Angela Price
Humble,TX
Summary
Credentialing Specialist II that is knowledgeable and responsible for timely and accurate identification of documentation submitted by healthcare providers. Dependable, detail-oriented team player seeking a position that is rewarding and challenging while offering opportunities for career growth and development.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Credentialing Specialist II
HCA Parallon Business
Houston, TX
07.2019 - Current
- Reviewed and verified documentation submitted by healthcare providers to ensure accuracy and completeness
- Maintained accurate records of all providers credentials in compliance with organizational policies and procedures
Home Caregiver
SEGNIK HEALTHCARE SERVICES
Houston, TX
01.2018 - 12.2022
- Assistant with bathing, dressing, grooming, and other personal tasks. Cleaning, doing laundry, and washing dishes. Running errands. Maintained a comfortable and safe home environment.
Medicare Collector
NORTH CYPRESS MEDICAL CENTER
Cypress, TX
06.2014 - 07.2019
- Ensure all claims are accurately transmitted daily within CBO targets and goals. Complete follow-up of claims on a timely basis according to the CBO productivity guidelines for accounting for follow-up goals. Pursue unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow up timelines. Employ measures to expedite claim adjudication by resolving issues that may delay processing of payment. Involve the patient or guarantor when necessary. Provide feedback to management regarding any issues or repetitive errors that may be encountered during claim review and submission. Documents account activity in an accurate and timely manner on all patient accounts. Review system generated work lists, reports and or aged trial balances to resolve unpaid accounts, based on specific third-party payer contracts and guidelines.
Patient Account Representative
XAM Business Services
Houston, TX
11.2008 - 06.2016
- PAR is responsible for insurance follow-up. The PAR works in coordination with Project Manager/Supervisor to secure payment from the insurance company and following accounts through to resolution. Demonstrates understanding of Managed Care, Medicare, Medicaid, and Worker's Compensation claims billing and collections. Ability to read and understand an Insurance Explanation of Benefits. Skill to use a personal computer, email, internet, and various software packages such as Meditech, Ivans Portal (remote sys), SSI system, Cubs, and Rumba. Ability to comprehend hospital managed care contracts.
Medical Bill Review Analyst
Texas Municipal League IRP
Austin, TX
04.2008 - 11.2008
- Input and adjudication of medical bills consisting of CMS-1500 forms, UB-04 forms for inpatient and outpatients’ hospital bills, and DWC 66 pharmacy bills for workers' compensation claims according to the Texas Workers' Compensation medical fee guidelines. Basic understanding of insurance industry, knowledge of CPT/ICD codes, medical terminology and medical procedures.
Data Entry Specialist
Texas Municipal League IRP
Austin, TX
01.2007 - 03.2008
- Sort and prepare CMS-1500 forms, UB-04 inpatient and outpatient hospital, and DWC 66 pharmacy medical bills for workers compensation. Enter data from each bill into the Bill Review system. Maintain daily goal of entering approximately 125-150 bills. Provide phone calls and written correspondence to health care providers for correct or missing information. Retrieve incoming faxes.
Bill Review Administrative Technician
JI Company
Austin, TX
08.2006 - 12.2006
- Prepare documentation for workers’ compensation. Scan and index HFCA and UB-92 forms. Review and return incomplete or inaccurate healthcare forms.
Data Entry Operator II
Vehicle Inspection Bureau
Austin, TX
08.1999 - 08.2006
- Provide customer service for both internal and external customers. Heavy data entry skills using DPS Mainframe and Data cap software. Responsible for writing procedures for office duties. Assisted in training new employees in all office procedures. Requested to assist other departments in data entry during heavy peak loads.
Clerk II
Texas Dept
Austin, TX
07.1998 - 07.1999
- Prepare inmate files for board hearings. Heavy alpha/numeric filing. Provide customer service both in person and via phone.
Education
Certificate - Medical Billing and Coding
Virginia College
Austin, TXSkills
- Typing, calculator, lifting boxes etc (10 years)
- Custodial experience
- Commercial cleaning
- Floor care
- Senior care
- Home care
- CPT Coding
- ICD-10
- Physiology Knowledge
- Documentation Review
- Insurance Verification
Certification
Medical Billing and Coding
Timeline
Credentialing Specialist II
HCA Parallon Business
07.2019 - Current
Home Caregiver
SEGNIK HEALTHCARE SERVICES
01.2018 - 12.2022
Medicare Collector
NORTH CYPRESS MEDICAL CENTER
06.2014 - 07.2019
Patient Account Representative
XAM Business Services
11.2008 - 06.2016
Medical Bill Review Analyst
Texas Municipal League IRP
04.2008 - 11.2008
Data Entry Specialist
Texas Municipal League IRP
01.2007 - 03.2008
Bill Review Administrative Technician
JI Company
08.2006 - 12.2006
Data Entry Operator II
Vehicle Inspection Bureau
08.1999 - 08.2006
Clerk II
Texas Dept
07.1998 - 07.1999
Certificate - Medical Billing and Coding
Virginia College
Additional Information
- SKILLS SET
- Medical Terminology Anatomy & Physiology
- CPT, ICD-9_CM
- Visual Cactus
- OnBase Launcher