Telecheck),Assisted customers with information regarding fraud prevention and Identity theft.Assisted Merchant clearing Transitions accounts verified funds for electronic check transfer. |
