Danell Lumar
Humble,TX
Summary
Diligent, detailed oriented professional with knowledge of all office functions. Excels at multitasking in a fast-paced environment, completing projects within time and budget constraints, while assisting the team with daily work flow issues. Superior intrapersonal skills and very dependable.
Overview
17
17
years of professional experience
Work History
Patient Account Specialist SR.
Christus Health
05.2023 - Current
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records. Working in a high call volume enviornment
- Collaborated with interdisciplinary teams to optimize billing procedures and ensure timely reimbursements from insurance providers.
- Promoted a culture of continuous improvement within the Patient Accounts team by participating in regular staff meetings, offering constructive feedback on department processes, systems, tools for achieving objectives more effectively.
- Electronically submitted bills according to compliance guidelines.
- Assisted patients with payment plans and charity applications, While in the Bad Debt department and collecting payments and offering discounts to those who may qualify.
Biopharma informatics
05.2021 - Current
- Assisted in taking calls, mainly making out bound calls, pre screening, over the phone, using the system CTMS, and Zoho, Studykick, Studyteams, scheduling patients, speaking with the doctors, doing research, faxing, collecting medical records
- Calling patients to confirm appointments, returning voicemails, brainstorming, etc
- Answering and resolving incoming and client payment & credit collection inquiries along with outbound collections contacts, processing customer refunds, reviewing account alterations, resolving clients inconsistencies, while collecting overdue payments
- Proficient in Microsoft Office (to include Access, Powerpoint, Excel and Word).
Acclara's
12.2018 - 12.2020
- Customer Service Rep
- Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS, DRGs and authorizations/referrals
- Gathered supplies to go out to homes, and businesses
- Provide Patient Friendly Customer Service
- Review, Interpret Patient Statements, Balance and Client Contractual Terms/Agreements
- Obtain Supporting Documentation Regarding Patient/Client Follow-up Efforts
- Identify Contractual and Administrative Adjustments
- Outbound Call Dialing
- Proficient in Microsoft Office (to include Access, Powerpoint, Excel and Word)
- Proficient in Epic, Dayforce and Cubs, also conducted insurance verification, on insurance claims, with benefits prior to date of service to insure payment of service.with authorizations and benefits
- Worked with Medicaid, Medicare, and Commercial Payers such as BCBS, Tri-Care, United, Blue Cross Blue Shield and Aetna.
Akyta Entrust Energy
07.2018 - 01.2018
- Customer Service Rep
- Research and reconcile customer accounts, including correct billing errors, misapplied cash, request account adjustments, process fee reversals, and administer settlements write-off recommendations
- Conduct customer calls, negotiate customer disputes, propose resolution, and document root cause
- Prepare various ad-hoc reports and complete daily assignments
- Take an active role in cross-functional teams and participate in special projects
- Mitigate bad debt by monitoring AR aging, completing daily work queues and maximize collections on delinquent accounts
- Work closely with Customer Care, Billings, Operations, Sales, and other departments and assist with customer related requests and past due/collection issues
- Document workflow processes and provide detailed notations in collection system
- Respond to customer inquiries in a timely and effective manner
- Audit various processes and provide feedback to generate improvements
- QA processes to ensure quality products and services
- Enter error logs where appropriate
- Proactive in identifying opportunities and continuous improvements to achieve best in class business practices.
LSG Staffing
09.2017 - 10.2017
- Harvey Relief Team
- Undertake special projects as assigned
- Gathered supplies to go out to homes, and businesses
- Received supplies to stock and to get ready for orders
- Analyzed patient accounts to determine patient responsibility.
Health Help, LLC
02.2008 - 03.2015
- Collections/Customer Service Representative
- Undertake special projects as assigned
- Investigate claim denials & rejections
- Respond to payer correspondent/EOB
- Analyzed patient accounts to determine patient responsibility
- Resolved patient responsibility balances through proven debt collection techniques
- Payer accounts included all Managed Care payers, including HMO, PPO, and POS benefit plans
- Performed area-specific functions to ensure adequate reimbursement
- Assisted with day-to-day planning, operation and problem-solving
- Follow up claim status
- Preform adjustment/write-off
- Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
- Identifies patients accurately and assigns the patient a unique identification number
- Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion
- AR follow-up Contacts insurance companies via telephone/website concerning unpaid accounts receivables
- Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims
- Assists with inquiries from outside parties regarding account status
- Drafts letters to the insurance company's Medical Review Board to expedite payment
- Evaluates if payments were made according to contract
- Researches and appeals insurance denials
- Resolves any unusual denials, low payments, or requests for information, including appeals
- Worked with Medicaid, Medicare, And Commercial Payers such as BCBS, Tri-Care, United, Aetna etc.
Education
Computer Graphic Design -
Remington College Metairie
01.2003
Skills
- HIPAA understanding
- Medicare and Medicaid knowledge
- Patient Care
- Team Collaboration
- Collections experience
- Patient account management
- Medical Terminology
- Medical Billing Expertise
- Payment Processing
- Administrative Support
- Medical coding proficiency
- Medical Billing
- Regulatory Compliance
- Insurance collaboration
- Coding expertise
- File coordination
- Debt Collection Strategies
- Healthcare Revenue Cycle
- Data entry proficiency
- Follow-up skills
- Teamwork and Collaboration
- Problem-Solving
- Time Management
- Problem-solving abilities
Languages
English
Full Professional
Timeline
Patient Account Specialist SR.
Christus Health
05.2023 - Current
Biopharma informatics
05.2021 - Current
Acclara's
12.2018 - 12.2020
Akyta Entrust Energy
07.2018 - 01.2018
LSG Staffing
09.2017 - 10.2017
Health Help, LLC
02.2008 - 03.2015
Computer Graphic Design -
Remington College Metairie
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