Annie McPherson
Laurelton,NY
Summary
With over 7 years of experience in the hospital industry, I bring a strong work ethic and a commitment to excellence. As an authorized worker in the US, I am well-equipped to contribute excellent communication, interpersonal, and organizational skills to any employer. Known for reliability and ability to swiftly adapt to new tasks and environments, I can leverage my experience and dedication to make a valuable impact in your organization.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Provider Claims Representative
AmeriHealth Caritas
05.2023 - Current
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Collaborated with internal departments and external vendors to resolve claims.
- Developed in-depth understanding of insurance policies and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Verified client information by analyzing existing evidence on file.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Checked documentation for accuracy and validity on updated systems.
- Processed and recorded new policies and claims.
- Calculated adjustments, premiums and refunds.
Medical Biller
Mount Sinai West Roosevelt
06.2017 - Current
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Verified that patients had the proper insurance coverage prior to any procedures or appointment scheduling
- Ensured that all patient and insurance data was updated regularly and carefully inputted into the company's computer system
- Closed and open batches for the unit
- Organized files, faxed reports and scanned documents
- Protected confidentiality of sensitive information to comply with HIPAA guidelines
- Resolved patient billing issues and communicated with insurance carriers
- Developed and maintained relationships with insurance companies
- Posted payments to in electronic medical records system upon receipt of payment for claims
- Prepared and reviewed claims for submission, resolving upfront claims edits and errors
- Communicated immediately with providers to clarify incomplete or unclear documentation
- Contacted and worked with patients to resolve insurance-related billing issues
- Assisted with answering telephone to provide requested billing information
- Operated typing, adding, calculating, and billing machines
- Routed statements for mailing or over-the-counter delivery to customers
- Fixed minor problems, such as equipment jams and notified repair personnel of major equipment problems
- Returned checks to customers or retrieved checks returned to customers in error, adjusting accounts and answering inquiries about errors as necessary
- Loaded machines with statements, canceled checks, or envelopes to prepare statements for distribution to customers or stuffed envelopes by hand
- Matched statements with batches of canceled checks by account numbers
- Kept records of invoices and support documents
Unit Clerk
Mount Sinai Beth Israel
05.2011 - 05.2017
- Prepare charts upon admission for patient
- Discharge patient from work flow charts
- Answer multi line telephone and routed calls to specific department and personnel
- Provide exceptional customer service
- Managed patient appointments with careful attention to unit care schedule
- Tended to discharges by reviewing treatment records and imparting necessary care details
- Supported availability of unit supplies by anticipating shortages and placing necessary orders
- Scheduled tests and procedures for patients, such as lab work and x-rays, based on physician orders
- Transcribed recorded messages and practitioners' diagnoses and recommendations into patients' medical records
- Scheduled and confirmed patient diagnostic appointments, surgeries, and medical consultations
Sales Associate
Raymour & Flanigan
03.2008 - 05.2011
- Engaged with customers to build rapport and loyalty.
- Solved customer challenges by offering relevant products and services.
- Helped customers locate products and checked store system for merchandise at other sites.
- Provided positive first impressions to welcome existing, new, and potential customers.
- Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
- Answered customer questions about sizing, accessories, and merchandise care.
- Engaged with customers to effectively build rapport and lasting relationships.
- Maintained calm demeanor and professionally managed issues in busy, high-stress situations.
- Assessed customer needs and utilized suggestive selling techniques to drive sales.
- Built relationships with customers to encourage repeat business.
- Performed cash, card, and check transactions to complete customer purchases.
- Maintained up-to-date knowledge of store sales, payment policies and security standards.
Education
ASSOCIATE OF APPLIED SCIENCE - MEDICAL ADMINISTRATION
Monroe College
Bronx, NY01.2011
Skills
- Medical Billing
- Epic
- ICD-10
- Multi-Line Phone Systems
- Effective Communication Skills
- Telephone Etiquette
- Insurance Eligibility
- HIPAA Regulations
- Electronic Patient Medical Record
- Microsoft Word
- Facets
Certification
Life Insurance License
Timeline
Provider Claims Representative
AmeriHealth Caritas
05.2023 - Current
Medical Biller
Mount Sinai West Roosevelt
06.2017 - Current
Unit Clerk
Mount Sinai Beth Israel
05.2011 - 05.2017
Sales Associate
Raymour & Flanigan
03.2008 - 05.2011
ASSOCIATE OF APPLIED SCIENCE - MEDICAL ADMINISTRATION
Monroe College
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