Arvette Herston
Conley,Georgia
Summary
Results driven Medical Biller with over [2] years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
14
14
years of professional experience
Work History
Billing Coordinator
Chris180
Atlanta, GA
03.2022 - Current
- Performed insurance verification, pre-certification and pre-authorizations
- Implements the concepts of required clinical documentation and medical necessity
- Checked claims coding for accuracy with ICD-10 standards
- Posted and managed patient account payments
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections
- Reconciled codes against services rendered
- Provided support for internal departments regarding billing inquiries
- Worked with team members and leadership to identify and develop process improvements
- Reconciled financial accounts using NetSmart My Evolv, Inovalon RevConnect, CareLogic, EverNorth Cigna, EPIC Kaiser, GAMMIS, Availity, Availity RCM, Waycross, Provider Connect, and other insurance portals to determine eligibility, submit authorization requests and submit/reconcile claims
- Researched and resolved billing inconsistencies and errors through individual and collaborative analysis
- Contacted insurance providers to verify insurance information and obtain billing authorization
- Submitted appeals on behalf of patients for denied claims
- Completed billing audits in identified timeframes to report and investigate findings
- Managed daily operations for billing department handling $[50,000] per month in payments.
- Created and maintained accurate customer records in database system.
- Completed documentation, reports and spreadsheets of financial information.
- Kept up-to-date with details of insurance plans and company requirements.
- Maintained up-to-date knowledge of all applicable laws related to billing activities.
- Enforced compliance with organizational policies and federal requirements regarding confidentiality
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology
Medical Biller & Coder (Extern)
First Medical Care
Decatur, GA
09.2021 - 11.2021
- Entered patient insurance, demographic and health information into software and confirmed records.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Adhered strictly to HIPAA guidelines when handling confidential patient information.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
Front Desk Associate
LaQuinta Inn by Wyndham
Hapeville, Georgia
10.2020 - 08.2021
- Ensure that the OPM and GM are fully aware of any relevant feedback from guests and other departments
- Support team members in handling guest requests and inquires to ensure a positive outcome is achieved
- Assist guests with check in/out process while following and adhering to company brand standards
- Verify guests ID, establish method of payment, and ensure accurate and prompt collections
- Generate daily reports, and perform audit processes at the beginning and end shifts.
Front Desk Supervisor
Hampton by Hilton Southlake
Morrow, Georgia
01.2019 - 08.2020
- Managed account and financial reporting for hotel with $70,000 monthly income
- Supervised day-to-day financial duties for the company
- Processed payments and reconciliations, including money orders, cashier's checks, and credit card payments
- Matched purchase orders, expense reports and/or receipts with monthly credit card statements.
Customer Service Representative
Logisticare
College Park, Georgia
08.2018 - 01.2019
- Scheduled; modified and cancelled reservations as requested
- Obtained and documented relevant details of complaints
- Maintained a polite and courteous manner at all times
- Referred unresolved customer grievances to designated departments for further investigation and resolution.
Senior Service Agent/Trainer
Hilton Garden Inn-Millennium
College Park, Georgia
07.2017 - 08.2018
- Handled a heavy inbound and outbound call volume to set up reservations; serviced their needs and addressed all issues concerning their stay
- Processed corrections on direct billing reservations and ensured correct codes were posted to guest folios
- Trained Team members as requested by management
- Reconciled discrepancies and adjusted guests folios when needed.
Guest Service Agent/Night Auditor
Hotel Indigo
College Park, Georgia
12.2015 - 06.2017
- Carried out responsibilities as Manager on Duty during night shifts - supervising overnight staff
- Nightly revenue reconciliation of room and all other revenue sources
- Addressed all guest concerns and delegated to staff as necessary
- Prepared and sent out direct bill packets for hotel credit clients
- Reconciled hotel bank deposits to what was recorded in property management system.
Guest Service Agent
Country Inn and Suites
Newnan, Georgia
12.2009 - 12.2015
- Checked in and out hotel guests in a confident, professional and friendly manner
- Aided during guest registration and departure
- Assisted guests with questions and billing issues.
Education
Medical Billing and Coding Diploma -
HapevilleLaQuintaAltierus Career College
Norcross, GA01-2022
Skills
- Productivity & Adaptability
- ICD-10 / CPT / HCPCS Coding
- Medical & Insurance Terminology
- Electronic Medical Records
- Claims Processing
- Denial & Appeals
- Collections Management
- Medicare / Medicaid / Private Insurance
- Collections & Account Receivables
- Data Entry / 10-Key
- Aging Report & Payment Posting
- Medical Records Management
- Insurance Verification
- Appointment Scheduling
- MS Office Suites
- Patient Confidentiality
- CMS1500
- EOB Interpretation
- Education & Certifications
Maintain Personal Information And Training
- Attend and participate in staff meetings as scheduled
- Attend and participate in required trainings as scheduled
- Maintain any required certifications
- Review, understand and responsible to program policies
- Provide documents in a timely fashion to Human Resources
- Report changes in status to HR as required by policy
Performance And Conduct
- Maintain confidentiality of consumer information
- Maintain appropriate professional boundaries
- Follow CHRIS180 Code of Ethics
- Follow mandated reporting requirements of the GA Code
- Support and maintain an environment of emotional and physical safety for consumers, and staff at all times
Documentation Requirements
- Timely documentation in accordance with billing guidelines - 90-120 day policy
- Adhere to organization policies and procedures
Timeline
Billing Coordinator
Chris180
03.2022 - Current
Medical Biller & Coder (Extern)
First Medical Care
09.2021 - 11.2021
Front Desk Associate
LaQuinta Inn by Wyndham
10.2020 - 08.2021
Front Desk Supervisor
Hampton by Hilton Southlake
01.2019 - 08.2020
Customer Service Representative
Logisticare
08.2018 - 01.2019
Senior Service Agent/Trainer
Hilton Garden Inn-Millennium
07.2017 - 08.2018
Guest Service Agent/Night Auditor
Hotel Indigo
12.2015 - 06.2017
Guest Service Agent
Country Inn and Suites
12.2009 - 12.2015
Medical Billing and Coding Diploma -
HapevilleLaQuintaAltierus Career College
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