Cora Tibbs
Fort Worth,TX
Summary
Medical billing and coding professional with extensive experience in healthcare administration. Proven expertise in accurately processing claims, ensuring compliance with regulations, and maintaining detailed patient records. Highly collaborative team member focused on achieving results and adapting to changing needs.
Overview
9
9
years of professional experience
Work History
Cash Poster
Fresenius Medical Care
Irving, TX
12.2021 - Current
- Posted routine electronic and manual cash receipts, adjustments, and denials, ensuring reconciliation of all posted data under general supervision
- Balanced electronic and manual cash receipts by generating and analyzing reports, resolving outstanding variances, errors, and issues
- Referred to assigned work lists to identify and resolve routine transactions within assigned functions, improving workflow efficiency
- Performed all responsibilities in compliance with company policies and procedures, maintaining audit readiness
- Assisted with various projects as assigned by direct supervisor, supporting departmental objectives
- Completed other duties as assigned, contributing to overall team effectiveness
Eligibility Representative
American Specialty Health
Fort Worth, TX
10.2019 - 06.2020
- Verified member eligibility using eligibility files, communications logs, health plan websites, or direct calls, ensuring accurate coverage determination
- Input and saved verified member information into communications log and/or member maintenance, maintaining data integrity
- Processed and completed research promptly to ensure turnaround times were met, supporting service level agreements
- Made follow-up calls to practitioners and members to provide research results, enhancing customer satisfaction
- Built or updated member and group records in ASH's proprietary claims processing system, including detailed documentation in notes
- Followed confidentiality guidelines to enforce security measures and protect proprietary information
- Maintained a minimum production level of 85 claims, 60 CSS/MNA, or 60 Ashlink requests per day with no less than 98% accuracy
- Assisted in multiple functions as needed, increasing team flexibility
- Participated in peer mentorship as needed, supporting team development
Front Desk Specialist
Alliance Rx Walgreen Prime
Irving, TX
03.2019 - 03.2020
- Scanned documents and saved them in a database to maintain accurate records of essential organizational information
- Maintained optimal quality levels to prevent critical errors and support team performance targets
- Added documents to file records and created new forms to support filing needs, improving document management
- Evaluated source documents to locate information needed for each data entry field, ensuring data accuracy
- Maintained confidentiality of patient finances, records, and health statuses, adhering to HIPAA regulations
- Tracked all pending authorizations to ensure timely resolution and avoid revenue loss
- Communicated effectively with staff, including members of operations, finance, and clinical departments, facilitating cross-functional collaboration
- Followed up on denials, late payments, extensions, and other exceptional circumstances to resolve outstanding issues
- Processed eligibility and benefits verification and authorization requests, expediting patient access to services
- Managed all front desk operations for a busy high-volume environment, ensuring smooth daily workflow
Biller/ Follower Up
Esha Inc
Fort Worth, TX
10.2017 - 10.2019
- Prepared and submitted clean claims to third party payers electronically or by paper, reducing claim rejections
- Maintained relationship with the clearinghouse, including appropriate follow-up with support issues to ensure timely claim processing
- Coordinated patient eligibility verification through various third-party sources, improving billing accuracy
- Coordinated collection process for Medisoft accounts and tracked current collections in eClinicalWorks, increasing collection rates
- Managed monthly statement process, reviewed statements before mailing, and fielded patient inquiries, supporting Patient Services staff as needed
- Coordinated and administered policy and procedure for sliding scale, ensuring compliance with organizational guidelines
- Worked with reception staff to ensure appropriate collection of co-pays, spend down, and self-pay fees, maximizing revenue capture
- Handled patient inquiries and answered questions from clerical staff and insurance companies, resolving issues efficiently
- Identified and resolved patient billing problems, improving patient satisfaction
- Managed denial and insurance follow-up, increasing successful claim resolutions
- Issued adjusted, corrected, and/or rebilled claims to third party payers, reducing outstanding balances
- Posted adjustments, transfer of responsibility, and refunds as necessary, maintaining accurate account records
- Assured coding compliance and kept records up to date, reducing audit risk
- Reviewed accounts and made recommendations to the Controller regarding non-collectible statements, supporting financial decision-making
- Maintained strictest confidentiality and adhered to all HIPAA guidelines/regulations
- Filed claims for Medicaid, Medicare, and commercial insurances, ensuring timely reimbursement
- Called insurance to check the status of claims, expediting payment resolution
- Reviewed and solved account and billing discrepancies, minimizing revenue loss
- Pursued and processed payments for outstanding balances, increasing cash flow
- Conducted monthly pre-billing review and data quality analysis to verify complete accuracy of invoices delivered to customers and providers
- Negotiated to collect balance in full, improving collection rates
- Processed payments and applied to customer balances, maintaining up-to-date account information
Education
Associate of Applied Science - Health Care Administration
Concorde Career Institute
Grand Prairie, TX01-2014
Associate of Applied Science - Medical Biller and Coder
The College of Health Care Professions
Houston, TX09-2021
High School Diploma -
Timberview High School
Arlington, TX06-2010
Skills
- Medical Terminology
- Coding Proficiency
- Billing Software
- Insurance Knowledge
- Revenue Cycle Management
- Regulatory Compliance
- Data Entry and Analytical Skills
- Attention to Detail
- Communication Skills
- Problem-Solving
- Time Management
- Organization
Additional Information
Authorized to work in the US for any employer
Timeline
Cash Poster
Fresenius Medical Care
12.2021 - Current
Eligibility Representative
American Specialty Health
10.2019 - 06.2020
Front Desk Specialist
Alliance Rx Walgreen Prime
03.2019 - 03.2020
Biller/ Follower Up
Esha Inc
10.2017 - 10.2019
Associate of Applied Science - Health Care Administration
Concorde Career Institute
Associate of Applied Science - Medical Biller and Coder
The College of Health Care Professions
High School Diploma -
Timberview High School