| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Chicago, IL Street Address PHONE NUMBER AVAILABLE (H) PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL SUMMARYEffective Medical Claims Insurance Processor with strong background in follow-up billing and collecting, with over thirteen years experience. Work to build and maintain good rapport with payers to obtain timely payment status. For claim denials, identify trend. Obtain retro-auth, if necessary, appeal with notes. Driven performer equipped to handle multiple administrative tasks effectively. Dependable team player. Verified insurance.SKILLSBilling System: EPIC, MediTech, Cerner, Change Healthcare (Emdeon), Nebo(Ecare), Real Med. OneSource, Availity, Encoder Pro, Paragon, Change Health. Medical Insurance Knowledge: BCBS, Medicare, Medicare Advantage, Medicaid Managed care and Traditional Medicaid, and Commercial Insurances. Insurance coverage verification. Detailed account review and notation. Data entry. Microsoft Office, Outlook, Word, Excel.WORK HISTORYZero Bal Follow-Up Rep, 06/2024 to currentBOOST HEALTHCARE, LLCWorked on denied claims with zero balances both high and low dollar accounts for aged accounts. Utilize both payer portals and phone for follow-up payer calls on third party claims. Worked additional assignments as given.Financial Service Rep II, 01/2022 to 01/2023RUSH UNIVERSITY AND MEDICAL CENTERWorked on improving cash collections and reducing aged accounts receivable. Performed research on denied claims to resolve coding, duplicate, additional documentation required, and other denials and reconsiderations. Possess a sound medical insurance billing and collection process. Verify eligibility for accuracy and requirements of private and government payers. Data entry. Obtained retro authorization, when necessary. Appeal sent with appropriate documentation and verbiage to obtain payment for denied claims. Utilized Epic, Cerner, Availity, NEBO, eCare for billing, collections, medical records retrieval and claim reprocessing with appropriate documentation and verbiage attached to obtain payment.Third Party Medical Biller and Collector, 07/2018 to 01/2022Cook County Hospital & Health Sciences Chicago, ILAnalyzed claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated. Verify correct order of insurance such as primary, secondary and tertiary for billing and collection and resolution of claims including Medicare and other government and non-government accounts. Data entry. Handled incoming and outgoing billing correspondence and phone inquiries relating to patient, third party administrators, attorneys, vendors and other insurance payers. Utilized Epic, Cerner, Availity, Change Health, eCare for follow-up billing, collections, medical records retrieval and claim reprocessing with appropriate documentation and verbiage attached to obtain payment.Patient Account Representative, 10/2010 to 07/2018 Wolcott, Wood, and Taylor Chicago, ILWolcott, Wood, and Taylor Inc Chicago, ILWork daily AR reports for Traditional Medicaid, Medicaid HMO and Medicare Managed Care, and Commercial insurances. Worked with customers with overdue accounts and solicited payment in compliance with fair debt collection practices. Processed debtor payments and updated accounts to reflect new balance. Data entry. Verified insurance. Obtained retro authorization, when needed. Appealed with appropriate documentation and verbiage to obtain payment. Utilized Epic, eCare, Cerner, OneSource and Availity to obtain current claim status, verify insurance, obtain medical documentation and request reconsideration in a timely manner. Also, referred to Encoder Pro to obtain correct cpt modifiers and ICD 10 for specifically denied claims.EDUCATIONHigh School Diploma: 06/1986 Simeon Career Academy High School - Chicago, ILOlive Harvey City College 02/2002Certified Nursing Assistant |
