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Click here or scroll down to respond to this candidateCandidate's Name
Extensive experience in Medical Customer service. Developing long-term relationships with a variety of clients, bridging internal and external stakeholders. Manages day-to-day accounts between customers and cross-functional internal teams to ensure timely and successful delivery of our products.MedAssetsMcKessonZirmed/Gateway ClearingPatient ManagementTask managementHBOC/DOCSTAREOB/EDI ReportsPOINT CLICK (PCC)/ICD-10UB04/CMS 1500Professional ExperienceCenterwell/Kindred Hospice Marietta, GA 06/2016-01/04/2023Home Health and Hospice Medicare Billing/Collections, Accounts Receivable SpecialistDaily and monthly submissions of Medicare and Medicare Advantage primary and secondary claims.Verified UB-04 contained accurate and required information to ensure timely billing.Timely collection responsibilities or Medicaid/Medicare and Commercial payers.7+ years of experience working with medical billing and collection with all types of payers.Processed RAP/EOE claim for home health and NOE's Hospice.Daily review of claims acceptance and rejection reports.Process adjustments, overpayments, and refund requestsContact the branch to ensure proper diagnosis codes and documents are loaded for billing.Reviewing and interpreting EOBs to identify claim denials, underpayments, or overpaymentTimely submission of disputes and appeals to CMSEnsured all RTPs were worked within 24 hours to make sure all claims were received by the payer.Provide daily and monthly submission of Medicare primary and secondary claims following the guidelines of the UB-04.Provide a daily review of claims acceptance and rejection reports.Ensures daily submission of adjustments to resolve outstanding balances or credit balances.Submit quarterly Medicare credit balance reports.Oversees 30 facilities in NY, NM, TX and GAUHS Pruitt Corporation I Norcross, GA 7/2013-6/2016Hospice Medicare Billing Accounts Receivable SpecialistProcessed accurate monthly Medicare Pay billing for Georgia, South Carolina, and North Carolina Facilities.Researched, corrected, and re-billed outstanding Medicare and/or Commercial Insurance Claims.Responsible for AR Collection, Cash Velocity, and day sales outstanding for assigned agencies offices.Carried out all duties related to admission, billing, and cash posting, filed and organized all appropriate paperwork related to my job duties.Informed supervisor on daily activities and issues, and maintaining effective relationships with management staff and other partners and team members.Payments MD, Atlanta, GA 10/2009-07/2013Anesthesia Revenue Cycle Reimbursement SpecialistMaintained the company's AIR with payers such as government, worker-comp, liability, and commercial insurance as the liaison between hospital physicians and insurance companies.Generated over l million dollars in revenue for the company for billing errors, identified and report all credentialing and coding issues.Analyzed patient accounts using EOB/RA to ensure correct payment and required contractual allowances/adjustments are applied.Identified and reported denial trends, reviewed correspondence, and forwarded appeals which consist of coding issues, duplicates, and denials received in error.Worked on over l million special projects such as refunds, entering secure patients' demographics, charge capture, payment posting, pre-cert, insurance verification, fee schedule, and analyzed revenue-related information and another project that arose.Maintained accounts receivable by managing different reports; front-end edits. batch claims reports, insurance aging reports/spreadsheet, open A/R reports, and gateway clearing house rejections.Medical Management Professionals, Kennesaw, GA 7/2004-10/2009Radiology/ Anesthesia Billing SpecialistWorked on reports and projects to collect outstanding debt for the company's A/R such as collection reports, aging, and self-pay reports.Specialized in filing primary/secondary electronic claims.Followed-up and researched issues to obtain payments for government payers, third-party payers, managed care, and commercial payers.MILITARYUnited States Navy 10/1993-08/2003Supply Chain CoordinatorEducationAssociate of Applied ScienceSouthern Technical CollegeData ProcessingJohn Patterson Technical CollegeCertificationsHealth Insurance Portability and Accountability - HIPPAA |
