Avis C. Bostic
Clearwater,FL
Summary
Dedicated and knowledgeable professional with diverse expertise in healthcare, finance, and insurance industries. Extensive experience in the service field facilitates adept management of multiple projects simultaneously, ensuring timely completion. Proven ability to navigate complex challenges while delivering high-quality results. Committed to leveraging skills and knowledge to drive organizational success and enhance client satisfaction.
Overview
14
14
years of professional experience
Work History
Technical Lead/ Resolution Specialist I (Federal)
Optum/Formerly Tymesic
10.2011 - 03.2014
- Assisted with Pharmacy Operations teams as the Tier-1 support for escalations, pharmacy management and/or Front Range systems.
- Worked with all entities of Optum on adding /or correcting physician information and NDC pricing.
- Worked with Optum’s Operational Teams to capture, document & communicate outstanding payment or pricing disputes.
- Assisted with gathering weekly and monthly business unit KPI data used by the Pharmacy Operations team for reporting and improving overall performance.
Retro Specialist
Priority Care Solutions
04.2014 - 10.2014
- Analyzed requests from Network Providers, and Payers for unauthorized and/or retro dates of service.
- Analyzed requests to determine needed service based on the Injured Workers ICD-9 Code and HCPC, L-Code CPT Code of service.
- Negotiated with Providers using Medicare Allowable Usual & Customary or State Fee Schedule to determine a reduced rate for goods and services performed.
Sr. Customer Service Representative
United Health Group/Optum
11.2014 - 12.2020
- Managed incoming customer inquiries regarding Retiree Reimbursement and Health Savings Accounts.
- Worked with specialized divisions to promptly resolve reimbursement inquiries.
- Informed and educated new customers regarding billing invoices set up and billing payment procedures.
Case Coordinator
Ascellus Behavioral Health
12.2020 - 2024
- Review complex treatment notes to maintain engagement and monitor progress of patient care.
- Facilitate the effective and efficient management of case referrals assigned through all phases.
- Ensure all relevant data is received and entered into the appropriate database. Process the referral and select the appropriate provider. Schedule and monitor appointments including teleconferences for each referral until discharge.
- Build effective and supporting relationships with network physician/providers and referral sources (i.e., insurance companies, legal professionals, and other medical providers), supporting them throughout the referral and treatment process within Ascellus protocols.
- Communicate issues with new referrals for effective resolution, including those requiring escalation. Complete monthly Case Coordination file review note.
- Maintain dashboard to current date daily and performs effective Case Coordination for a workload of at least 50-60 referrals at any time.
Patient Customer Service and Collection Specialist
Solaris Health
07.2024 - Current
- Oversee patient accounts, verify and ensure the accuracy of accounts receivable (AR).
- Contact patients to collect outstanding payments.
- Research and resolve patient billing inquiries.
- Accurately document all actions taken to reconcile outstanding balances.
- Communicate with patients and insurance companies to resolve billing issues.
- Ensure compliance with federal and state regulations.
- Explain Care Credit to patients and encourage them to apply to resolve their balance in a timely manner.
- Help patients create reasonable payment plans that suit their needs and support the financial health of facility.
- Provide accurate customer service to patients and insurance companies.
- Prepare specialized invoices and information as needed.
- Prepare accurate files to send to the collection agency.
- Verify patient demographics and update registration as required.
- Performs other position related duties as assigned.
- adhere to high standards of ethical conduct and comply with all applicable laws and regulations.
Education
High School Diploma -
Dixie Hollins
St. Petersburg, FLBachelor of Arts - Interdisciplinary Science
USF
TampaSkills
- Experienced with Veridigm software
- Experience with Phreesia solutions
- CareCloud software expertise
- Experience with Instamed
- Experience with EHR clinical systems
- Skilled in collaboration tools and email communication ( Teams)
- Proficient in MS Office
- Biocore expertise
- Proficient in AWD systems
- Proficient in ISET
- Fiserv
- Rodeo
- ITI Citrix
- AccTerm/PICK
- AS400
Timeline
Patient Customer Service and Collection Specialist
Solaris Health
07.2024 - Current
Case Coordinator
Ascellus Behavioral Health
12.2020 - 2024
Sr. Customer Service Representative
United Health Group/Optum
11.2014 - 12.2020
Retro Specialist
Priority Care Solutions
04.2014 - 10.2014
Technical Lead/ Resolution Specialist I (Federal)
Optum/Formerly Tymesic
10.2011 - 03.2014
High School Diploma -
Dixie Hollins
Bachelor of Arts - Interdisciplinary Science
USF