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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Singletree DriveDouglasville, GA Street Address
Cell Phone: PHONE NUMBER AVAILABLEOBJECTIVE: My professional goal is to have the opportunity to expand my abilities to work systematically on a team, as well as increase the efficiency of my problem-solving skills with a stable corporation.QUALIFICATIONSStrong communication, computer and people skillsCapable of handling multiple task effectivelyAbility to work under pressure and produceAddresses interdepartmental obstacles and formulates ideas for more efficient productionCreative and persistent collection skillsWORK HISTORYBilling Specialist Bridgeway Hospice and Palliative Care - Marietta, GA - August 2016 to January 2024 Electronic or manually submit Home Care/Hospice claims Review and follow up denials Post payments/ adjustments Submit appeals Verify insurance eligibility Create Narrative in the Billing System to document status Track A/R for outstanding balances and work resolutions Handled correspondence Run weekly A/ R and patient balance reports Perform other responsibilities as assigned.Patient Account Representative I EMORY UNIVERSITY HOSPITAL - Decatur, GA - May 2016 to August 2016 Post payments and or adjustments as required. Greet customers warmly and ascertain problem or reason for calling. Keep Patient accounts updated. Open and close daily batches. Make collection calls to clients with overdue accounts. Problem escalation and customer service. Perform special assignments and projects as required. Resolve customer complaints. Use telephones to reach out to customers and verify account information. Cancel or upgrade account demographics/insurance information. Verify insurance eligibility using GPR software Advise on company information. Take payment information and other pertinent information such as addresses and phone numbers. Inform customer of payment options; such as charity care and budget plans. Read from scripts.ACCOUNT RECEIVABLE SPECIALIST ZOTEC PARTNERS, INC - Kennesaw, GA - September 2015 to January 2016 Reviewed and resolved denied claims for electronic or manual refiling. Worked New York and New Jersey Medicare, Blue Cross, Commercial, Workers Comp. Handled correspondence. Verify insurance eligibility. Applied adjustments to claims. Upon review of denied claims submitted appeals where necessary. Handled accounts in collections status. Worked claim rejections; suspended claims, claims on hold. Contacted insurance companies via-online or telephone for denial resolution. Adjusted/corrected claims reflecting duplicate charges. Submitted alerts to appropriate clients (New York or New Jersey).PATIENT ACCESS/GEISINGER CMC 6/15 8/151800 Mulberry St, Scranton, PAGreeting patients and directing them to required units.Checking the identity of patients. Inquiring about medical insurance. Gathering information about medical history. Reporting all new medical cases to the ER nurse.Making decisions based on confidentiality. Obtaining signatures, filling in forms.Gathering information from friends and families in cases where patients are severely injured.Verifying the eligibility of medical insurance.Making copies of insurance cards.Entering data into computer.Evaluating the accuracy of information.Answering the phone, taking and transmitting messages.ACCOUNT REPRESENTATIVE/ATLANTIC HEALTH SYSTEM 12/06 10/14475 South Street Morristown, NJ 07962-1906Scan/Map patient care reports and other documentation from RightCad.Review and/or determine the appropriate primary source of payment.Assign appropriate insurance carrier by utilizing the billing address and/or prefix.Ensure complete and accurate data prior to submitting PFS for processingWork with dispatch to assure complete and accurate transportation documentation.Determine and diagnose levels of service to be billed on supporting documentation on the (PCR) and/or in the Computer Aided Dispatch (CAD) notes.Verification of insurance coverage, eligibility and benefits via-PassportCreate Narrative in the Billing System to document status of trip for use in claim appeal process.Produce reports from Rightcad billing software as needed.Assure HIPAA compliance with regard to billing practices.Scan documentation to appropriate accounts on completion of billing. / Other duties as assigned.COLLECTOR/EASTON HOSPITAL CHS 7/04 12/06250 South 21st Street, Easton, PA 18042Ran and worked Account Trial Balance Report (30-150 days) on a weekly/daily basis for Medicaid/HMO accounts for timely follow up.Reduced A/R balance from $1.2 million to $300,000.00 during 3 month probationary period.Worked remits (including zero pays) and correspondence.Submitted appropriate and timely written appeals for denied accounts.Submitted daily adjustments via-adjustment sheet to either correct of zero-out account balance as necessary.Analyzed account balances/worked mail/email correspondence per 24 hour response guideline.Verified insurance eligibility/changed financial class/ data entry as required.Daily telephone calls to appropriate insurance companies for account status/resolution.Utilized SSI billing system for UB-92 verification of billing submissions.Participate in training of new Collector(s) working Medicaid/HMOs.MEDICAL BILLER/NEUROLOGY CENTER 10/03 - 7/04232 Independence Rd, East Stroudsburg, PA 18301Responsibilities:All facets of commercial insurance billing and self-pay accounts.Analyze outstanding account balances for resolution.Correspond (via-telephone or letter) with appropriate insurance representatives to resolveunpaid accounts.Handle high volume of mail correspondence to determine problematic accounts.Negotiate insurance company payments with Concentra Representatives.CASH RECEIPTS/BILLING/NEW YORK HEAL TH CARE 4/01 - 1/03946 McDonald Ave., Brooklyn, NY 11218Responsibilities include:Run, analyze and make appropriate corrections on weekly billing edits.Track, correct and update prior approval numbers for expedient Medicaid billing.Process weekly denial report and make necessary corrections for re-billing.Post A/R payments and adjustments as well as batch entries.Run monthly overage reports for client surplus billing.Resolve problematic accounts via-HRA and/or CSC contacts.Upload weekly HRA billing via-floppy diskette.BILLING CLERK/PEOPLE CARE, INC. 11/98 - 4/0116 West 32nd Street, New York, NY 10001Responsibilities include:Check and correct billing edits for appropriate rates and billing codes.Electronic billing on a weekly cycle.Correspond with Human Resources Administration to resolve problematic accounts.Process daily/weekly denial report for follow-upOVERALL OUTSTANDING ACCOMPLISHMENTS:Reduced New York Health Care's outstanding denial report from $250,000.00 to$29,000.00 within nine months.Awarded Eastons/CBO recipient of Best New Recruit award in 2004Wrote proposal for a EOB filing system, which helped improve accountpayment/denial research at Neurology Center.Recipient of the "Outstanding Performance" award 1st quarter 2004COMPUTER/OFFICE SKILLSOmniPro Medicare/Blue Cross electronic BillingUnibol/Dataline Interactive Home Care SystemProComm Plus 32/data transmitting, searching and retrieving softwareFedEx Powership/postal software for shipping packagesMicrosoft Office/ExcelWindows XP/7Promise/Passport Internet Insurance Verification ToolsVarious Payor WebsitesEmail/Scanner/FaxSTAR: Hospital Registration SoftwareRIGHTCAD: Billing SoftwareEpic Software |
