Anthony Green
Forney,TX
Summary
A friendly and ambitious Medical Biller with great customer service skills and knowledge of several billing software applications. Looking to use my skillset to tackle new challenges with a company that values dynamic skills and a strong work ethic. Authorized to work in the US for any employer
Overview
11
11
years of professional experience
Work History
Prior Authorization Specialist
Navitus
Forney, TX
06.2023 - Current
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
Benefit Verification Specialist
Amgen
Forney, TX
04.2022 - 06.2023
- Receive benefit verification requests from provider offices via fax or provider portal
- Review Patient Enrollment form to ensure all information is available
- If any information is missing a call is placed to the provider office or the patient to obtain the information
- Contact any health insurance carriers listed on the enrollment form and acquire any patient coverage information for medication Tezspire
- Generate a summary of benefits that includes any patient coverages and prior authorization explanations
- This is then faxed to the providers office
- Make outbound call to providers office to explain Fast Start program and verify shipping address for dispense
- Initiate first dispense of medication through proprietary software
Patient Care Coordinator
Tailored Management/ Cardinal Health
Coppell, TX
10.2020 - 04.2022
- Take calls from patients with questions about different Pfizer products
- Place outbound calls to patients to retrieve any missing documents, and answer any questions for the
- Patient Assistance Program
- Approved/Deny Patient Assistance Program applications
- Steward patient accounts from initial contact to final approval/denial
- Maintaining quality while providing an empathetic and supportive experience to the patient by educating the caller and answering questions
- Enter detailed information into company software while speaking on the phone
- Report AE’s as needed per patient conversations and business regulations
Medical Insurance Verification Specialist
DialogueDirect
Billings, MO
09.2019 - 10.2020
- Answer phone calls for insurance verification for Wisconsin insurance companies
- Work from home
- Explain current benefits for insurance subscribers
- Answer phones and emails
- Updated patient and insurance data and input changes into company computer system.
Medical Biller
Heno
Orlando, FL
03.2019 - 07.2019
- Sent claims for Physical Therapy to clearing house
- Posted insurance payments to accounts from EOB’s
- Called insurance for some verification and called for claim status
- Made sure all documentation was attached to claims for proper processing
Insurance Verification Specialist
Robert Half
Orlando, FL
11.2018 - 03.2019
- Used Availity to verify patient insurance for BCBS and UHC
- Verify patient information is correct, current deductible and out of pocket is posted correctly for upcoming patient appointments.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
Medical Biller / AR Specialists
Physicians' Billing of Houston
Houston, TX
08.2013 - 09.2018
- Answered desk phone and handled phone calls and questions
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Reviewed incoming correspondence and determined the action required and its priority
- Ability to read EOB's to determine denials and payments
- Ability to post insurance payments to patient accounts
- Answered calls from patients regarding billing statements
- Answered calls from patients and took payments over the phone
- Reviewed all claims for accurateness and appropriateness
- Maintained computers and billing software for office
- Mailed CMS-1500 and UB-04 claims forms to Clearinghouse
Education
Medical Billing and Coding -
The College of Health Care Professions
01.2013
Skills
- BILLING (5 years)
- PAYMENTS (3 years)
- EXCELLENT COMMUNICATION SKILLS (10 years)
- HEALTHCARE (5 years)
- Medical Insurance
- Medical Billing
- Excel
- Medical Collection
- Insurance Verification
- ICD-9
- ICD-10
- Additional Information
- Skills
- Computer proficient
- Excellent communication skills
- Over 15 years Customer Service
- Proficient in Insurance Verification on phone and websites
- Proficient in reading EOB's
- Proficient in posting patient and insurance payments
- Proficient in several Medical Billing Software
Timeline
Prior Authorization Specialist
Navitus
06.2023 - Current
Benefit Verification Specialist
Amgen
04.2022 - 06.2023
Patient Care Coordinator
Tailored Management/ Cardinal Health
10.2020 - 04.2022
Medical Insurance Verification Specialist
DialogueDirect
09.2019 - 10.2020
Medical Biller
Heno
03.2019 - 07.2019
Insurance Verification Specialist
Robert Half
11.2018 - 03.2019
Medical Biller / AR Specialists
Physicians' Billing of Houston
08.2013 - 09.2018
Medical Billing and Coding -
The College of Health Care Professions
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