Carla-Marie Weaver

To obtain a general position with a progressive organization that can utilize my administrative skills and abilities while providing a challenging environment with the opportunity for personal and professional growth and advancement.

• Senior Collector/Biller, 03/21/14, Current, Kindred Hospital DBA Scion Health, Stop Loss Claims, Billing for Inpatient rehabilitation patient (interims and Final billing), EOB and Correspondence follow-up (Payments, Denial and Underpayment), Researches and adjust all request for underpayment, process and calculate the overpayment and refunded back to insurance also contract issues to ensure compliance with department and company policies and procedures., Adjusts claims/appeals and responds to providers in timely manners, Interprets and properly applies provider contract, HMO, PPO, POS, Managed Care, Workers Compensation contract and LOA Agreements.
• Patient Account Representative, 05/01/11, Current, Cymetrix Healthcare, Responsible and In-charge for all High Dollars accounts: Stop-Loss, Variances and Denial accounts, as well Mom and Baby claims; Underpayment and Workers Compensation claims; using the correct Contract rates between the Facility and Insurance Company.
• Patient Account Representative, 05/29/08, 04/14/11, Anthelio Health (formerly PHNS), Cerritos, CA, Billing Collection for Cedar Sinai Medical Center and HCA, Managed a high-volume workload within a deadline-driven environment., Resolved an average 35-50 account in day depend on the account issue, EOB reviewer (underpayment, appeal, stop-loss and Mom/Baby Claims), Artiva, On Base, Synergy and Corporate Etran and Epic system
• Patient Account Representative, 12/01/04, 05/29/08, Permanent, Olympia Medical Center, Los Angeles, CA, Responsible for manage care collection, billing and appeal on Mid-high dollars and low balance patient account and In charge of all Capitation account thru Olympia Medical Center., Reviewing all the explanation of Benefits for Capitation account., In charge of Accruals for Capitation Account for End of the Month., Dealing with the patient account services., Identifying underpayment or adjustment due to system calculation.
• Patient Account Representative, 02/2004, 12/01/04, Tenet Health System, Westminster, CA, Responsible for managed care collections, billing and appeal on Mid-high dollars balance patient accounts., Trouble shooting account and identifying underpayments or adjustment due to system calculations., Insurance follow-up., Preparation and resolution of managed care insurance claims, including but not limited to: claims follow-up, billing and appealing.