Dana Moore

• Identified, researched and resolved billing variances to maintain system accuracy and currency.
• Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
• Performed targeted collections on past due accounts aged over 30 days and really focusing on accounts over 120 days to lower AR days
• Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
• Responded to customer concerns and questions on daily basis.
• Executed billing tasks and recorded information in company databases.
• Managed invoicing and payment processing operations.
• Handled account payments and provided information regarding outstanding balances.
• Monitored outstanding invoices and performed collections duties.
• Performs collection functions for First Physician Group.
• Reviews charges and verifies appropriate usage of modifiers, CPT-4, ICD-9 and ICD-10 code ensure appropriate reimbursement.
• Analyzes and corrects claims to ensure accurate and timely claims submission.
• Responsible for resubmission of claims for additional reimbursement and/or appealing said claims with timely follow up.
• Responsible for calculating and posting contractual allowances accurately and timely keeping AR to minimum.
• Responsible for incoming and outgoing mail. Researches and answers customer’s questions regarding billing disputes.
• Interacts Office Managers, CBO staff, and other appropriate SMH staff to review coding and billing issues.
• Responsible for keeping abreast of and complying with all third party regulations.
• Job knowledge is section specific. Ability to demonstrate Customer Service Recovery, be flexible and adapt to changes in growth within CBO Department.

• Supported customer service goals and enhanced relations through friendly, knowledgeable and positive communication.
• Consulted with customers regarding needs, addressing concerns.
• Answered inbound calls per day and directed to designated individuals or departments if unable to resolve myself.
• Maintained up-to-date knowledge of store policies regarding payments, returns and exchanges in order to provide speedy and accurate service to each customer.
• Assisted with purchases, locating items and signing up for rewards programs.
• Processed returned items in accordance with store policy.
• Helped customers find specific products, answered questions and offered advice.
• Wrapped items and bagged purchases properly to prevent merchandise breakage.
• Learned roles of other departments to provide coverage and keep store operational.
• Observed company return policy when processing refunds, including inspecting merchandise for wear or damage.
• Processed customer payments quickly and returned exact change and receipts.
• Properly verified customer identification for alcohol or tobacco purchases.
• Welcomed customers, offering assistance to help find necessary store items.
• Worked closely with front-end staff to assist customers.
• Wiped down counters and conveyor belt to remove debris and maintain cleanliness.
• Processed all sales transactions accurately and promptly to prevent long customer wait times.
• Resolved issues with cash registers, card scanners and printers.
• Maintained high productivity by efficiently processing cash, credit, debit and voucher program payments for customers.
• Confirmed transactional data by verifying name and payment information and clearly communicating costs and fees to patrons.

• Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
• Recognized by management for providing exceptional customer service.
• Earned reputation for good attendance and hard work.
• Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
• Handled all delegated tasks, including Training and answering inbound phone calls.
• Collaborated with managers after discovering new and updated billing procedures on CPT billing codes.
• Reviewed and verified benefits and eligibility with speed and precision.
• Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
• Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
• Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
• Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.
• Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
• Accurately coded diagnostics and prepared billing statements for patients.
• Completed appeals and filed and submitted claims.
• Meticulously tracked and resolved underpayments.
• Evaluated accuracy of provider charges, including dates of service, procedures, level of care and diagnoses, identifying and correcting billing errors .
• Applied payments, adjustments and denials into medical manager system.
• Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
• Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
• Thoroughly reviewed remittance codes from EOB'S and Insurance web portals.
• Posted charges, payments and adjustments.
• Precisely completed appropriate paperwork and system entry regarding claims.
• Performed full-cycle medical billing for fast-paced company, reducing errors.
• Collaborated closely with other departments to resolve claims issues.
• Performed quality control of data entry system to verify proper posting of claims and payments.
• Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
• Posted and adjusted payments from insurance companies.
• Submitted refund requests for claims paid in error.
• Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
• Prepared billing statements for patients, ensuring correct diagnostic coding.

• Completion of Daily FARBs on Accounts
• Run weekly Aging reports for 109 Centers responsible for open balances on accounts 60 days and over and working those accounts for resolve.
• Submitted Primary claims and corrected claims via Relay or via insurance web portal for processing and Reconsideration on denied claims.
• Working Bad Debt accounts via submitting Appeals. Also informing Superiors on trends causing Bad Debt to resolve from continuing.
• Ensuring Patient Responsibility is correct per EOB and correct if not via system adjustments or Moving to other insurance for billing and payment or resubmission on insurance web portal with Primary EOB.
• Adjusting balances that are EOB contractual or True Bad Debt write offs after all efforts have been exhausted and is non collectible.
• Special projects
• Training Others and other duties as assigned.
• Worked directly with Business Office Managers to achieve Compliance to ensure correct balances on accounts.
• Achieve Billing Objectives and goals using my knowledge and experience.
• Supported Chief Operating Officer with Daily operational functions to meet Monthly Financial Goals

Senior Cash Applications

• Processing Insurance Credit Card Payments.
• Setting up patient Debit/Credit recurring payments for ALL centers on specific date for specified amount on Secured Applications System via Recurring FORM that was signed by BOM at that Facility and received via Secured Mail.
• Performing Daily Debit/Credit card and Daily Bank Withdrawal Transactions for ALL centers and importing those transactions into Excel file for cash posting to those patients accounts.
• Running Daily Insurance EFT Posting file report for ALL centers and importing that file into Excel file for Insurance Cash Batch posting.
• Manually processing Daily Direct CC/Debit transactions via Secured CC/Debit Card applications system for ALL centers.
• Keeping Good and Professional relationship with BOM's of every Facility we did billing for.