Anitra Smith
Woodstock,GA
Summary
Strong analytical and problem-solving skills, very detail oriented, dependable, goal-oriented, works effectively, independently or with a team. I have acquired many of my skills from hands-on experience while working in multiple industries. I have more than 17 years experience in accounting and multiple years of experience working with insurance, including, but not limited to, healthcare and medical billing. This experience has led me to have the ability to work in a fast-paced environment while paying attention to detail to make sure the job is always completed in a timely manner and reflect on accuracy.
Overview
9
9
years of professional experience
Work History
Accounts Receivable Specialist
Beacon Oral Specialists
04.2023 - 03.2024
- Analyze accounts and create claims as necessary for resolution
- Assist revenue cycle management as it receives payments, partial payments and denials on services rendered
- Identify problem accounts with payers; investigate and correct error, follow-up on missing account information, and resolve past-due accounts
- Research inquiries regarding past-due balances and insurance guidelines
- Resolve delinquent accounts; prepare payment plans and monitor adherence to plans by guarantor; direct accounts to inside collection department when necessary
- Prepare reports to identify and resolve accounts receivable issues
- Compose and type routine correspondence, memos, letters, appeals, etc
- Work with practices within the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas
- Review account information, correct discrepancies, and ensure that accounts are properly billed and that payments are collected
- Identify patient accounts for collection action when delinquent or when unable to contact patient or guarantor
- Verify all patient and guarantor demographics are entered correctly when confirming account for refunds team
- Initiate contact if there is a delay in responding to statements or claims
- Review correspondence and post, correct denials
- Thoroughly research denied claims and submit reconsiderations and appeals via insurance payer portals
- Research, analyze, correct and refile rejected claims via the clearinghouse portal
- Enter contact notes related to all communications regarding account including phone, email, letter, TEAMS, and all other methods of communications between patient, guarantor, insurance carrier, practice, and surgeon
- Provide the utmost level of customer service to the practice
- Perform tasks for other accounts receivable representatives while they are on vacation or out of the office
- Provide support for other team personnel during periods of high activity.
Credit & Refunds Specialist
Wellstar Health Systems, Inc.
05.2022 - 03.2023
- Resolve credit balance accounts and process refunds on hospital and guarantor accounts
- Research all payment and adjustment transactions to identify credit resolution
- Process adjustments and/or refunds to resolve the account credit balance
- Process accurate and timely credit resolutions per policies and procedures
- Verify insurance policies for patients and/or guarantors.
Complaint Handler-Medicare
Prudential Insurance Company of America
10.2021 - 04.2022
- Respond to Insurance Carriers/TPA’s in the form of a request for information in preparation for the Carrier/TPA response directly to the complainant
- Creation of complaint records
- Analyzing and completing all incoming inquiries & complaints
- Processing records within the Prudential Profile System (PPS), to create and complete complaint records
- Rerouting misdirected correspondence to the appropriate Business Unit
- Monitoring Complaint Mailboxes
- Monitoring sales/service calls
- Facilitating responses to carrier/TPA, including the update of PPS, and sending documentation where appropriate
- Updating and maintaining records of Sales and Service Complaints based on established procedures and required time frames.
Senior Accountant/Financial Analyst
Fiserv-First Data
03.2016 - 03.2021
- General accounting entries
- Chargeback responses and completion
- Accounts Receivable entries and reporting
- Reconciliation of company owned and non-owned networks
- Assist and Report to Management
- Transaction research for fraudulent credit and debit card transactions
- Verification of new fees for all seven networks
- Responsible for the month-end closing process and balance sheet reconciliations
- Creating month-end invoices for merchants.
Insurance Verification Specialist
AICA Ortho&Spine
03.2015 - 03.2016
- Analyzing correspondence needed to verify claims
- Verify and obtain benefits from all resources available
- Communicates with clinics and doctors to obtain any additional information needed to verify claims
- Follow ups with doctors, clinics, and attorneys for claim information
- Works with billing department, medical records, and attorney representatives to manage all incomplete accounts within the system
- Manages all aging accounts that require additional information.
Education
Medical Billing and Coding Certificate -
Chattahoochee Technical College
Acworth, GA12.2006
Nationally Certified Medical Billing/Coding Specialist -
Nationally Certified Coding Testing
2006
Skills
- Accounting—Accounts Receivable, Accounts Payable, Reconciliation, Month-to-Month invoicing, Year-end Closing, Risk analysis
- Medical—Receptionist, Records, Pre-Certification, Pre-Authorization, Billing, Coding, Investigative research
- Insurance—Verification, Claims, Denials, Appeals, Follow-up, Property and Casualty
- Microsoft Office
- WinOMS
- EPIC
- Imagine
- MicroMD
- NueMD
- Zirmed
- SQL
- Salesforce
- Sage
- Oracle
Timeline
Accounts Receivable Specialist
Beacon Oral Specialists
04.2023 - 03.2024
Credit & Refunds Specialist
Wellstar Health Systems, Inc.
05.2022 - 03.2023
Complaint Handler-Medicare
Prudential Insurance Company of America
10.2021 - 04.2022
Senior Accountant/Financial Analyst
Fiserv-First Data
03.2016 - 03.2021
Insurance Verification Specialist
AICA Ortho&Spine
03.2015 - 03.2016
Medical Billing and Coding Certificate -
Chattahoochee Technical College
Nationally Certified Medical Billing/Coding Specialist -
Nationally Certified Coding Testing
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