CARMEN SIMPSON
Heartland,TX
Summary
Hard-working and resourceful medical claims representative with an excellent healthcare education, is seeking opportunities to continue career with a proven organization. Possess strong leadership skills and a keen ability to build trust within the team dynamic. Display uncompromising integrity and consistency, while exceeding targeted results. Competently communicate with clients, peers and management to increase cooperation/collaboration of ideas. Type 45 words per minute with 10-key skills.
Overview
19
19
years of professional experience
Work History
Senior Credit Balance AR Analyst
Optum 360
Irving, Texas
01.2017 - Current
- Daily AR Functions; post check payments, balance cash reconciliations, etc
- Special projects as assigned
- Audit and provide trend report Financial Activity
- Research self-pay credit balances and prepare for check refunds, refund of credit/check payments through current system as required or transfer payments to open accounts
- Provide oversight, training and support to the Credit Balance Specialist.
Patient Care Coordinator
Strive Medical
Irving, Texas
01.2015 - 01.2017
QC Billing Specialist / Auditor
Mortgage Specialist, Inc.
Hurst, Texas
01.2014 - 01.2015
- Audit billing invoices
- Check invoices for accuracy, while ensuring records are in compliance with guidelines/requirements for multiple mortgage clients
- Verify, compile and type application information for mortgage loans, revise billing errors and review photos to ensure vendors remain in compliance
- Accurately process, verify, balance and adjust billing/accounts payable transactions.
Call Center Representative/Retention Specialist
Terminix
Lewisville, Texas
01.2010 - 01.2014
- Ensure appropriate changes are made to resolve customer issues, while keeping records of customer interactions and transactions, recording details of inquiries, complaints and comments, as well as actions taken
- Resolve customer service/billing complaints by exchanging merchandise, refunding money and adjusting bills.
Accounting Clerk
Ambit Energy
Dallas, Texas
01.2010 - 01.2012
- Handled calculating, posting and verifying of duties to obtain financial data and maintain accounting records, while executing daily operations of customer services assistance regarding personal accounts.
Intake Claims Representative - Managed Health Network
Kelly Services
Irving, Texas
01.2009 - 01.2010
- Compared computer printouts to manually maintained journals to ensure matching, resolved phone inquiries concerning claim status and handled all claims reprising, medical billing and coding and provider inquiries
- Checked figures, postings and documents for correct entry, mathematical accuracy and proper codes
- Researched and recommended payment options, secured and added missing data, reviewed insurance policies to determine coverage and accurately calculated amount of claim
- Audited processing production workers' activities to verify conformance of activities to quality assurance.
Disability Claims Specialist
Sedgwick Claims Management Services
Irving, Texas
01.2005 - 01.2009
Education
Medical Office Billing Specialist Diploma -
Ultimate Medical Academy
01.2014
BA - Business Management -
South University - Atlanta, GA
01.2012
Skills
- Medical Billing
- Medical Administrative
- Patient Registration
- Medical Terminology
- Charge Entry
- Insurance Verification
- Reimbursement Systems
- Medical Basics and Healthcare Claim Cycle
- Healthcare Payers
- Medical Records Management for the Billing Specialist
- Referrals
- Accounts Receivable
- Greenway
- Electronic Medical Records (EMR)
- Electronic Health Records (EHR)
- Managed Care (HMO, PPO, and POS)
- Medicare / Medicaid Government Payers
- CPT Coding & ICD Coding
- Payment Posting
- Denials & Appeals
- HIPAA Compliance
- Medical Charts
- Basic Anatomy & Physiology
- Computer Systems and Software Applications for the Medical Office
- Payment reconciliation
- Microsoft Excel
- Invoice Processing
- Oracle Financials
- General Ledger
- Account Reconciliation
- Teamwork and Collaboration
- Multitasking
Timeline
Senior Credit Balance AR Analyst
Optum 360
01.2017 - Current
Patient Care Coordinator
Strive Medical
01.2015 - 01.2017
QC Billing Specialist / Auditor
Mortgage Specialist, Inc.
01.2014 - 01.2015
Call Center Representative/Retention Specialist
Terminix
01.2010 - 01.2014
Accounting Clerk
Ambit Energy
01.2010 - 01.2012
Intake Claims Representative - Managed Health Network
Kelly Services
01.2009 - 01.2010
Disability Claims Specialist
Sedgwick Claims Management Services
01.2005 - 01.2009
Medical Office Billing Specialist Diploma -
Ultimate Medical Academy
BA - Business Management -
South University - Atlanta, GA