| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Lithonia, GA Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEWork ExperienceAccounts ReceivableNew Era Construction - Atlanta, GAMarch 2020 to January 2024Post customer remittances and research unapplied cash in a timely and efficient manner.Receive prepared refund packets from on-site refund staff for review and distribution to payer analystProcessed returned payments, pulling of daily data from bank portals for payment processingApply cash, check, credit card, wire transfers, and lockbox payments for assigned reloads/assigned sitesCash Applications SpecialistBlueLinx Company -Atlanta, GaAugust 2018 to February 2020Cash Application/ Payment Posting *Post manual/ electronic payments to accounts balance goals accordingly.Apply cash, check, credit card, wire transfers, and lockbox payments for assigned reloads/assigned sites.Depending upon the functional group, may resolve past due accounts, customer deductions from remittances and/or all other accounts receivable issues.Processes requests from the sales group and furnishes information requested regarding customer accounts.Analyses customer account status and reports findings to management as required. *Solves routine customer problems, investigates reasons / causes for customer dissatisfaction and evaluate customer satisfaction (for both internal and external customers).Cash Application SpecialistTreatment Management - Atlanta, GAJanuary 2018 to August 2018Payment Posting *Post manual/electronic payments to accounts *Post all zero pay explanation of benefits to accounts *Review/documenting in the master reconciliation work log daily.*Posting commercial, government and patient payments *Apply cash, check, credit card, wire transfers, and lockbox payments *Posts adjustments in an accurate and timely mannerMedicare Part B Claims RepCahaba GBAMay 2017 to January 2018 Follow-up on unpaid claims and underpaid claim Submit claim resubmissions to insurance carriers Handling incoming phone calls from providers and patients in regards to the status of medical insurance claims. Knowledge of Medical Provider network process Interprets and understands health insurance appeals and provider dispute resolution processes, applicable clinical guidelines, and health payer coverage policies in order to effectively prepare claim packages Managed /Update Provider Information. Assisted with the Appeal ProcessAccounts Receivable SpecialistLaureate Medical Group - Atlanta, GAJanuary 2017 to May 2017Account Receivable/Cash Application Apply cash remittances, consisting of lockbox deposits, credit cards, and ACH / wires, accurately and in a timely manner Perform cash reconciliation on disputed applications, as necessary. Post customer remittances and research unapplied cash in a timely and efficient manner in Oracle. Processed returned payments Verify EOB's Processing of lockbox uploads Audits patient accounts for insurance or personal over payments. Ensures appropriate authorization and signing of checks Monitors and acts on Refund or Credit reports as needed. Interact with EMR and other IT systems for claims research, recoups, refunds, reprocessing, posting payments and collectionsAccount Receivable SpecialistAlthea Medical Group - Atlanta, GAJuly 2016 to December 2016Account Receivable/Cash Application Apply cash remittances, consisting of lockbox deposits, credit cards, and ACH / wires, accurately and in a timely manner Perform cash reconciliation on disputed applications, as necessary. Post customer remittances and research unapplied cash in a timely and efficient manner. Processed returned payments Pulling of daily data from bank portals for payment processing Processing of lockbox uploads Audits patient accounts for insurance or personal over payments. Ensures appropriate authorization and signing of checks Monitors and acts on Refund or Credit reports as needed. Receive prepared refund packets from on-site refund staff for review and distribution to payer analyst to review and approve.Senior Care AssociateMindlance/Cigna HealthSpring - Atlanta, GAJanuary 2016 to July 2016* Accurately create and document assessments, notes and reviews in the case management system * Facilitate the request for prior authorization information of inpatient and outpatient services, ensuring timely and accurate responses in compliance with state and federal guidelines * Prepare approval/denial letters and meet regulatory turnaround times * Facilitate CHT Meetings * Manage the fax boxes and submit pertinent information to the nurse pre\-auth team, UM leadership team and the medical directors in a timely manner * Prepared Discharge Reports and Calls * Prepared commercial and government insurance Admissions, Transportation/Ambulance rides to providers.* Case Management ProfilesCall Center LeaderMorneau Shepell/Health Republic Insurance - Atlanta, GAJanuary 2013 to December 2015Monitor service levels of the team to ensure that client service standards are being maintained. * Conducts quality evaluations with Service Representatives.* Responds to escalated calls from client's plan members.* Conducts research to identify solutions to client issues.* Leads internal training sessions to help develop Service Representatives.* Provides feedback to Call Center Manager regarding Service Representatives; participates in performance management for the team.* Provides feedback to management regarding status and effect of outstanding issues.* Manages the relationship between clients, administrators, insurance providers, and analysts. * Prepares reports on Call Center metrics.* Participates in internal and external meetings.* Peer review of documentation regarding client memberships.* Manages multiple priorities simultaneously in a fast paced environment.* Devises ways to continuously improve team operations and performance.Merchant Account Services RepInteractive Communication/Incomm - Doraville, GASeptember 2009 to December 2012Responsible for first level support of technical problem resolutions on point-of-sale activation of financial card holders.* Respond to high volume in-bound calls from merchant (store) sales representatives/customers who sell the company's products.* Communicate via telephonic and email correspondence to/from tech support to the fraud department for vendors, account managers, and store owners.* Activate and Reactivate financial cards * Strong analytical and problem solving skills; able to develop and use structured approaches to identify root causes and recommend resolutions; can present results in a meaningful term.* Understand, utilize and adhere to SnapPay/MIO desktop application, Payment Manager, and proper navigation of.* Tracks client financial and other performance vs. plan figures. Identify key issues (product/platform, financial, regulatory, or other) affecting performance and works with Regional Sales Manager to actively manage outcomesFront Desk RegistrarSouthside Medical Center - Atlanta, GAJuly 2005 to August 2009* Collected personal and medical data from the patient or the family of the patient. * Initiated medical records written and electronically.* Collected personal data as well as payment information and verified health insurance coverage. * Utilized knowledge of medical terminology on a daily bases as a liaison between the hospital patients as well as outside medical clinics and laboratory facilities.* Compiled and recorded patients information from notes of doctors and nurses.Burn Unit Ward Clerk/Burn ClinicGrady Health Care System - Atlanta, GAFebruary 2000 to June 2005Dermatology Clinic/Clerk II * Handled clerical tasks at the nurse's station of the intensive care unit of hospital floor.* Created records of new patients and regularly update patient records from chart. * Recorded diagnoses and treatments on insurance and medical forms also processed discharge forms. * Arranged, and transported patient transfers to other wards.* Scheduled surgeries/patient care plans * Responsible for processing patient's claim * Verified patient's insurance coverage through online and telephonic contact.* Pulled denial report and resubmitted billable claims.* Also responsible for filing appeals and specialized in Medicare and Managed Care follow-ups. * Managed 7-10 employees to assure that all office duties/rules are completed.* Referrals and pre-certificationsEducationMedical Billing and CodingGeorgia Medical Institute - Decatur, GAMarch 2004 to June 2004Academic Studies, Benjamin E. Banneker High School, College Park, GeorgiaSkills 45 wpm (10+ years) AS400 (6 years) Cisco (Less than 1 year) Citrix. (6 years) Posting (8 years) Cash Application (5 years) Driving Experience (3 years) Customer Service (10+ years) Live chat English Typing Typing Medical terminology ICD-9 Clerical experience Hospital experience Customer service PeopleSoft Cash handling Research Technical support Salesforce QuickBooks EMR systems Accounts receivableAdditional InformationSkills* SMS, Med iSOFT, Medical Manager, Cisco, QuickBooks, Outlook, Lync, Oracle, Medics, CashPro, Emdeon, Availity, NavinetKIPU, Salesforce, CPT, ICD-9 Codes, Billing/Posting, SAP, Phreesia EMR, AS400 Systems, Citrix. HIMR, MCS, PeopleSoft* Microsoft Office XP* Alpha and Numeric Filings* Switchboard Operator, Multi Line Phone System* Data Entry 10,000 ksph* 44-45 wpm |
