Proactive, detail-oriented self-starter with interest and willingness to learn new skills.
Extensive administrative skills, strong communication and inter-personal skills to provide efficient techniques that will contribute and assist in maximizing the growth of the company. Travel arrangements Manage multiple schedules Coordinate and execute office events
Proficient in Microsoft Office (Excel, PowerPoint, Access, Outlook) Manage communications; phone messaging, calendars, expense reports, mail review, document flow processing draft concise internal and external correspondence.
Friendly and adaptable professional. Demonstrated abilities to resolve even the toughest challenges.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Account Representative I
OHSU
Portland, OR
03.2023 - Current
Reconciled payments received against outstanding invoices ensuring proper posting of credits and debits.
Research discrepancies in patient accounts to determine appropriate resolution.
Research denials and underpaid insurance balances.
Submit reconsiderations/appeals on behalf of the provider when appropriate, based on findings from research conducted into denied and/or underpaid claims.
Interacts with insurance companies and agencies in the resolution of unpaid balances.
Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
Responded promptly to customer inquiries via telephone or email in a professional manner.
Refunds
Adjustments per department policy.
Reimbursement Specialist
CloudMed
Remote
01.2022 - 03.2023
Oversaw the monthly invoicing for multiple clients.
Track payments and follow up on outstanding accounts.
Identify client rebills and follow-up trends that may impact revenue.
Generate client facing invoices (account level and summary)
Complete quarterly historical invoicing projects.
Attend and document Client HIS/EMR System Navigation Training.
Monitor client rebills performance via bi-weekly reconciliation and escalate timely delays, non-DRG payers, and removals to the associate managing the client account.
Manage client invoicing inquiries and work to resolve account discrepancies.
Contribute to the development of invoicing methodologies and application tool enhancements.
Develop summary guides on the invoicing process for each client.
Contribute towards achievement of DRG-V and CC service line goals.
Patient Account Representative I
OHSU
Portland, OR
06.2021 - 12.2021
Reconciled payments received against outstanding invoices ensuring proper posting of credits and debits.
Research discrepancies in patient accounts to determine appropriate resolution.
Research denials and underpaid insurance balances.
Submit reconsiderations/appeals on behalf of the provider when appropriate, based on findings from research conducted into denied and/or underpaid claims.
Interacts with insurance companies and agencies in the resolution of unpaid balances.
Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
Responded promptly to customer inquiries via telephone or email in a professional manner.
Refunds
Adjustments per department policy.
Patient Account Representative I
University Medical Group
Remote
12.2020 - 06.2021
Reconciled payments received against outstanding invoices ensuring proper posting of credits and debits.
Research discrepancies in patient accounts to determine appropriate resolution.
Research denials and underpaid insurance balances.
Submit reconsiderations/appeals on behalf of the provider when appropriate, based on findings from research conducted into denied and/or underpaid claims.
Interacts with insurance companies and agencies in the resolution of unpaid balances.
Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
Responded promptly to customer inquiries via telephone or email in a professional manner.
Refunds
Adjustments per department policy.
Billing / Prior Authorizations
Columbia Memorial Hospital
Astoria, OR
09.2018 - 11.2020
Billing Medicare and Medicare Advantage claims.
Investigated and resolved problem accounts for Medicare and Medicare Advantage claims.
Appeals for denied claims related to medical necessity and/or prior authorizations.
Prior authorizations for the OHSU Knight Cancer Center and other departments, as needed.
Problem solving related to diagnosis-related medical necessity prior authorizations.
Liaison between Columbia Memorial Hospital and insurance companies (including sub-contracted companies).
Miscellaneous tasks, as assigned by management.
Medical Billing Specialist / Administrative Assistant
Cedar Sinai Park (Aerotek – Contract position)
Portland, OR
01.2018 - 06.2018
Enter resident payments.
Enter resident charges.
Submitted statements to Long-Term Care insurance companies on behalf of the residents.
Customer Service.
Document proofreading/writing for Administration.
Miscellaneous tasks assigned by management.
Lead Biller & Administrative Assistant
Center for Natural Medicine
Portland, OR
07.2016 - 01.2018
Entered and billed all clinic services.
Provider billing and charting education.
Referrals and prior authorizations.
Investigate and resolve problem accounts.
Credentialing
Patient Advocacy.
Miscellaneous tasks assigned by management.
Billing Specialist – Patient Accounting
Tuality Healthcare (Contract position)
Hillsboro, OR
03.2016 - 07.2016
Billing of daily charges from the hospital.
Investigate and resolve problem accounts with insurance companies.
Administrative Assistant/Authorization Specialist
DePaul Treatment Centers (Contract position)
Portland, OR
11.2015 - 02.2016
Eligibility and Benefit verifications.
Authorization submissions for residential clients to insurance companies.
Investigated and resolved problem accounts, data entry, training, and filing.
Administrative Assistant/Department Coordinator II – Cardiothoracic Surgery
Palo Alto Medical Foundation
Santa Cruz, CA
10.2014 - 06.2015
Office point of contact for patients, Physician(s), care team(s), and Hospital
Greeted and registered patients.
Insurance coverage eligibility and benefit verification, and procedure/surgery scheduling.
Miscellaneous projects as assigned by Physician/Management.
Education
Associate of Arts - Law And Society
Foothill College
Los Altos, CA
Skills
Proactive
Detail-oriented self-starter
Willingness to learn new skills
Dependable
Adaptable
Computer literate
Excellent communication skills
Analytical skills
Organizational skills
Extensive administrative skills
Strong communication and interpersonal skills
Proficient in Microsoft Office (Excel, PowerPoint, Access, Outlook)
Manage communications
Problem solver
Travel arrangements
Manage multiple schedules
Coordinate and execute office events
Medical Billing
Coding
File coordination
Insurance Verification
Collections experience
Follow-up skills
Physicians' orders
Medical Terminology
Patient Care
HIPAA understanding
Insurance Billing
Excellent judgment
HIPAA Compliance
Verbal and written communication
Insurance collaboration
Administrative Support
Payment Processing
Medical terminology knowledge
Team Collaboration
Certification
Certified Revenue Cycle Specialist - CRCS
Career Experience
OHSU, Remote, Portland, OR, 03/2023, Present, Patient Account Representative I, Processes and documents transactions on insurance accounts in EPIC, Research denials and underpaid insurance balances, File reconsiderations and medical necessity appeals, Interacts with insurance companies and agencies in resolution of unpaid balances, Refunds, Adjustments per department policy
CloudMed, Remote, 01/2022, 03/2023, Reimbursement Specialist, Oversee the monthly invoicing for multiple clients, Track payments and follow-up on outstanding accounts, Identify Client rebills and follow-up trends that may impact revenue, Generate client facing invoices (account level and summary), Complete quarterly historical invoicing projects, Attend and document Client HIS/EMR System Navigation Training, Monitor Client rebills performance via bi-weekly reconciliation and escalate timely delays/non-DRG payers/removals to the Associate managing the Client account, Manage client invoicing inquiries and work to resolve account discrepancies, Contribute to the development of invoicing methodologies and application tool enhancements, Develop summary guides on invoicing process for each Client, Contribute towards achievement of DRG-V and CC service line goals
University Medical Group, Remote, Portland, OR, 12/2020, 6/2021, Patient Account Representative I, Processes and documents transactions on insurance accounts in EPIC, Research denials and underpaid insurance balances, File reconsiderations and medical necessity appeals, Interacts with insurance companies and agencies in resolution of unpaid balances, Refunds, Adjustments per department policy
Columbia Memorial Hospital, Astoria, OR, 09/2018, 11/2020, Billing / Prior Authorizations, Billing Medicare and Medicare Advantage claims, Investigated and resolved problem accounts for Medicare and Medicare Advantage claims, Appeals for denied claims related to medical necessity and prior authorizations, Miscellaneous tasks as assigned by management, Prior authorizations for the CMH Cancer Center, and other departments as needed, Problem solving related to diagnosis related medical necessity prior authorizations, Liaison between CMH and insurance companies (including sub-contracted companies)
Cedar Sinai Park (Aerotek – Contract position), Portland, OR, 01/2018, 6/2018, Medical Billing Specialist / Administrative Assistant, Enter resident payments, Enter resident charges, Submitting statements to Long Term Care companies for residents, Customer Service, Document proofing / writing for Administration, Miscellaneous tasks assigned by Management
Center for Natural Medicine, Portland, OR, 07/2016, 1/2018, Lead Biller & Administrative Assistant, Billing all clinic charges, In office referrals, Investigate & resolve problem accounts, Credentialing, Patient Advocacy, Miscellaneous tasks assigned by Management
Tuality Healthcare (Contract position), Hillsboro, OR, 03/2016, 7/2016, Billing Specialist – Patient Accounting, Billing of daily charges from the hospital, Investigate and resolve problem accounts with Insurance companies
DePaul Treatment Centers (Contract position), Portland, OR, 11/2015, 2/2016, Administrative Assistant/Authorization Specialist, Authorization submissions for residential clients to insurance companies, Investigated and resolved problem accounts (billing), data entry, training, and filing
Palo Alto Medical Foundation, Santa Cruz, CA, 10/2014, 6/2015, Administrative Assistant/Department Coordinator II – Cardiothoracic Surgery, Office point of contact for patients, Physician(s), care team(s), and Hospital, Greeted patients, patient registration, insurance coverage eligibility and benefit verification, procedure/surgery scheduling, Telephoned management, scheduled change implementation, fee ticket preparation, orientation/training for department new hire(s), Miscellaneous projects as assigned by Physician/Management
Timeline
Patient Account Representative I
OHSU
03.2023 - Current
Reimbursement Specialist
CloudMed
01.2022 - 03.2023
Patient Account Representative I
OHSU
06.2021 - 12.2021
Patient Account Representative I
University Medical Group
12.2020 - 06.2021
Billing / Prior Authorizations
Columbia Memorial Hospital
09.2018 - 11.2020
Medical Billing Specialist / Administrative Assistant
Cedar Sinai Park (Aerotek – Contract position)
01.2018 - 06.2018
Lead Biller & Administrative Assistant
Center for Natural Medicine
07.2016 - 01.2018
Billing Specialist – Patient Accounting
Tuality Healthcare (Contract position)
03.2016 - 07.2016
Administrative Assistant/Authorization Specialist
DePaul Treatment Centers (Contract position)
11.2015 - 02.2016
Administrative Assistant/Department Coordinator II – Cardiothoracic Surgery