Candace Ogden
Clarkston,WA
Summary
Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. Organized Medical Biller boasts 10-year career performing difficult multitasking and claims-processing tasks.
Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers and clients to handle invoicing within high-traffic office environment.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Biller
Tri-State Memorial Hospital
Clarkston, WA
07.2022 - Current
- Submit electronic claims to various insurance carriers.
- Assess medical codes on patient records for accuracy.
- Review received payments for accuracy and applied to intended patient accounts.
- Working to improve overlap charges for Medicare for best practice.
- Assessed medical codes on patient records for accuracy.
- Reviewed received payments for accuracy and applied to intended patient accounts.
Medical Biller, Accounts Receivable
Garfield County Hospital and Clinics
Pomeroy, WA
07.2021 - 07.2022
- Obtained remittance advices to upload to Athena for posting.
- Prepared daily deposit working closely with Accounts Payable.
- Checked patients in for outpatient services.
- Processed credit card payments and other forms of payment received from patients or insurance companies.
- Adhered strictly to HIPAA regulations when handling confidential patient information.
- Prepared financial reports related to accounts receivable activity.
- Tracked aging reports of unpaid claims and took corrective action when necessary.
- Analyzed medical coding issues, identified errors, made corrections, and followed up with insurance providers on denied claims as necessary.
- Reconciled daily deposits with bank statements and posted payments into appropriate accounts.
- Performed data entry functions for entering new patient information into the system.
- Monitored delinquent accounts by sending collection letters and making phone calls to resolve outstanding balances due.
- Maintained records of all billing activities in a timely manner.
- Assisted in month-end closing procedures including preparing journal entries for accruals, adjustments.
- Provided customer service to both internal and external customers regarding billing inquiries.
- Verified accuracy of account information and processed adjustments as needed.
- Ensured compliance with applicable laws, regulations and company policies regarding billing practices.
- Audited patient files for accuracy prior to submitting claims to ensure maximum reimbursement rates were obtained.
- Resolved discrepancies on patient accounts by contacting the insurance companies or patients.
- Attended training sessions related to billing practices or updates from insurance carriers.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Handled billing, waivers and claims for private and commercial clients.
- Managed all payments processing, invoicing and collections tasks.
- Answered customer questions to maintain high satisfaction levels.
- Submitted claims to insurance companies.
- Performed insurance verification, pre-certification and pre-authorization.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
- Maintained accounting ledgers by verifying and posting account transactions.
Business Office Lead
Catalyst Medical Group
Lewiston, ID
06.2014 - 07.2021
- I billed all worker's compensation payers, Washington Medicaid, Idaho Medicaid, VA, All Blue plans, Aetna, First Choice, Crime Victims, Cigna, Kaiser Permanente of WA and OR, Allied Benefits, Providence Health Plans, ect...
- Organized and detail-oriented with a strong work ethic.
- Operated office equipment, such as copy machine, scanner and printer
- Prepared written memos for staff distribution
- Sorted and distributed business correspondence to correct department or staff member
- Maintained employee appointment calendar using MS Outlook
- Tracked and approved employee's time off
- Answered phone and routed calls to appropriate team members
- Counted and reconciled petty cash log to support accounting department
- Completed various reports and analyzed each report to decide where improvements could be made
- Created and updated spreadsheets
- Tracked outgoing and incoming money
- Enforced company policies, answered coworkers' questions and trained new personnel
- Coached team on company policies, procedures, and best practices to enhance operational efficiency, employee productivity and subsequently decrease labor costs
- Volunteered with ERC committee to support employees during hard times
- I can cover every position in the business office at Catalyst Medical Group
- I have been the business office lead for 2 1/2 years.
- Submitted electronic claims to various insurance carriers.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Applied HIPAA privacy and security regulations while handling patient information.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Performed daily reconciliation of accounts receivable with payment postings on the computer system.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Assisted in auditing process by verifying accuracy of submitted claim forms against documentation provided by physicians' offices.
- Maintained accurate records of all billing activity in accordance with departmental standards.
- Processed refunds requests timely and accurately according to established protocols.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Compiled and processed data for billing purposes utilizing billing software programs.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Input details into accounts and tracked payments.
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Provided training and support to new staff members regarding billing processes.
- Handled billing, waivers and claims for private and commercial clients.
- Organized information for past-due accounts and transferred to collection agency.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Generated reports in order to track payments due from insurance companies or other third party payers.
- Collaborated with managers to develop strategies for improving revenue cycle processes.
- Prepared detailed financial reports as requested by management team.
- Answered customer questions to maintain high satisfaction levels.
- Managed all payments processing, invoicing and collections tasks.
- Collected, posted and managed patient account payments.
- Submitted claims to insurance companies.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Performed insurance verification, pre-certification and pre-authorization.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
- Maintained accounting ledgers by verifying and posting account transactions.
- Checked claims coding for accuracy with ICD-10 standards.
- Input statement information, reconciled accounts and resolved discrepancies.
- Developed strong professional rapport with vendors and clients.
- Reconciled codes against services rendered.
- Office lead for 11-13 employees.
- Tracked employees time off requests and submitted timecards for all Business Office employees.
- Brought in all charges for entire clinic every morning.
- Created spreadsheet to submit to Phoenix Radiology for outside radiology readings.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Worked well in a team setting, providing support and guidance.
- Learned and adapted quickly to new technology and software applications.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Applied effective time management techniques to meet tight deadlines.
- Paid attention to detail while completing assignments.
- Proved successful working within tight deadlines and a fast-paced environment.
- Skilled at working independently and collaboratively in a team environment.
- Resolved problems, improved operations and provided exceptional service.
- Managed time efficiently in order to complete all tasks within deadlines.
Food Service Worker
Arby's
Lewiston, ID
12.2005 - 03.2015
- Received food orders from individuals and explained offerings
- Monitored inventory and promptly reported food items requiring reorder
- Controlled portion sizes and garnishing for optimal cost controls
- Kept food storage and preparation equipment in good working order to maximize safety and cost-efficiency of operations
- Checked and recorded refrigerator and freezer temperatures daily to verify proper working conditions
- Operated cash register to process cash, check and credit card transactions
- Maintained order and cleanliness of work areas to conform with health codes
- Cleaned and sanitized work areas, equipment, utensils, dishes and silverware
- Performed prep work such as washing, peeling, cutting and seeding fruits and vegetables
- Sought out and implemented methods to improve service and team performance to boost business sustainability
- Cross-trained in other kitchen positions to support team and meet customer needs
- Carried pans, kettles and trays of food to and from work stations, stove and refrigerator.
Education
Associate of Applied Science - Administrative Medical Assistant
Lewis Clark State College
Lewiston, ID06-2014
Educational Opportunity Center
Skills
- Ability to analyze reports
- Customer service
- Team building
- Active listening
- Computer skills
- Microsoft Office
- Decision-making
- Patient relations
- Supervision
- Organization
- Submission of medical claims
- Data entry
- ICD-10 coding
- Claim review
- Reimbursements
- Insurance claims
- CPT code modifiers
- Training and development
- Medical coding understanding
- Account management
- Billing codes
- Insurance collections
- Knowledgeable in Centricity
- Quick learner
- Time management
- Claims Processing
- Claims Review
- Billing and Collection Procedures
- Commercial and Private Insurance
- Multitasking and Organization
- Teamwork and Collaboration
- Account Follow-Up
- Work Prioritization
- Insurance Verification
- Proficiency in [Software]
- Medical Billing
- Accounts Receivable
- Medicaid and Medicare Knowledge
- Insurance Billing
- Patient Billing
- Worker's Compensation Knowledge
- ICD-10
- Payment Posting
- HIPAA Compliance
- Insurance Collections
- Claim Review
- Centricity, Athena, Meditech, and Experian Use
- Insurance Claims
- Submission of Medical Claims
- CMS-1500 Billing Forms
- Medical Coding Understanding
- Medical Terminology
- Electronic Claims
- Insurance Claims Processing
- ICD-10 Coding
- Critical Thinking
- Customer Service
- Knowledgeable in excel, and word
- Billing Codes
- Patient Collections
Certification
- In the process of obtaining CRCR certificate through HFMA.
Training
- Completed EMTALA 4 hour training class
- Completed MOAB (Management of Aggressive Behaviors) 4 hour training.
- Accepted on SPARC committee at Tri-State Memorial Hospital.
Timeline
Medical Biller
Tri-State Memorial Hospital
07.2022 - Current
Medical Biller, Accounts Receivable
Garfield County Hospital and Clinics
07.2021 - 07.2022
Business Office Lead
Catalyst Medical Group
06.2014 - 07.2021
Food Service Worker
Arby's
12.2005 - 03.2015
Associate of Applied Science - Administrative Medical Assistant
Lewis Clark State College
Educational Opportunity Center
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