Amy Doxtater
1509 Phelps Rd, Corfu,NY
Summary
To secure employment in a professional environment where there is opportunity for growth.
Overview
21
21
years of professional experience
Work History
Payment Posting Specialist
NAPA Management Services Corporation
09.2020 - Current
- Post all personal, insurance and liability payments from Remittance and EOB's to appropriate accounts with minimum errors
- Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances;
- Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to very accuracy of patient balances
- Scan all EOB's into system and create hardcopy file for original EOB's by day
- Add appropriate denial codes and comments to assure all necessary appeals and post
- Investigate the source of unidentified payment to ensure they are applied appropriately to the correct accounts and payors
- Reconcile shortage on both paper and electronic EOBs to determine proper allowance is reported
- Assist in performing comparison of downloaded files to the Direct Deposit and correct any discrepancies
- Assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare payors;
- Assist in running and balancing credit cards daily
- Send all batch reconciliation information to the Finance department
- Assist in performing check deposits and assembling logs daily
- Contact patients, insurance or third party administrators when clarification of information is needed
- Work on recoupment accounts to settle
- Follow up with outstanding A/R all payers and/or including self-pay
- Read, analyze, and interpret common scientific or technical information, financial reports
- Research inquiries in a professional and courteous manner and work with accounts receivable to resolve any interdepartmental issues
- Identify and resolve any payor payment issues or trends in a timely manner, potentially without direct Supervisor oversight
- Act as point of contact for the team when Supervisor/Manager/Team Lead are unavailable;
- Perform other duties as assigned
Clinical Administrative Coordinator
Humana Inc
01.2018 - 07.2020
- Complete initial triage of members and administrative intake
- Manage admission and discharge information
- Manage incoming member and provider calls related to requests for service, network services and clinical appointments
- Document clinical decisions and recommendations resulting from interdisciplinary team meetings
- Support clinical staff in care plan development
- Create and verify if authorization for services are needed, if required build cases and approve or pend for further review for providers and members
A/R Billing Specialist
TLK Medical Management
01.2015 - 01.2016
- Responsible for the follow up and review of all insurance companies for a general physicians practice
- Generate weekly aging reports in a timely manner
- Review reports and find trends to enhance A/R performance
- Answering phones and addressing patient or office staff issues
- Responsible for working with insurance companies and patients to resolve outstanding balances on accounts
- Provide outstanding customer service to not only our clients, but their patients and staff
- Expected to be up to date and knowledgeable on payor fee schedules, insurance changes, and denial trends that would negatively impact practices revenue cycle
- Tracking and resolving outstanding payment issues quickly and efficiently in order to minimize impact on account receivables
Clinical Administrative Coordinator
Cogent Healthcare
01.2011 - 01.2014
- Responsible for overseeing the daily operations of the hospitalist team at United Memorial Hospital
- Scheduled employee shifts and ensured admitting and discharge functions were providing for optimal patient flow
- Ensured that hospital resources were being used in the most efficient manner
- Assigned patients to appropriate health practitioners
- Processed and approved employee payroll
- Expected to sort and code all new billing sheets and daily billing log including initial visits, consults, and daily charges
- Reconciled daily hospital census to ensure all patients were accounted for
- Entered all new patient information into Cogent system for billing, coding, and claims submission
- Responsible for insurance verification and follow up of patient coverage
- Responded to billing and insurance inquiries and provided information in a timely manner to resolve issues quickly and efficiently in order to minimize impact on account receivables
Patient Account Representative
Lakeside Hospital
01.2009 - 01.2012
- Responsible for organizing inpatient and outpatient claims for electronic or hard copy mail and forwarding to appropriate payers
- Expected to review claims to make sure that payer specific billing requirements were met, followup on billing, determine and apply appropriate adjustments, answer inquiries, and update accounts as necessary
- Responsible for preparing and reviewing patient statements
- In charge of preparing information for bad debt/collection agency
- Trained new staff on billing expectations and hospital EMR, as well as electronic claims submission systems
- Participated in educational activities and attended monthly staff meetings
Customer Service/Claims Analyst
Meritain Health
01.2004 - 01.2006
- Answering phones and addressing insurance related issues with customers and providers
- Approved medical and dental claims for reimbursement through third party administrative insurance company
- Expected to be goal oriented and work alone as well as with team members to meet daily agendas and deliver high quality customer service to our clients
- Expected to work in a fast paced environment and multitask well under pressure
- Quick navigation through multiple computer programs to solve client issues and complaints
- Expected to perform basic office duties such as faxing, filing, photocopying, and e-mailing
Education
BS - Medical Administration Management
Bryant & Stratton
Buffalo, NY12.2024
Medical Billing and Claims Specialist -
U.S. Career Institute
Fort Collins, CO01.2009
Skills
- ICD-10
- Medical Coding
- Medical Records
- Triage
- Insurance Verification
- Scheduling
- Payroll
- Leadership
- Supervising experience
- Operations management
- HIPAA
- EMR systems
- Negotiation
- Hospital experience
- Analysis skills
- ICD-9
- Workforce management
- Quality control
- Customer service
- Accounts receivable
- Knowledge of Commercial, HMO's, Medicare, Medicaid, and Managed Care Plans
- Office 365 and OneDrive
- Knowledge of CPT, HCPC, ICD-9 and ICD-10 Coding
- Familiar with manual and electronic payment posting
- Strong verbal and customer service skills
- Excellent problem solving and analytical skills
- Adheres to HIPPA guidelines
- Microsoft Word
- PowerPoint
- Excel
- Outlook Express
- Gmail
- Excellent insurance verification and website navigation skills
- Filing/Data Entry
- Medical Billing and Coding
- Strong liaison, networking, and relationship building skills
- Reviewing and Processing Medical and Dental Claims
- Experience working on EMR systems & Facets System
- Excellent negotiation and critical thinking skills
Personal Information
- Title: Clinical Administrative Coordinator
- Work Permit: Authorized to work in the US for any employer
Timeline
Payment Posting Specialist
NAPA Management Services Corporation
09.2020 - Current
Clinical Administrative Coordinator
Humana Inc
01.2018 - 07.2020
A/R Billing Specialist
TLK Medical Management
01.2015 - 01.2016
Clinical Administrative Coordinator
Cogent Healthcare
01.2011 - 01.2014
Patient Account Representative
Lakeside Hospital
01.2009 - 01.2012
Customer Service/Claims Analyst
Meritain Health
01.2004 - 01.2006
BS - Medical Administration Management
Bryant & Stratton
Medical Billing and Claims Specialist -
U.S. Career Institute
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