Results driven Medical Biller with over 25 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Work History
Lead Payment Poster
Boston Baskin Cancer Foundation
Memphis, TN
06/2/08 - 08/20/15
Posted payments for insurance companies, including Medicare and Medicaid, by accurately entering data into the system.
Balanced daily cash postings with deposits to ensure accuracy of information entered into the system.
Assisted in resolving payment issues, such as rejections or delayed payments due to incorrect coding or missing information.
Researched discrepancies between patient accounts and remittance advice received from insurance carriers.
Developed detailed reports on benefits utilization, costs, trends and variances.
Drafted policy documents related to benefit offerings and communicated updates to management teams.
Compiled data from multiple sources into comprehensive reports outlining current benefit program information.
Conducted regular audits of benefit programs to identify areas for improvement and cost savings.
Reimbursement Specialist
Semmes-Murphey Clinic
Memphis, TN
04/01/04 - 05/20/08
Reviewed and processed reimbursement requests in accordance with company policies and procedures.
Performed monthly audits for accuracy of claims submitted for payment.
Generated reports summarizing daily activity related to reimbursements and payments.
Investigated complex cases involving multiple providers or incorrect coding issues.
Analyzed patient data to ensure accuracy of reimbursement information.
Maintained a database of all reimbursements, payments, and other transactions.
Responded to customer inquiries regarding the status of their reimbursement requests.
Revenue Recovery Specialist
Methodist Le Bonheur Hospital
Memphis, TN
09/08/15 - Current
Reviewed insurance claims for accuracy and completeness, ensuring that all required information was present.
Resolved discrepancies between charges on invoices and those billed to the insurance company.
Validated policyholder eligibility for coverage of services rendered.
Submitted appeals to insurance companies when necessary.
Interpreted Explanation of Benefits documents from various insurers.
Provided timely follow-up on unpaid claims to ensure prompt resolution of issues causing delays in reimbursement.
Developed strategies for minimizing denials and improving collections processes.
Analyzed provider contracts and fee schedules to determine appropriate reimbursement rates for services provided by healthcare providers.
Participated in meetings with other departments to discuss ways to improve workflow processes related to insurance billing activities.
Submitted claims to insurance companies.
Assisted in the preparation of financial reports related to revenue recovery activities.
Reconciled accounts receivables data with general ledger postings on a monthly basis.
Education
Bachelor of Science - Business Administration And Management
Bethel University
Mckenzie, TN
Skills
HIPAA Compliance
Payment Posting
Insurance Verification
Verbal Communication
Excel
Managing and creating Worksheets
Data Analysis
Timeline
Bachelor of Science - Business Administration And Management
Secretariat/Secretaria/Receptionist Assistant at Gogo Foundation Pediatric Cancer FoundationSecretariat/Secretaria/Receptionist Assistant at Gogo Foundation Pediatric Cancer Foundation
Executive Assistant to the Chief Executive Officer at The V Foundation for Cancer ResearchExecutive Assistant to the Chief Executive Officer at The V Foundation for Cancer Research