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Click here or scroll down to respond to this candidateCandidate's Name
Glendale, AZ Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEMedical Insurance Billing and Collections- Insurance Collector.High School Graduate, plus twenty (20) years prior experience in medical claims processing. Billing for physician office services and Inpatient hospital services on HCFA & UB-04. Complex knowledge of HMO, PPO, POS, AHCCCS and MEDICARE plans. Ability to accurately enter patient demographics, provider & insurance cob information. Analytical ability to review claim edits and attaches necessary information to successfully bill claims. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. Advanced knowledge of coding and researching CPT/ICD9/HCPCS and modifiers required to bill appropriately. Excellent ability to communicate payer and/or system trends to Management Ability to read and comprehend an EOB to post payments, payment reversals and deductibles with coinsurance. Able to post contractual and discount amounts Proficient in coding guidelines, CCI, Advanced knowledge A/R billing laws and regulations, third party and managed care payer of billing requirements, verification. Inputs authorizations into Mysis/Vision & links them to invoices to bill in timely manner. Payment posting, EMR and electronic billing and EFT A/R experience. Participates in special projects as directed by management teams.Work ExperienceCollectorPinnacle Health Care-Phoenix, AZNovember 2022 to PresentAr collections and follow upCollector IISteward Health Care-Phoenix, AZSeptember 2020 to October 2022Medical Ar collections and insurance follow up. Claims resubmission, appeals etc. Medical AR CollectorUnited surgical partners-Phoenix, AZApril 2019 to April 2020follow up. Submitted appeals, and reconsiderations. Worked All Commercial Payors as well as Medicare and AHCCCS. Extensive knowledge of cpt and diagnosis codes as well as modifiers, extensive knowledge of payors and payor guidelines. answer Phones, reported directly to management any denial trends.Medical AR CollectorMetro SurgeryJuly 2017 to February 2019Medical AR collections working from an Aging sent by management once per month, filing appeals, reconsiderations. Working all commercial and workmens comp payors. Working self pay accounts, Extensive knowledge of cpt codes and ICD9 or ICD10 codes, extensive knowledge of payors and payor guidelines. Back up front desk duties, checking in patients, answering calls. Training new employees. Medical BillerSun RadiologyJanuary 2017 to April 2017Medical collections for radiology, Insurance follow up and collections both for Insurance and private pay. Knowledge of all billing guidelines.Medical BillerHEI Healthcare Excellence InstituteOctober 2015 to October 2016Medical AR collections for a third party inpatient claims for a hospital in Maine. Knowledge of all billing guidelines, knowledge of HMO, PPO, POS and AHCCCS as well as Medicare guidelines.Collector-EligibilityAz Kidney Disease and Hypertension CenterJune 2013 to October 2015Medical insurance billing and verifying eligibility. Complex knowledge of HMO, PPO POS Ahcccs and Medicare. Complex knowledge of HMO, PPO, POS, AHCCCS and MEDICARE, plans .Ability to accurately enter patient demographics, provider & insurance; cob information. Analytical ability to review claim edits and attaches necessary information to successfully bill claims. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. Advanced knowledge of coding and researching CPT/ICD9/HCPCS and modifiers required to bill appropriately Sr CollectorPhoenix Children Hospital - Phoenix, AZOctober 2007 to April 201385016Insurance collections leadership Certified Nurses Aide Medical Insurance Billing and Collections- Insurance Collector. High School Graduate, plus twenty (20) years prior experience in medical claims processing. Billing for physician office services and Inpatient hospital services on HCFA & UB-04. Complex knowledge of HMO, PPO, POS, AHCCCS and MEDICARE plans .Ability to accurately enter patient demographics, provider & insurance cob information. Analytical ability to review claim edits and attaches necessary information to successfully bill claims. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. Advanced knowledge of coding and researching CPT/ICD9/HCPCS and modifiers required to bill appropriately. Excellent ability to communicate payer and/or system trends to Management Ability to read and comprehend an EOB to post payments, payment reversals and deductibles with coinsurance. Able to post contractual and discount amounts Proficient in coding guidelines, CCI, Advanced knowledge A/R billing laws and regulations, third party and managed care payer of billing requirements, verification. Inputs authorizations into Mysis/Vision & links them to invoices to bill in timely manner. Payment posting, EMR and electronic billing and EFT A/R experience. Participates in special projects as directed by management teams.CollectorInsight Radiology-Phoenix, AZAugust 2005 to August 2007Radiology insurance collections. Billing and collections for a Radiology office. Team Trainer training new employees, Created and submitted appeals and resubmissions. Advanced knowledge of coding and researching CPT.ICDP/HCPC and modifier required to bill correctly. Ability to read and comprehend and EOB, post payments, payment reversals and deductibles with co insurance. Efficient with coding guidelines CCI edits and the RVU spreadsheet used by Medicare. Familiar with both the HCFA and UB billing forms.EducationGEDReal estate school in Real estate pre licensing - Phoenix, AZ April 2020 to PresentAssociate in CNAGlendale community college - Glendale, AZ2015Paradise valley community college - Phoenix, AZJanuary 2005 to August 2005Notary in Certified notaryAugust 2022Skills Mysis Excel Contract managment Payment Posting Collect Logix Advantix AR collections Leadership skills knowledge of payor guidelines and coding Medical Billing CPT Coding Medical Collection ICD-9 EMR Systems Medical Office Experience Hospital Experience ICD-10 Accounting Anatomy Knowledge Insurance Verification Managed Care Medical Coding Medical Receptionist Medical Records Accounts Receivable Data Entry Experience Administering Injections HIPAA Medical Terminology Physiology Knowledge Analysis Skills Medical Scheduling Phone Etiquette Transcription Auditing Clerical Experience Microsoft Powerpoint QuickBooks Time Management Microsoft Office Microsoft Excel PCI Microsoft Word Customer Service English Cerner Computer literacy Microsoft Outlook Supervising experience DRG Writing skills EMR systems Medical records HIPAA ICD-10 Hospital experience ICD-9 DRG Medical coding Medical terminology Data collection Revenue cycle management Leadership Research PCI Physiology knowledge Financial auditing Customer service Clerical experience Supervising experience QuickBooks Accounting Front desk Payroll Accounts receivable Anatomy knowledge Windows Analysis skills |
