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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Robinson Dr, Chattanooga TN PHONE NUMBER AVAILABLEEMAIL AVAILABLEIt is my objective to use my skill and knowledge to serve those around me and grow in the community. EXPERIENCE05/20/2024-PRESENTUNIVERSITY SURGICAL ASSOCIATES- AR SPECIALISTManage accounts for various assigned payorsProcess an average of 50 claims a day and log claim status in Claim Control Research and resolve issues with common causes of delays Resolve insurance corrections, rebill claims, file appeals as necessary Reconcile past due invoicesAccurately process adjustments and write-offs12/18/2023-05/14/2024CONIFER HEALTH SOLUTIONS-EES PATIENT ADVOCATEConducts interviews with patients and/or family members. Records and maintains complete documentation of activities performed on account while Performs financial clearance function including collections. Cancels accounts that have not had any patient cooperation and are not eligible for any programs and prepares accounts for Financial Assistance review. Follows up on EES assigned accounts to ensure follow-through on Government application submitted. Develops a working relationship with patients, based on good communication skills, enabling accounts to be processed quickly with government program eligibility.Calls SSA to schedule phone interviews, completes Medicaid and Food Stamp applications when appropriate Conducts field visits to patient homes for skip tracing and or assisting patient with documents. Notifies hospital case management, social services and admissions staff of case screening determinations and outcomes via verbal and written communication.09/19/2022-12/17/2023CONIFER HEALTH SOLUTIONS-PATIENT ACCESS REP IIGreeting customers following Conifer Standards of Care Provides world-class customer serviceCompletes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).Scan Protected Health InformationCreate and file patient information packets/folders for upcoming Hospital services Assist with scheduling and coordination post discharge care for patients Secure medical necessity checks/verification in accordance with CMS & Medicaid services Verify insurance, benefits, coverage & eligibility Complete assigned registration financial clearance work list activities, obtain insurance authorization Arrive patients presented by EMSAssist with training new employees and support management as necessary 07/11/22-09/16/22MEDICAL PERSONNEL SERVICES-BILLING SPECIALIST (SKIN CANCER AND COSMETIC DERMATOLOGY) Download remits daily from each applicable vendorPost insurance payments to the appropriate accounts Apply copayments, contractual write off and adjustments Transfer copay/coinsurance and deductible balances to patient responsibility Working knowledge of EOBS, EFTS, AND ERAS2Post denials to patient accountsBalance end of the day reports.06/01/2021 - 07/08/22Mountain Management-Financial Assistance Counselor Knowledge of accounting, credit, collection laws, current insurance and government financial assistance programs and regulations, as well as clinic financial options, payment alternatives, insurance billing/authorization requirementsKnowledge of federal and state payer requirements (Medicare, DSHS, HMO/PPO Contracts), medical terminology, abbreviations and coding protocols (e.g., / ICD-10) Ability to explain reimbursement questions regarding health-plan eligibility, benefit issues, co-pay requirements and medical referral requirements, billing processes, hospital and clinic statements and availability of financial assistance, alternative medical financing and assists in completion of applications and/or contracts to meet patient needs while assuring maximum reimbursement Receive and process charity care and/or financial assistance applications, work with health insurance providers to determine coverage and benefit limits Verify financial information to determine insurance coordination of benefits, pre-certification/prior authorization requirements, estimates of procedures, calculates payments requirement, and informs patient of acceptable payment arrangements on balance, both current and previous Self-pay adjustments made on charity accounts to zero balance Daily work queue of Financial Assistance accounts and FA for follow up 09/07/2007 to 06/01/2021Eranger Health System-Financial AdvocateServe as a liaison to explain hospital charges, financial assistance And providing various financial assistance forms.Completed TennCare applications for uninsured patients completed Newborn Presumptive EligibilityResponsible for screening self-pay patients at hospital bedside for Eligibility in various governmental and non-governmental programs. Responsible for identifying all sources of potential payers including Auto insurance, workers' compensation, commercial insurance, private Insurance, TPL, etc. and assisting patients in the process of applying Verify insurance information and update patient demographics Collection of patient financial responsibilitiesPrepare collection reportsWork with clinical staff to update patient information in timely manner Organizational skills and commitment to teamworkDiscuss patient account balances and createEstimates for upcoming procedures or hospital stays 01/2014-02/2015PM Pediatrics-Front Desk/Billing follow up Part time Provide excellent customer service to patientsCheck in patientsVerify benefits, collect co-pays and patient balances schedule Follow up on outstanding claims and rebill as necessary Post insurance payments from EOB as well as patient payments Scan patient forms and labsBalance end of day reportsComplete daily depositsWorked Aging Accounts Receivable to collect Bad Debts Posted Insurance Payments and downloaded remits from the website Billed secondary claimsFiled appeals for denied claims10/2012-01/2014Cigna HealthCare-CSA Medical Call Center Choice Fund Analyst Provide excellent customer service to members and providers Verify patient eligibility and benefitsVerify in/out of network providersCheck claim status and resolve claim issuesSend adjustable claims back to be reprocessedProvide excellent customer service to members and providers 3Choice fund trained to handle HRA, HSA & FSA account issues and Access to account balance information05/2008-9/2012Med Write, Inc. - Claims processing PHONE NUMBER AVAILABLE Enrolled physicians/practice with ZirMed clearinghouse as needed Provide excellent customer service patients and providers Check all charges entered for errorsBatch and submit all claims to insurance or clearinghouse Payment posting and AR followDownload remits and reportsWork all errors or forward to designated person for that account Enter coordination of benefit info to submit secondary claims Enter daily charges and hospital charges for 2 primary accounts Answered billing questions from patients (8 accounts we handled) Coded and entered charges for thoracic surgery group in Kansas Maintained good working relationship with physicians and PAs out of state 08/2007-05/2008Northgate Neurology PHONE NUMBER AVAILABLEEntered daily office charges and hospital chargesCoded and entered Ambulatory EEGs performedCheck all charges entered for errorsGenerate and submit all claims to insurance or clearinghouse Payment posting and AR follow upDownload remits and reportsEnter coordination of benefit info to submit secondary claims Answered billing questions from patientsFiled Appeals for insurance denials11/2002- 08/2007Chattanooga Neurology & Headache Center PHONE NUMBER AVAILABLE Provide excellent customer service to scheduled patients and physicians Check in patientsVerify patient insurance and demographicsCollect and post office visit co- payments and old balances Schedule radiology procedures/obtain precertification and authorizations Triage patients- patient assessment, blood pressure/pulse and temp Preparation of all medical records request and billing appropriately Worked the AR and insurance follow up aggressively 4/2000-11/2002Baptist Health Center - Front desk, billing specialist PHONE NUMBER AVAILABLE Provide excellent customer service to scheduled patients Worked both check-in/check-out windowsVerify patient insurance and demographicsEnter coordination of benefit info to submit secondary claims Worked Aging Accounts Receivable to collect Bad Debts Collect and post office visit co- paymentsEntered daily office charges, hospital charges, some ambulatory Worked AR and insurance follow up aggressivelyFiled insurance appeals for denied claimsTriage patients- patient assessment, blood pressure/pulse and EDUCATIONDeVry University, Medical Coding and Billing Certificate Upon completion/graduation July 2024Miller Motte Technical College, Massage Therapy diploma 2005 Northwest Shoals Community College, Medical Office Administration Certificate Graduate May 20024Phillips High School, Bear Creek, AL Graduate 1992 SKILLS Certified Application Counselor ICD-10, CPT, and Medical Terminology Various Practice Management Software Patient Access Registration Prior-Authorization Revenue Cycle Management Claim Entry and Payment Posting Productivity Adaptability Case Management Appeals Medicare, Medicaid, Commercial payer |
