Allison Adkins
Post Falls,ID
Summary
Experienced in customer service since age 16, excelling in high-pressure situations and fostering positive team dynamics. Dedicated to exceeding customer expectations and pursuing a career as an Administrative Assistant to contribute to a supportive work environment and make a difference in people's lives.
Overview
19
19
years of professional experience
Work History
Claims Specialist
Elevate Patient Financial Solutions
03.2023 - Current
- Required to learn a variety of hospital systems and user interfaces.
- Assure all tasks and projects assigned are completed timely.
- Assist in the final invoice auditing process. Ensure the accuracy of the invoices; work with the corporate billing department to resolve issues or concerns identified.
- Perform Eligibility and TAR approvals, reclassifying with correct insurance, document, updating billing indicators, and updating authorization eligibility to ensure the correct insurance will be billed for the patient’s date(s) of service.
- Aged approved audits on assigned hospitals are submitted to RVP’s and leadership monthly.
- Responsible for assigned active, closed, approved inventories and making sure reclassification is correct.
- Monitor and verify the hospitals have reclassified the account when approved and/or reclassifying for selected hospitals.
- Perform ongoing audits on assigned hospitals. Reconciliation with PAT, hospital system and MPower identifying any errors or inconsistencies, staff advocates issues, and delays or trends.
- Provide results to hospital on a periodic basis.
- Communicate on problem accounts and resolving with hospital staff if appropriate as well as aged approved accounts.
- Monitor company’s performance and proactively identify risks and communicate to management.
- All risks are identified and reviewed for quality control evaluations.
- Ensures payments fall within the parameters of the hospital contract.
- Audit and verify assign activity business codes in MPower to ensure accurate payment for assigned clients match PAT.
- Progress accounts to a billed status if Elevate PFS completed the work.
- Verify and update information required on the 'Update log.'
- Identify approval/billing trends that impact the client and/or internal operations.
- Summarize the findings and communicate directly with the Billing Manager for review.
- Assist in the final invoice auditing process. Ensure the accuracy of the invoices; work with the corporate billing department to resolve issues or concerns identified.
- Following up on unresolved claims. Make phone calls and use insurance company websites to check on claim status.
- Identify why payment has not been received from the payer. Take appropriate actions to resolve issues in a way that results in payment and/or complete closure of insurance balance.
- Follow up on patient balances as assigned.
- Analyzed claim submissions to ensure compliance with industry regulations and company policies.
- Processed complex claims efficiently, reducing turnaround time and enhancing customer satisfaction.
- Collaborated with healthcare providers to resolve discrepancies and streamline claim resolution processes.
- Educated clients on claims processes, improving understanding and reducing follow-up inquiries.
- Mentored junior staff on best practices for claims management and effective communication techniques.
- Implemented process improvements that enhanced accuracy in claim adjudication and reduced errors.
- Developed training materials for new hires, promoting consistent knowledge across the team.
- Led cross-functional teams in identifying trends in claims data, informing strategic decision-making initiatives.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
Billing Specialist/DRG auditor
Heritage Health
05.2021 - 03.2023
- I work in the claims department and help with correspondence.
- I am responsible for ensuring that all medical coding in documents and patient files is accurate.
- I also provide support to senior analysts, evaluate billing and reimbursement documentation, and determine whether the files meet federal regulations.
- I Obtain new patient demographic info and enter into software system in accordance with client contract.
- I Verify all patient's payer sources with CWF and /or other insurance websites and notify facility of any changes.
- Set up and maintain all client and patient information in client specific electronic folders.
- Check ABN’s for accuracy and timeliness.
- Responsible for accuracy of all patient information entered in all systems in accordance with client contract.
- Prepare for and participate in triple check of all claims prior to submission.
- Submit all billing claims timely.
- Enter deposits and remits in accordance with client contract.
- Complete A/R close process timely in accordance with client contract.
- Follow up on claims status until paid.
- Maintain aging reports with notes and dates of billing activity etc.
- Review aging reports with Director of Revenue Cycle Management monthly.
- Review aging reports with Facility Administration monthly.
- Make and document collection calls as necessary.
- Assure Demand bills are submitted to carriers as necessary.
- Communicate in writing to Administrators when system errors occur.
- Maintain Medicare/ Medicaid bad debt logs with all required documentation.
- Quarterly complete Medicare and Medicaid Credit Balance Reports and submit to Director of Revenue Cycle Management.
- Respond to emails and phone calls to clients daily.
- Use Quick Books Timer for tracking client’s tasks and export for payroll every Friday.
- Stay up to date on current and future changes in the billing process by participating in educational webinars, seminars, Medicare, Medicaid, and Insurance email updates.
- Implemented improvements in billing procedures, enhancing efficiency and reducing turnaround times.
- Trained new staff on billing systems and best practices for data entry and documentation.
- Collaborated with insurance providers to resolve discrepancies and expedite claim approvals.
HR Administrative Assistant
Greenleaf Landscaping
05.2018 - 05.2021
- My role was to post jobs, schedule interviews, help with on boarding, help move over to workday, help recruit and do paperwork for positions, screen applicants, ran background checks, did paperwork for extending offers.
Patient Care Coordinator
Riverstone Dental Care
08.2015 - 08.2018
- I responsible for greeting and assisting patients the moment they enter a dental office.
- I make appointments for patients and maintain their accounts.
- I help coordinate the dentist's schedule and bill patients and their insurance companies.
- I also monitor a visitor's access to the office and collect mail.
- Most dental receptionists use a computerized filing system to organize patient records and keep them updated.
- I answer phones, present Treatment plans, verifies insurance.
Patient Care Coordinator
Riverstone Dental Care
08.2015 - 08.2018
- I responsible for greeting and assisting patients the moment they enter a dental office.
- I make appointments for patients and maintain their accounts.
- I help coordinate the dentist's schedule and bill patients and their insurance companies.
- I also monitor a visitor's access to the office and collect mail.
- Most dental receptionists use a computerized filing system to organize patient records and keep them updated.
- I answer phones, present Treatment plans, verifies insurance.
Patient Service Coordinator/ Billing Specialist
Kaiser Permanente
09.2009 - 08.2015
- Clerical tasks like answering phones and processing paperwork, including discharge, transfer, and admittance forms. I acted as a liaison between patients, nurses, doctors, and different departments within the hospital or care facility.
- I also scheduled procedures like tests and x-rays, transcribing doctors' orders, and ordering medical and office supplies.
- I worked closely with patients on a one-on-one basis. I provided guidance, support, and advice to patients dealing with complex medical issues.
- I tried as much as possible to help the clients navigate through a medical care scenario that may involve a variety of different doctors and treatment methods.
- My billing responsibilities were to Properly coding services, procedures, diagnoses, and treatments.
- Preparing and sending invoices or claims for payment.
- Correcting rejected claims.
- Tracking payments.
- Following up with patients and insurance companies about outstanding bills.
Evergreen Dental Clinic
08.2006 - 09.2009
- Efficient and organized in providing patient coordination efforts for a large dental office that performed various dental procedures including exams, hygiene and surgery; interacted with staff and patients for scheduling of patient procedures and ensured all payment options were discussed before scheduling of appointments and/or procedures.
- Completed all end of day accounting and production reporting, collected fees and recorded as needed; oversaw referrals to other dental offices and quickly responded to all patient requests or inquiries.
- Coordinated patient information through all caregivers, insurance companies, billing departments, and according to facilities policies and procedures.
- Met one-on-one with patients to acquire all demographic information and coordinated health information with insurance companies or other payers.
- Communicated with all internal and external divisions and expressed ideas and recommendations clearly and concisely with management regarding efficiency improvements.
Education
Associate Degree - undefined
Spokane Falls Community College
01.2019
High School - undefined
Evergreen valley high school
01.2009
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
Timeline
Claims Specialist
Elevate Patient Financial Solutions
03.2023 - Current
Billing Specialist/DRG auditor
Heritage Health
05.2021 - 03.2023
HR Administrative Assistant
Greenleaf Landscaping
05.2018 - 05.2021
Patient Care Coordinator
Riverstone Dental Care
08.2015 - 08.2018
Patient Care Coordinator
Riverstone Dental Care
08.2015 - 08.2018
Patient Service Coordinator/ Billing Specialist
Kaiser Permanente
09.2009 - 08.2015
Evergreen Dental Clinic
08.2006 - 09.2009
Associate Degree - undefined
Spokane Falls Community College
High School - undefined
Evergreen valley high school