Abbie Mollica
Coraopolis,PA
Summary
An experienced Customer Billing Representative III seeking a role in a company where my skills, experience and knowledge can be utilized.
Overview
20
20
years of professional experience
Work History
Customer Billing Representative III
Allegheny Health Network
03.2019 - Current
- Investigated and rectified claim rejections from clearinghouses, ensuring prompt and precise reimbursement processes.
- Provided expert guidance and support to colleagues in mastering the Epic system for improved operational efficiency.
- Ensured adherence to payer policies for Highmark, UPMC, and Medicaid (EPSDT) to support compliance and operational efficiency.
- Utilized in-depth knowledge of ICD-10 and CPT coding to enhance accuracy in medical billing processes.
- Leveraged AI platforms, including Sidekick and Co-Pilot, to enhance task efficiency and decision-making processes.
- Facilitated discussions during out-of-state Medicaid meetings to address team challenges. Guided colleagues through problem-solving processes for effective resolutions.
- Resolved hospital billing claim rejections to ensure compliance with Tricare, VA, and CHAMPVA payer policies.
- Managed billing processes across diverse specialties including pediatrics, primary care, cardiology, and behavioral health.
Billing Specialist/Medical Collections Specialist
Pediatric Alliance
10.2014 - 03.2019
- Accounts Receivable (A/R) processes, including monitoring aging reports and implementing strategies for timely collection
- Analyzed and addressed unpaid and denied claims through direct communication with insurance companies to expedite resolution.
- Demonstrated expertise in billing regulations and procedures for Highmark UPMC and Medicaid (EPSDTS).
- Achieved accurate posting and reconciliation of insurance and patient payments, enhancing financial accuracy. Resolved payment discrepancies and EOB rejections, improving overall account management efficiency.
- Managed identification of overpayments and duplicate payments, leading to effective investigations and resolutions. Oversaw processing of refund requests to maintain financial accuracy.
- Executed daily cash report generation and payment batching from lockbox and EFTs.
- Executed collection strategies to maintain cash flow and minimize delinquency rates.
- Conducted daily collection calls and sent correspondence in a fast-paced department focused on achieving targets. Provided customer service assistance regarding collection matters. Processed customer refunds and evaluated account adjustments. Resolved patient discrepancies and accepted payments. Created payment plans for patients.
- Monitored and maintained assigned accounts. Assisted customers with account adjustments. Processed small balance write-offs and personal payments.
- Follow up on accounts that have reached collections department to ensure they have been fully worked before the account is referred to an external collection agency.
- Reviewed and processed account reinstatement requests, adhering to necessary approval guidelines.
- Coordinated the transfer of delinquent accounts to an external collection agency for effective resolution.
- Administered the sending of collections letters, adhering to established company policy for bad debt pre-collection and discharge communications.
- Collaborated with office managers to ensure effective handling of escalated account matters.
- Processed and recorded payments accurately in patient accounts.
- Recorded and reconciled payments received from collection agency following report verification.
Front Office
First Steps Pediatrics
01.2012 - 01.2014
- Perform the tasks of greeting patients and scheduling appointments
- Conducted thorough checks of patient medical records and insurance details to maintain compliance and accuracy.
- Code medical charts using ICD-9
- Resolved and collected outstanding balances on patient accounts.
- Managed preparation and maintenance of patient medical charts.
- Maintained accurate records and streamlined communication through proficient faxing, emailing, and data entry.
- Coordinated patient greetings and efficiently processed appointment check-ins to enhance patient experience.
- Provided prompt and courteous responses to incoming calls, ensuring clarity and professionalism in all interactions.
- Managed accurate recording and timely updates of patient insurance and demographic data to ensure compliance and efficiency.
- Collecting payments from patients by following the insurance guidelines
- Perform the tasks of receiving and distributing mail and faxes on a daily basis
- Knowledge of handling general administrative and clerical tasks
- Maintained a welcoming presence and upheld high standards of telephone etiquette in all customer interactions.
- Achieved accurate billing outcomes through proficient application of medical terminology and coding practices. Enhanced coding accuracy by leveraging comprehensive knowledge of medical terminology. Improved efficiency in medical billing operations by effectively utilizing medical coding and terminology expertise.
Front Desk Receptionist
Neurobehavioral Medicine Group
04.2011 - 01.2012
- Coordinated patient greetings and organized appointment schedules to ensure smooth operations.
- Perform responsibilities of registering patients by following the protocols of the office
- Responsible for checking and verifying the accuracy of medical records and insurance information of patient
- Handle the task of preparing and maintaining patient's medical charts
- Perform essential clerical tasks like faxing, e-mail, and data entry
- Improved patient experience through effective appointment check-in and welcoming procedures. Streamlined patient check-in to promote a positive first impression.
- Provided prompt and courteous responses to incoming calls, ensuring clarity and professionalism in all interactions.
- Perform responsibilities of maintaining and updating patients insurance and demographic information in the system
- Processed patient payments efficiently and accurately.
- Perform the tasks of receiving and distributing mails and faxes on a daily basis
- Extensive knowledge of medical terminology, medical billing and medical coding
- Handling general administrative and clerical tasks
Customer Service Representative
Nco Group Inc
Pittsburgh, PA
05.2006 - 04.2011
- Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment
- Attempted to collect payment on delinquent accounts
- Posted payments to customers' accounts
- Set up repayment plans to stop service from being disconnected
- Corresponded with other departments to help better serve customers with their account information through telephone or email
- Effectively answered calls in high-volume of inbound and outbound customer calls
- Defused volatile customer situations calmly and courteously
- Navigated through multiple computer screens while discussing options for the customer to resolve their outstanding balance
- Trained new employees entering in the department
- Worked in credit and collections for both Nstar and Direct TV
- Met all department goals
Education
Associates Degree - Medical Coding/Medical Billing
Pittsburgh Technical Institute
Pittsburgh, PA04-2011
Communications Emerging Technology
Slippery Rock University
Butler, PA01-2002
High School Diploma -
Montour High School
06-2000
Skills
- Billing Expertise
- Problem solving
- Training and Development
- Goal Oriented
Timeline
Customer Billing Representative III
Allegheny Health Network
03.2019 - Current
Billing Specialist/Medical Collections Specialist
Pediatric Alliance
10.2014 - 03.2019
Front Office
First Steps Pediatrics
01.2012 - 01.2014
Front Desk Receptionist
Neurobehavioral Medicine Group
04.2011 - 01.2012
Customer Service Representative
Nco Group Inc
05.2006 - 04.2011
Communications Emerging Technology
Slippery Rock University
Associates Degree - Medical Coding/Medical Billing
Pittsburgh Technical Institute
High School Diploma -
Montour High School