Alexus Selmon
Lansing
Summary
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
5
5
years of professional experience
Work History
Provider Services Representative Remote
Priority Health
08.2023 - Current
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Researched and resolved complex medical claims issues to support timely processing.
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Checked documentation for accuracy and validity on updated systems.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Medical Billing Assistant Remote
The Wellness Institute of Michigan
01.2022 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Filed and updated patient information and medical records.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Liaised between patients, insurance companies, and billing office.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Handled account payments and provided information regarding outstanding balances.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
- Reconciled accounts receivable to general ledger.
- Verified accuracy of accounts payable payments, resulting in [Number]% reduction in payment errors and check reissues.
- Disbursed petty cash by recording entries and verifying documentation.
Patient Service Representative Remote
Trinity Health
01.2023 - 07.2023
- Resolved billing inquiries and disputes in timely fashion.
- Investigated insurance claims denials and appeals.
- Verified patient insurance eligibility and entered patient information into system.
- Provided excellent customer service to patients and medical staff.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Recommended service improvements to minimize recurring patient issues and complaints..
- Entered patient demographic and insurance data into electronic medical record system.
Patient Access Representative
Mercy Health Hospital
09.2018 - 05.2019
- Verified demographics and insurance information to register patients in computer system
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans
- Documented patient counters in hospital system and initiated follow-up actions
- Optimized provider time and treatment room utilization with appropriate appointment scheduling
- Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care
- Communicated financial obligations to patients and collected fees at time of service
- Organized timely and accurate referrals to help patients obtain health care services and access available resources
- Applied HIPAA privacy and security regulations while handling patient information
- Explained various admission forms and policies, acquiring signatures for consent
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
- Processed patient responsibility estimate determined by insurance at pre-registration
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Kept patient appointments on schedule by notifying providers of patients' arrival and reviewing service delivery compared to schedule
- Verified patients' insurance and payment methods during admissions or check-in processes
- Obtained necessary signatures for privacy laws and consent for treatment
- Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements
- Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
- Obtained informed consent and payment documentation from patients and filed in system.
Education
High School Diploma -
Auburn High School
Rockford, ILCertification : Medical Administrative Assistant -
New Horizons Regional Institute
Hampton, VACertification: Medical Assisting -
TIdewater Medial
Hampton, VASkills
- Proficient in Microsoft suite of products including Outlook, Word and Excel
- Medical Terminology Knowledge
- Remote Office Availability
- Data Entry
- Administrative and Office Support
- Multi-Line Phone Talent
- Customer Service
- Call Documentation
Timeline
Provider Services Representative Remote
Priority Health
08.2023 - Current
Patient Service Representative Remote
Trinity Health
01.2023 - 07.2023
Medical Billing Assistant Remote
The Wellness Institute of Michigan
01.2022 - Current
Patient Access Representative
Mercy Health Hospital
09.2018 - 05.2019
High School Diploma -
Auburn High School
Certification : Medical Administrative Assistant -
New Horizons Regional Institute
Certification: Medical Assisting -
TIdewater Medial