Amy Swenson
Omaha,NE
Summary
- Detail oriented
- Task prioritization
- Written communication
- Microsoft Word
- Customer relations
- Time management
Hardworking healthcare professional knowledgeable about insurance standards, patient finances and available resources. Adept at developing solutions that meet diverse needs. Practiced at meeting financial demands while providing exceptional service to patients. Proficient at working with insurance providers and hospital services to develop the best possible solutions for all parties. Experienced Patient Financial Services Lead with over 25 years of experience in medical billing. Excellent reputation for resolving problems and improving customer satisfaction.
Overview
25
25
years of professional experience
Work History
Patient Financial Services Supervisor
Nebraska Medicine
Omaha, NE
12.2020 - Current
- Performed targeted collections on past due accounts aged over 30 days.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Generated financial statements and reports detailing accounts receivable status.
- Worked the claim from beginning to end, such as data entry of patient demographics, insurance information, diagnosis codes and CPT & HCPCS codes.
- File claims electronically and by paper daily.
- Run end of month reports and send to our clients.
Patient Financial Services Lead
Nebraska Medicine
Omaha, NE
07.2016 - 12.2020
- Organized and coordinated work for 12 team members.
- Work closely with provider reps and attend monthly meetings to discuss issues we are having and we work together to get our issues resolved.
- Consistently working the high dollar claims to ensure issues are identified and to ensure we get payment in a timely manner.
- Developed and implemented workflow's and consistently achieved targets.
- Supported team with expert billing knowledge, time management, and compassion.
- Helped my team handle high-volume work by prioritizing tasks and organizing payer spreadsheets with the most up to date claim information on issue claims.
- Developed solid relationships with staff and customers.
- Trained new team members with specific Medicaid processes and ways to exceed performance expectations.
- Worked effectively with diverse team to accomplish daily objectives and meet long-term goals.
- Used coordination and planning skills to achieve results according to schedule.
- Developed and maintained courteous and effective working relationships.
- Developed team communications and information for meetings.
Reimburs Appeals Sr Associate
Nebraska Medicine
Omaha, NE
02.2016 - 07.2016
- Worked hospital accounts that were underpaid & overpaid to ensure we received the correct reimbursement.
- Owned the payer issue spreadsheet for various payers on problem claims to get additional reimbursement.
- Sent reconsideration's to all payers for additional reimbursement according to our contract with the payers.
- Developed junior team members and cultivated collaborative culture.
- Produced documentation, status reports and presentations.
- Approached each problem with fresh mind and analytical strategies to quickly resolve concerns.
Specialty Billing Sr Associate
The Nebraska Medical Center
Omaha, NE
10.2009 - 01.2016
- Worked with specialty government payers such as Veterans Administration on getting claims billed correctly and ensure payment received was correct.
- Worked with Nebraska Medicine Clients and sent monthly invoices.
- Assisted with creating policies and procedures for the many specialty payers and getting the policies updated.
- Monitored the grant and research billing to ensure the charges on the grant accounts were correct and related to the research study.
- Created monthly invoices for the Executive Physical accounts and monitored to ensure the correct payment was received.
- Issued refunds to doctors for Executive Physical accounts
- Collected confidential financial information from clients to construct comprehensive financial plans.
- Worked with various state programs such as Every Woman Matters, Medically Handicapped Children's program, State of NE TB program, State Ward and the Department of corrections for claims billing and follow up.
- Educated clients on account services and resolved client inquiries regarding statement information and account balances.
- Built and maintained relationships with new and existing clients while providing high level of expertise.
Medical Billing Sr Associate
The Nebraska Medical Center
Omaha, NE
03.2004 - 09.2009
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Reviewed outgoing bills for eligibility and accurateness.
- Researched and followed up on denied insurance claims.
- Billing and follow up with all Medicaid products and Tricare. Ensuring the claim was billed to the correct payor with the correct patient ID number. Verifying patient eligibility through various websites.
- Sent corrected claims when coding has been updated. Mailing and faxing reconsideration's with medical records or itemized statements.
- Calling insurance companies to follow up on claim status and denials to get more detailed information. Working with the payors on rejected claims.
- Contacting patients to get correct insurance information or to let them know they need to contact their insurance to provide requested information to them.
- Researching and finding missing checks and EOB's.
- Work as a team to identify and resolve claim issues.
- Prepared billing statements for patients and verified correct diagnostic coding.
DME Billing Specialist
HealthCare Management Solutions
Bellevue, NE
08.1999 - 03.2004
- Performed targeted collections on past due accounts aged over 30 days.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Generated financial statements and reports detailing accounts receivable status.
- Worked the claim from beginning to end, such as data entry of patient demographics, insurance information, diagnosis codes and CPT & HCPCS codes.
- File claims electronically and by paper daily.
- Run end of month reports and send to our clients.
Education
High School Diploma -
Omaha South High School
Omaha05.1999
Skills
- Billing
- Clients
- Government
- Meetings
- Organizing
- Processes
- Research
- Spreadsheets
- Spreadsheet
- Time management
- Workflow
- Professional telephone etiquette
- Data entry expertise
- Schedule Management
- Medical insurance
- Payment collection
- Excellent work ethic
- Responsible
- Multitasking abilities
- Project Management
Timeline
Patient Financial Services Supervisor
Nebraska Medicine
12.2020 - Current
Patient Financial Services Lead
Nebraska Medicine
07.2016 - 12.2020
Reimburs Appeals Sr Associate
Nebraska Medicine
02.2016 - 07.2016
Specialty Billing Sr Associate
The Nebraska Medical Center
10.2009 - 01.2016
Medical Billing Sr Associate
The Nebraska Medical Center
03.2004 - 09.2009
DME Billing Specialist
HealthCare Management Solutions
08.1999 - 03.2004
High School Diploma -
Omaha South High School