Catherine Wallace

Communicated with insurance providers to resolve denied claims and resubmitted.

• Precisely evaluated and verified benefits and eligibility.
• Precisely completed appropriate claims paperwork, documentation and system entry.
• Determined prior authorizations for medication and outpatient procedures.
• Communicated effectively and extensively with other departments to resolve claims issues.
• Located errors and promptly refiled rejected claims.
• Prepared billing correspondence and maintained database to organize billing information.
• Filed and updated patient information and medical records.
• Delivered timely and accurate charge submissions.
• Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
• Gathered information from multiple sources to simplify billing and organize accounts.
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

• Request and process medical records from hospital contacts
• Follow up on concurrency irregularities.
• Oversee client service representatives, assisting with and resolving any escalated issues.
• Responsible for providing weekly reports on team metrics.
• Review accounts with collection agencies.
• Coordinate patient requests and status updates.
• Resolve issues with third party groups, Expecteds, Dictionary, and Ajuba assist clients and patients.

• Manage the anesthesia claim submission process to Medicare, Medicaid, and commercial payers.
• Responsible for sending Electronic Data Interchange (EDI) transactions to GE Centricity, including corrections and re-spooling as necessary.
• Balanced billing to secondary and tertiary insurance with correct primary insurance.
• Processed and posted credit card payments taken by phone.
• Answered patient calls and assisted with overall concerns.
• Managed delinquent accounts including collections.