Desireé Parker

• Review and reconcile all credits and underpayments

• Manage the entire cycle of insurance claims process, including submission, tracking, and follow-up on unpaid claims.

• Ensure timely and accurate billing of services to insurance companies

• Complete appeals and medical record requests for denied claims

• Review EOBs/remits for correct payment rates, denial remarks, and adjustments

• Accurately and promptly reconcile all posting transactions, including payments, adjustments, etc

• Facilitated communication between departments to streamline revenue cycle operations.
• Conducted audits of patient accounts in order to identify any potential inaccuracies or inconsistencies that may lead to lost revenue.
• Maintained up-to-date knowledge of CPT and HCPCS codes, ICD-10 CM diagnosis codes along with applicable federal and state regulations.

• Processed claims efficiently using Centene's proprietary billing systems.
• Reviewed patient accounts for accuracy and compliance with regulations.
• Coordinated with healthcare providers to resolve billing discrepancies.
• Maintained documentation of all billing activities and communications.
• Communicated effectively with patients regarding their billing inquiries.
• Contacted insurance providers to check patient coverage.
• Identified and corrected payment problems involving patients or third-party payers.
• Reviewed claims for accuracy and completeness before processing.
• Followed up on outstanding claims to ensure timely resolution.
• Analyzed trends in claim submissions to identify potential issues.
• Assisted customers via telephone inquiries related to their specific claim status or general questions about the company's services.
• Coordinated benefits with medical insurance plans and Medicare providers.

• Processed incoming payments and reconciled customer accounts efficiently.
• Maintained accurate records of transactions using accounting software.
• Communicated with clients regarding outstanding invoices and payment statuses.
• Managed customer invoicing and billing processes for accuracy and efficiency.
• Processed payments and ensured timely posting to customer accounts.
• Assisted in preparing reports on outstanding accounts for management review.
• Conducted periodic reviews of delinquent accounts and initiated appropriate action based on company policies.
• Analyzed customer accounts to identify and resolve discrepancies.
• Assisted in resolving payment issues, such as rejections or delayed payments due to incorrect coding or missing information.
• Communicated effectively with internal teams about any changes or updates made to patient accounts during the posting process.
• Reviewed payment batches for accuracy and completeness.
• Processed insurance payments using electronic payment systems.
• Communicated with insurance companies for clarification on payments.
• Maintained detailed records of transactions in database systems.
• Downloaded, printed and batched electronic funds transfers and remits.
• Posted payments for insurance companies, including Medicare and Medicaid, by accurately entering data into the system.

• Provide ongoing administrative support to clinical director and providers
• Managed patient scheduling and appointment coordination efficiently.
• Maintained electronic health records with accuracy and confidentiality.
• Coordinated communication between patients and healthcare providers effectively.
• Ensured compliance with HIPAA regulations related to privacy of patient information.
• Processed patient referrals and coordinated with other health care providers regarding treatment plans.
• Verified patient insurance coverage and collected payments for services rendered.
• Collected co-pays and insurance data, applying full and proper payment to patient accounts.