Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. On top of my 10 years of experience in AR, I have also simultaneously been a bartender at Wicked Weed Brewing along side my professional career.
Assigned to specialized team designated to address denials for United Health Care and all affiliates. Review high dollar accounts with expected reimbursement of $50,000.00 and above. Review claim denials issued by payers, including but not limited to, medical necessity, no prior authorization, timely filing, and any coding related denials. Submit detailed appeals for the applicable denials while utilizing specific contract language to assist in overturning the denial. Coordinated with various departments when additional information was required for a successful resolution of an appeal. Consistently meet company production standards while also maintaining quality. Adhere to company Codes of Conduct.
Oversaw AR for largest practice in the company billing out more than 1 million claims per month. Addressed and corrected claim rejections. Followed up with insurance companies regarding the processing of claims. Composed and submitted appeals to insurance carriers if applicable. Reviewed and approved refunds to be issued to insurance. Maintained aging AR greater than 60 days at 5% or under. Researched and resolved inquiries made by Practice Management, Physicians, and patients. Resolved billing issues raised by patients in a timely manner. Provided excellent customer service when responding to inquiries about invoicing or payment status. Assisted in streamlining accounts receivable process by identifying areas for performance improvement.
Reviewed/addressed all claim denials issued by insurance. Followed-up with insurance carriers regarding processing of claims. Posted insurance payments and adjustments to accounts. Reviewed and approved/denied chargebacks and refund requests. Prepared monthly aging reports of all outstanding receivables for management review. Processed incoming checks, money orders, and other forms of payment received from patients. Collaborated with accounting team members on special projects as needed. Created standard operating procedures and training workbook for new employees.