Dominique Galloway
Austell,Ga
Summary
Organized and goal-oriented, with 13 years' experience in AR Billing and collections with a strong focus in Hospital, Medicare/Medicaid, Managed care, Commercial, Workman Comp, and Specialty claims. Analytical problem-solver and resolves concerns and improve efficiency. Demonstrate success working in a team environment focused on meeting organization goals and objectives required. Skilled in building excellent rapport with team members and payers. Able to see the big picture, delegate effectively and motivate team members to achieve on-time project completion. Computer skills include: MS Word, Excel, Access, Publisher, PowerPoint, and Internet research. COMPETENCY Leadership - A highly motivated and ambitious individual able to give timely and accurate advice, guidance, support and training to team members and individuals. Problem Solving – Capable of identifying and resolving problems in a timely manner; knack for gathering and analyzing information skillfully. Demonstrate the ability to work independently, perform duties and make decisions with minimal supervision. Oral Communication – Articulate speech accompanied with a positive attitude, and great listening skills to respond well to questions. Customer Service – Experienced in managing difficult situations with a prompt response to the needs with immediate attention and resolve.
Overview
11
11
years of professional experience
Work History
AR Specialist
Jackson Revenue
Atlanta
02.2015 - 06.2018
- Manage AR Billing/Collections for 5 Facilities, 3 Surgery Centers.
- Ensure accurate Billing/Collect for Medicare, Medicaid, Managed care, Commercial and Workman Comp.
- Claims.
- Collected/entered data in multiple databases and maintained accurate records.
- Perform billing task to ensure CPT, DX codes and times are keyed for maximum reimbursement.
- Ensure HIPPA compliant work environment at all times.
- Review EOB’s and remittances for accurate reimbursement of billed charges.
- Perform daily hospital business office functions, to include accurate and timely submission of daily assigned claims, rejected claims, and application of payments.
- Actively call payer organizations or utilize web-based connectivity to pursue reimbursement of medical claims.
- Responsible for handling all Workman Comp claims.
- Ensuring all documentation required are submitted timely.
- Work Daily correspondence via Inbox and imaging system.
- Handle patient inquiries from customer service for my designated Facilities.
- Collect on entire AR 180 days to current for maximum reimbursement via research and analysis.
- Responsible for identifying discrepancies in payments, charges and adjustments in the AR.
- Exhibit the ability to work productively in a dynamic, high-energy, fast-paced, and rapidly changing environment.
AR Team Lead
Pediatric Service of America
Norcross, GA
08.2011 - 02.2015
- Allocated daily responsibilities and workloads to a team of 8 people.
- Ensured HIPPA compliant work environment.
- Managed team performance and progress.
- Enforced all company approved policies and procedures.
- Payer contract: over payment and under payment reconciliation.
- Reported my findings to management.
- Follow up on unpaid claims and denial and prepared/ submitted appeals when applicable (Medicare, Medicaid, Commercial payers).
- Prepared and processed refund documentation with management approval to patients and payers when applicable.
- Point of contact for escalated queries from all external and internal parties associated with my AR.
- Responsible for identifying discrepancies in payments, charges/adjustments and working with Cash Dept.
- To resolve.
- Monitored/reconciled aging reports and collections of past due accounts.
- Worked correspondence from imaging system to be worked and resolved.
- Ensued all bills were submitted in a time efficient and accurate manner for my team.
AR Supervisor
Anesthesia Healthcare Partners
Duluth, GA
08.2009 - 08.2011
- Supervised and trained a team of 8 individuals.
- Attended and participated in staff leadership meetings for team improvement strategies.
- Ensured HIPPA compliant work environment at all times.
- Reviewed EOB’s and remittance advices for contracted accounts for Medicare, Medicaid, Commercial payers.
- Billed and worked AR using GE Centricity.
- Exhibited the ability to work productively in a dynamic, high-energy, fast-paced, and rapidly changing environment.
- Managed and collected on an A/R of 23 Million.
- Responsible for billing claims within contracted timely filing guidelines for max reimbursement.
- Identified and resolved discrepancies with billing and effectively communicated issues discovered with management for resolve.
- Responsible for patient calls with regard to statements, account issues and/or complaints.
- Made adjustments and posted payments to patient accounts via Remittance.
Billing Specialist
Pediatrics At Nite
Fairfax, VA
09.2007 - 08.2010
- Coded records by following prescribed coding standards such as ICD-9 and CPT to insure HIPPA compliance for all payers.
- Reviewed physician notes and obtained necessary clarifications from MD for billing clean claim.
- Ensured signatures on all medical records.
- Ensured appropriate medical codes and diagnosis for services were documented.
- Prepared appropriate claim documents for submission.
- Responsible for posting remittances to applicable patient accounts for MD approval for month end close.
- Worked Remote from home; posting EOB’s and collecting patient balances; resolved patient inquiries via email/phone.
Accounts Receivable Specialist
Fair Oaks Anesthesia
Fairfax, VA
08.2007 - 08.2009
- Specialized in resolving aged and high dollar AR.
- Responsible for billing/collections on the total AR designated (4 Facilities)- All payers.
- Prepared appropriate claim documents for claim submission/Appeals.
- Responsible for handling delinquent hospital accounts in courtroom setting.
- Responsible for setting payment arrangements with the patients on delinquent accounts & F/U with Attorney Office.
- Followed up with insurance companies and ensured that all claims were paid according to contract.
- Worked with team members to accomplish educational goals to determine future improvements.
Education
Training includes: New Hire training, Leadership training -
Medical Billing & Coding Certificate - undefined
Sanford Brown Institute
2005
Advanced Diploma - undefined
West Potomac High School
2002
Skills
- Data Entry and 10-Key
- Accounts Payable
- Proactive and Self-Motivated
- Record Reconciliation
Timeline
AR Specialist
Jackson Revenue
02.2015 - 06.2018
AR Team Lead
Pediatric Service of America
08.2011 - 02.2015
AR Supervisor
Anesthesia Healthcare Partners
08.2009 - 08.2011
Billing Specialist
Pediatrics At Nite
09.2007 - 08.2010
Accounts Receivable Specialist
Fair Oaks Anesthesia
08.2007 - 08.2009
Training includes: New Hire training, Leadership training -
Medical Billing & Coding Certificate - undefined
Sanford Brown Institute
Advanced Diploma - undefined
West Potomac High School