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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLEStreet Address Turnberry PlLithonia, Ga. Street Address EMAIL AVAILABLESummaryI have 20+ years of experience, including as a Medical Billing Specialist in pediatrics, as a Finance Analyst and as a Patient Access Representative in Healthcare Business Services. My skills and experiences include: File Management, Human Resources Benefits, Medical Terminology, Policy Analysis. I hold an Associate of Business Administration degree in Pediatrics from Missouri CollegeExperience:Anthem Co, Stone mountain, GA Aug. 2021 to Feb. 2022Provider ServicesPerformed duties such as processing Medicare Medicaid and commercial insurance Utilizing software of Epic and Solutions central. Received incoming phone calls from providers andRecorded details of customer transactions and inquiries. Prioritized data entry daily to ensure customers needs were met. Appeals, data entry, filing, copying and faxing.Washington University, St Louis, MO July 2019 to Oct. 2019Medical Billing Anesthesia SpecialistProcessed Government and commercial claims, insurance follow up, authorizations, pre certs, insurance follow up denials appeals and provider intake callsRobert Half/Peoples Health center, St Louis, MO Feb. 2018 to Feb. 2019Finance AnalystWorked Nextgen and Epic systems by processing corrected and denials, credit card payments, posting insurance and patent sliding fees, bankruptcy data, insurance verification pre certifications, authorizations, provider calls, lawyer request, meeting patients one on one to print and discuss itemized bills, faxing and filing.BJC/Northwest Health Care, St Louis, MO Nov. 2016 to Jan. 2018Patient Access RepresentativeRegistered patients for outpatient services such as Mammograms, CT's, X-rays, Ultrasounds, MRI's and Lab orders Accurately collecting copays/coinsurance payments and medical records pullingRobert Half/Dohmen Services, St Louis, MO June 2016 to Aug. 2016Liaison AnalystPerformed duties of providing Authorizations and Pre Certifications for Carticel KneeSurgery Patients Insurance Follow Up/Verification for billing purposes Precertificationand authorizations follow up for future surgery dates Busy phone duties to providers discussing problem solving issuesParallon Health Solutions, St Louis, MO July 2015 to Sept. 2015 Appeals AnalystProcessed Appeals to completion on commercial and government insurances Generated letters of Appeal approvals or denials to patients on claims that were medically andnon medically necessary Worked ATB Report on timely filing claims Busy phone dutiesConifer Health Solutions, St Louis, MO Apr. 2015 to July 2015 Claims AnalystProcessed Medicare/Medicaid, commercial and private pay claims Insurance Follow Up/Verification Checked for authorizations and pre certifications on claims in hold upstatus Worked Timely Filing Reports to completion.United Seating and Mobility, St Louis, MO Jan. 2015 to Apr. 2015Data AnalystProcessed claims for authorizations and pre cert purposes Insurance follow up/verification on patients that received Durable Medical Equipment Busy phone duties toproviders in getting authorizations extended on equipmentSSM Corporate OfficeMedicare Government Follow Up, St Louis, MO July 2011 to Dec. 2014 Government ClerkReviewed insurance policies to determine coverage Processed and recorded new insurance policies and claims Prepared insurance claim forms or related documents,adjustments and review them to completeness Pre Certifications, Authorizations, Appeals and Referrals Worked with the Social Security Administration processing inmateclaims Provider services.Perot Systems, St Louis, MO Aug. 2008 to June 2011Claims AnalystMedicare/Medicaid and Commercial Claims processing, Adjustments, Reimbursements, insurance verification/follow up, pre certifications, authorizations, referralsBusy phone duties to providers discussing unresolved claim issues.St. John's Mercy Health, St Louis, MO July 2006 to Aug. 2008 SeniorClaims AnalystVerify accuracy of processing Medicare/Medicaid, Commercial Insurances and Private Pays Claims Followed up on claims for payment, Phone calls to liaisons, denials, prepare itemized statements, invoices, insurance verification, authorizations, pre-certifications, appeals and referrals.appeals and referrals Worked (ATB) report for timely filing purposes and Team LeadSkills...Balance Billing, Copy, Credit, Customer Relations, Customer Service, Data Entry, Fax, File Management, Financial, Forms, Government, Human Resources, Insurance, Legal Letters, Medical Terminology, Microsoft Access, Microsoft Office, Policy Analysis, Problem Solving, Telephone Skills, Word Processing1996 Missouri College, St. Louis, MOAssociate of Business Administration (ABA): PediatricsCourse Work Completed : Associates Certification Medical Assistant/Billing and Coding/Pediatrics |
