Dedicated accounts receivable specialist with strong customer service and multitasking skills. Focused on delivering positive experiences while efficiently resolving claims and billing issues. Demonstrates proficiency in appealing claims, negotiating payments, and maintaining high standards for service.
Overview
18
18
years of professional experience
Work History
A/R Revenue Cycle Specialist III
Johns Hopkins University School of Medicine
Middle River, Maryland
06.2008 - Current
Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
Identifies insurance issues related to primary vs. secondary coverage and coordinated benefits eligibility to resolve non-payment of claims.
Reviewed and updated patient registration information, including demographics and insurance.
Contacted payors and patients to initiate corrective actions, facilitating timely claim resolution.
Prepared delinquent accounts for transfer to self-pay collection unit, ensuring compliance with follow-up matrix.
Retrieved supporting documents, such as medical reports and authorizations, and submitted them to third-party payers.
Appeals reflected claims and claims with low reimbursement.
Performed claim edits to ensure accuracy.
Confirm credit balances and gathers necessary documentation for processing refund.
Applies appropriate discounts / courtesies based on department policy.
Monitor invoice activity until problem is resolved.
Identifies and escalates non-standard appeals to a higher level specialist.
Revenue Cycle SBU Billing Specialist III at Carle Home Infusion and Specialty PhamacyRevenue Cycle SBU Billing Specialist III at Carle Home Infusion and Specialty Phamacy