Carolyn Andrew
Manchester,NH
Summary
Dynamic Medicare Patient Account Representative with a proven track record at Catholic Medical Center for enhancing revenue recovery and reducing aged receivables through meticulous audits and effective follow-up with insurers. Skilled in medical billing and exceptional at fostering patient and provider relationships. Demonstrates unparalleled attention to detail and customer service excellence, ensuring high standards of financial and operational efficiency.
Professional with proven expertise in patient account management and revenue cycle operations. Adept at resolving billing issues, ensuring accurate financial records, and maintaining compliance with healthcare regulations. Strong focus on team collaboration and achieving results, with flexible approach to adapting to changing needs. Known for excellent communication, problem-solving skills, and commitment to patient satisfaction.
Overview
18
18
years of professional experience
Work History
Medicare Patient Account Representative
Catholic Medical Center
05.2018 - Current
- Utilized computer programs to create invoices, letters and other documents.
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
- Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
- Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
- Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
- Electronically submitted bills according to compliance guidelines
- Followed up on all denials in a timely manner
- Billed out claims to insurance carriers everyday both on paper and electronically
- Followed up on all Hospice, Skilled Nursing Home and Home Health claims for payment.
MCO Provider Representative
Conifer Health Solutions
03.2016 - 05.2018
- Established strong relationships with healthcare providers, fostering trust and loyalty between parties.
- Cross-trained and provided backup support for other payers
- Worked on denials and follow up daily to get claims paid
- Sent out Appeals daily on Medical denials for MCO accounts.
- Monitored High dollar accounts so that the AR was not out of control
- Worked with coding to make sure claims were coded correctly after denial
- Worked on Epic System
Medicare Provider Contact Center Representative
National Government Services, Inc
03.2007 - 03.2016
- Increased first call resolution rates by utilizing comprehensive product knowledge and problem-solving skills.
- Maintained detailed records of customer interactions, ensuring accurate documentation for future reference.
- Navigated multiple software applications simultaneously, ensuring accuracy and efficiency in handling customer inquiries.
- Provided exceptional customer service by actively listening to inquiries and offering personalized solutions.
- Reduced handle time by quickly identifying customer needs and providing accurate information.
- Managed high call volume while remaining focused on delivering excellent customer experiences.
- Maintained up-to-date knowledge of product and service changes.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Met customer call guidelines for service levels, handle time and productivity.
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
Education
Associate of Science - Computer Programing
Keene State College
Keene, NH05-1982
Skills
- Medical Billing
- Follow-up skills
- Data entry proficiency
- Payment Processing
- Hospital operations
- Organizational Skills
- Attention to Detail
- Customer Service
- Multitasking
- Knowledge of EOB's , 1500Form, UB04 Form, Part A and B Claims, Appeals and Audits, DME Claims and Reopening's
Timeline
Medicare Patient Account Representative
Catholic Medical Center
05.2018 - Current
MCO Provider Representative
Conifer Health Solutions
03.2016 - 05.2018
Medicare Provider Contact Center Representative
National Government Services, Inc
03.2007 - 03.2016
Associate of Science - Computer Programing
Keene State College
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