Dedicated administrative professional with successful experience in fast-paced office settings. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision.
Entered client details and notes into system for interdepartmental access and review.
Researched billing errors and discrepancies to initiate corrective action.
Maintained strict compliance with federal regulations and industry best practices to ensure ethical collection practices at all times.
Performed collections activities for multiple Medical Plans, prioritizing follow-up actions, and making informed decisions regarding payer updates, rebills, and invoice credits
Enhanced collections efficiency by implementing strategic plans and procedures to optimize revenue recovery.
Excellent communication skills, both verbal and written.
Worked effectively in fast-paced environments.
Adaptable and proficient in learning new concepts quickly and efficiently.
Sr. Collections Consultant
Healthcare Provider Solutions
02.2020 - 07.2021
Used critical thinking to break down problems, evaluate solutions and make decisions.
Self-motivated, with strong sense of personal responsibility.
Reviewed provider/payer contracts for remittance advice discrepancies or denials
Demonstrated respect, friendliness and willingness to help wherever needed.
Organized and detail-oriented with strong work ethic.
Communicated frequently with insurance payors and clients to resolve claim denials in timely manner
Posted Payments: Medicaid, Medicare, patient, and facility payments
Completed monthly payment posting reconciliation
Complete appeals for upheld denials- Providing all necessary documentation to Medical Plan, as proof of proper billing
Revenue Cycle Supervisor
Mental Health Cooperative
12.2015 - 11.2019
Promoted to Billing Supervisor after first year of employment
Excellent communication skills, both verbal and written.
Paid attention to detail while completing assignments.
Identified issues, analyzed information and provided solutions to problems.
Updated and corrected demographic information to facilitate smooth billing operations.
Served as subject matter expert on reimbursement regulations, maintaining up-to-date knowledge of industry best practices and compliance requirements.
Provided exceptional customer service by addressing billing questions and concerns in timely, professional manner.
Verified eligibility, authorizations, and plan coverage specifications to ensure accurate billing
Managed accounts receivable aging, ensuring timely follow-up on outstanding balances and prompt resolution of discrepancies.
Senior Reimbursement Specialist
Verus Healthcare, LLC
04.2014 - 11.2015
Promoted to Senior level in 6 months because of ability to produce results
Maintained confidentiality of patient finances, records, and health statuses.
Worked effectively in fast-paced environments.
Identified issues, analyzed information and provided solutions to problems.
Organized and detail-oriented with strong work ethic.
Paid attention to detail while completing assignments.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Insurance Representative
Ducklo EyeCare
10.2011 - 03.2014
Proven ability to learn quickly and adapt to new situations.
Skilled at working independently and collaboratively in team environment.
Manually filed vision exams and materials claims via vision insurance portals
Investigated and processed claims swiftly to ensure most efficient reimbursement turn around times
Posted insurance and patient payments
Answered incoming calls and routed to appropriate departments
Prepared patient charts and obtained authorizations for upcoming appointments
Billing Representative
Tennessee Retina, PC
08.2002 - 10.2011
Used data entry skills to accurately document and input claims.
Worked with multiple departments to check proper billing information.
Keyed multiple physicians encounter forms within system, daily, ensuring accuracy for electronic claims submission
Contributed to company revenue growth by identifying potential billing errors
Analyzed insurance remittances to determine denial codes
Surgical Coordinator
Tennessee Retina, PC
Maintained accurate office and procedural appointments and promptly addressed any changes or concerns.
Completed paperwork, recognizing if discrepancies and promptly addressing for resolution.
Maintained strict adherence to HIPAA regulations, protecting privacy of patient information at all times.
Performed various administrative tasks by filing, copying and faxing documents.
Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Communicated daily with patients, hospitals, providers and staff to schedule surgical procedures or make changes as necessary
Verified insurance coverage and obtained pre-authorizations.
Provided comprehensive education materials for patients regarding their upcoming surgery, answering questions and alleviating concerns related to procedure itself or recovery expectations afterward.
Updated patient records to reflect upcoming surgeries and medical histories.
Coordinated with facilities to set up surgeries for 8 Retina Specialists
Front Desk Coordinator
Tennessee Retina, PC
Updated client records accurately and efficiently, ensuring data integrity within system.
Scheduled patient appointments in computer system.
Oversaw daily clinic flow and delegated tasks to employees
Handled assignments independently with good judgement and critical thinking skills.
Verified patient demographic information, copied documentation and directed to provided information.
Collaborated with team members to address patient needs and ensure seamless operations.
Prepared weekly employee work schedules to meet operational needs.
Answered multi-line phone system and enthusiastically greeted callers.
Trained staff on front desk procedures and policies.
Education
General Studies
Middle Tennessee State University
Murfreesboro, TN
General Office Services
Nashville State Community College
Nashville, TN
Skills
Professionalism and Confidentiality
Documentation and Recordkeeping
Data Entry Efficiency
HIPAA Compliance
Problem-Solving
Clerical Support
Payer/provider contract understanding
Customer service
Patient and insurance billing/collections
Accounts receivable
Remittance advice analysis
Account management
Process improvement
Corrected claims and appeals
Cash posting
Electronic billing
Microsoft Office
Insurance website portal access and migration
Various practice management systems (eClinicalWorks, Waystar, Change Healthcare, Availity, SalesForce, OnBase, PeopleSoft, Brightree, Wellsky, TIER, My Vision Express)