DeMario Moore
LEWISVILLE
Summary
Veteran Medical Billing Specialist bringing 3-year background to growing collections agency. Expert in debt collections, repayment negotiations and repayment plan development. Successful in managing escalated accounts and producing aging reports to cut down delinquent invoices. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Medical Billing Specialist position. Ready to help team achieve company goals.
Overview
15
15
years of professional experience
Work History
Medical Billing and Collections Specialist/Accounts Payable Clerk
Stonegate Senior Living LLC
2022.05 - Current
- Submit claims and verify that the claim information is complete and accurate
- Follow-up with insurance carriers on unpaid or rejected claims
- Analyze cash reconciliation on each Skill Nursing Facility building for month end close
- Submit insurance claims to clearinghouse or individual insurance companies electronically or via paper using the CMS 1500 form
- Provide necessary information to collection agencies for delinquent accounts
- Prepares and submits secondary claims upon processing by primary insurer.
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Implemented efficient workflows within the department that led to increased productivity levels among staff members while reducing errors in claim submissions.
- Increased overall collection rates with a focus on reducing aged receivables and minimizing writeoffs.
- Corrected, completed and processed claims for multiple payer codes.
- Assisted in reconciling deposit and patient collections.
- Reconciled accounts receivable to general ledger.
- Processed invoices and journal entries with efficiency and accuracy, resulting in decreased discrepancies.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
Insurance Billing Specialist
Foremost Family Health Center
2021.01 - 2022.05
- Responsible for reviewing patient cases and insurance coverage information
- Verify patient demographic information
- Ensure records in Athena are complete
- Ensure completion of documentation and coding on charges entered to patient accounts
- Run eligibility through TMHP for patients with Texas Women’s Health.
- Minimized errors in claims submissions through regular cross-checking of CPT and ICD codes against medical documentation.
- Assisted colleagues during peak workload periods, demonstrating strong teamwork and commitment to overall departmental success.
- Ensured strict adherence to HIPAA guidelines while handling sensitive patient information during the billing process.
- Assisted patients in understanding their coverage benefits, providing clear explanations and addressing any concerns or questions.
- Handled account payments and provided information regarding outstanding balances.
Certified Patient Access Representative
St Francis Hospital
2018.12 - 2020.12
- Registered inpatients, outpatients, and other ER patients
- Verified insurance coverage for patients
- Determined when patients may be eligible for financial assistance
- Verified work-man’s compensation patients
- Focused on satisfying the needs of patients.
- Contributed to the continuous improvement of departmental performance metrics, actively participating in process improvement initiatives and offering constructive feedback on systems and procedures.
- Ensured prompt resolution of billing issues, working closely with financial counselors to provide patients with necessary assistance or payment plans.
- Expedited patient check-in process by utilizing electronic systems for registration and data entry accurately and swiftly.
- Streamlined front desk operations for improved patient flow and decreased wait times.
- Maintained accurate patient records with diligent attention to detail and strict adherence to HIPAA regulations.
- Demonstrated adaptability by quickly learning new software applications maintaining current knowledge industry best practices.
- Reduced billing errors by consistently updating insurance information and verifying coverage prior to services rendered.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Educated patients on importance of preventive health care and insurance coverage.
- Resolved patient billing issues in line with established guidelines.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Patient Registration Specialist
University Health
2016.10 - 2018.12
- Completed patient registration, insurance, and benefits verification
- Authorized referral management and patient liability collections
- Interviewed patients and guarantors to obtain information to screen for financial counseling
- Verified eligibility of benefit levels and obtained treatment authorizations.
- Provided exceptional customer service, addressing patient concerns and answering questions promptly and professionally.
- Strengthened relationships with healthcare providers by coordinating pre-authorization requirements for various procedures.
- Reduced registration errors through meticulous data entry and attention to detail.
- Improved patient satisfaction by efficiently registering patients and verifying their insurance information.
- Upheld HIPAA regulations and standards for protecting patient information.
- Verified insurance eligibility for patients quickly and accurately, reducing financial discrepancies between patients and providers.
- Explained financial responsibilities to patients as well as payment options and potential collection procedures imposed upon patients and other responsible parties.
Agent Services Representative
Trubridge Medical Center
2015.07 - 2016.10
- Processed insurance payments on patient’s accounts
- Processed credit card payments on patient’s accounts
- Verified HIPPA with patients to know their rights
- Completed the checkout process with patients to verify they have all details from the visit in package
- Followed up with patients to make sure they were satisfied with treatment plan within 24 hours.
- Acted as a liaison between multiple departments, facilitating efficient information exchange crucial for delivering exceptional customer experiences.
- Balanced competing priorities effectively while consistently delivering high-quality support to both agents and customers alike.
- Coordinated training sessions for new agents, ensuring they were equipped with essential knowledge and skills for success.
- Developed strong relationships with stakeholders across the organization, fostering collaboration and mutual support among team members.
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Provided essential support to the medical billing team, allowing for a more efficient and effective overall operation within the department.
- Enhanced revenue by streamlining medical billing processes and improving accuracy in claims submissions.
- Promoted a positive work environment by consistently demonstrating professionalism, mutual respect, and cooperation with fellow team members.
- Facilitated effective communication between healthcare providers, patients, and insurance companies to resolve billing disputes promptly.
- Maintained excellent relationships with insurance representatives to expedite claims processing and secure timely reimbursements for services rendered.
- Assisted in maintaining a high-quality database of patient information by accurately entering demographic and insurance details into the system.
- Trained new employees on medical billing software, policies, and procedures, ensuring accuracy in claims submission from day one.
Assistant Manager
World Acceptance Corporation
2013.07 - 2015.07
- Utilized marketing strategies to increase revenue
- Transported money and deposits to/from the bank
- Assisted in preparing weekly progress reports
- Signed checks for loans, branch expenses, and money remittances
- Assisted in closing current renewal loans to meet standard goals
- Ensured high quality scores by following policy and procedures.
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Maintained a clean, safe, and organized store environment to enhance the customer experience.
- Developed strong working relationships with staff, fostering a positive work environment.
- Oversaw daily cash reconciliations, ensuring accurate financial reporting and minimizing discrepancies.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Managed inventory levels to minimize stockouts while reducing overhead costs.
- Mentored team members to enhance professional development and accountability in workplace.
- Enforced company policies consistently while handling disciplinary actions when necessary with fairness and respect.
- Scheduled staff shifts to ensure proper coverage during peak shopping hours without exceeding labor budgets.
- Implemented staff training programs, enhancing product knowledge and improving customer service skills.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets.
- Launched quality assurance practices for each phase of development
Property Manager
Sunquest Properties
2009.06 - 2013.07
- Completed weekly reports
- Performed monthly inspections
- Managed weekly work orders
- Collected tenant rental payments
- Closed leases on rental properties.
- Handled tenant complaints promptly and appropriately, calling in repairmen, and other support services.
- Completed final move-out walk-throughs with tenants to identify required repairs.
- Maintained positive landlord-tenant relationships, ensuring clear communication and prompt resolution of any disputes.
- Oversaw lease agreements from inception to termination, ensuring compliance with local regulations and protecting the interests of both landlords and tenants.
- Maintained original leases and renewal documents in digital and hardcopy format for property management office.
- Followed up on delinquent tenants and coordinated collection procedures.
- Introduced prospective tenants to types of units available and performed tours of premises.
- Verified income, assets, and expenses, and completed file tracking sheet for each applicant.
- Monitored progress of construction and maintenance projects and notified appropriate individuals of project updates, delays, and schedule changes.
- Monitored tenant behavior and implemented corrective action to maintain order in assigned properties.
- Coordinated with legal counsel to resolve tenant disputes.
- Developed and implemented marketing strategies to increase occupancy rates.
- Provided ongoing training opportunities for staff, promoting professional growth and fostering a cohesive team environment.
- Established strong relationships with local authorities, ensuring prompt attention to code violations or other regulatory matters affecting the property''s operations.
- Communicated effectively with owners, residents, and on-site associates.
- Planned special events such as lotteries, dedications and project tours.
Education
Medical Billing and Coding Certificate -
DeVry University
Downers Grove, IL11.2018
Bachelor of Science in Business Admin. -
Northwestern State University
Natchitoches, LA12.2008
Skills
- Proficient with Microsoft Office Software
- Proficient with Marketing Tools
- Excellent Interpersonal and Customer Relation Skills
- HIPAA Compliance Knowledge
- Medical Billing Software Proficiency
- Claims Processing Proficiency
- Professionalism and Ethics
- Insurance Verification
- ICD-10 Familiarity
- Patient Billing Assistance
- HIPAA Compliance
- Insurance understanding
- Time Management
- Attention to Detail
- Multitasking
- Reliability
- Microsoft Office
- Work Planning and Prioritization
- Analytical Thinking
- Payment Collection
- Customer Account Management
- Billing Document Creation
Timeline
Medical Billing and Collections Specialist/Accounts Payable Clerk
Stonegate Senior Living LLC
2022.05 - Current
Insurance Billing Specialist
Foremost Family Health Center
2021.01 - 2022.05
Certified Patient Access Representative
St Francis Hospital
2018.12 - 2020.12
Patient Registration Specialist
University Health
2016.10 - 2018.12
Agent Services Representative
Trubridge Medical Center
2015.07 - 2016.10
Assistant Manager
World Acceptance Corporation
2013.07 - 2015.07
Property Manager
Sunquest Properties
2009.06 - 2013.07
Medical Billing and Coding Certificate -
DeVry University
Bachelor of Science in Business Admin. -
Northwestern State University
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