Donna Catron
Damascus,MD
Summary
I have over 20 years’ experience working with medical professionals and insurance carriers. I have worked for a major insurance carrier and also in private practice’s and for a major hospital. I have also worked for a major insurance company in the customer service department and processing insurance claims. Experienced in medical collections, demonstrating robust knowledge of insurance processes, patient billing inquiries, and payment resolution strategies. Strong ability to communicate effectively with diverse groups including healthcare providers, insurers, and patients. Consistently contribute to improving revenue cycle management through diligent attention to detail and proactive problem-solving skills. Have successfully reduced outstanding receivables and improved cash flow in past roles.
Overview
35
35
years of professional experience
Work History
Medical Collection Specialist
Children’s National Medical Center
Washington, DC
01.2013 - Current
- Follow-up with insurance carriers, to facilitate appropriate reimbursement for physician services
- Investigate reasons for non-payment and collect information and provide necessary documentation to insurance carrier
- Writes letters of appeal to support payment of denied claims
- Documents activities and contacts in system
- I have a detailed understanding of managed care contractors and payer requirements
- I am the person that is assigned to work on any accounts that have fallen behind from a person that has been out for an extended length of time of has a large amount of past due claims
- When team members have question regarding a insurance they come to me for the answers
- When the current operating system, Cerner was first installed I was chosen as a Super User to help with the training within our team
- I am the person that trains all new employees in collection department
Collections Rep.
Maryland Heart
Bethesda, MD
08.2004 - 11.2009
- Follow-up with insurance carriers to assure appropriate reimbursement for physician services
- Investigate reasons for non-payment and collected information
- Provided needed information to the insurance carrier for processing claims and appealed denied claims for payment
- Helped with the billing of medical claims to the insurance carrier and billed all claims to the secondary insurance carriers
- Filled in at the front desk scheduling appointments and checking patient’s in and out
Medical Billier / Collections
David Plotkin, MD
Olney, MD
01.2004 - 08.2004
- Submitted all Medical claims to the insurance carrier for processing
- Followed up with the insurance carrier to insure prompt payment of all claims supplying any additional information needed for processing of claims
- Posting of all payments and co-payments received for medical services provided
- Sent statements to patients for medical services rendered and not covered by their insurance plan
- Was the main contact in setting up of the electronic billing system
- Worked with all insurance carrier’s including workers compensation and PIP
Office Manager
Dr. Inder Chawla, MD
Potomac, MD
09.1999 - 01.2004
- Billed for all services in the 5 offices for this provider
- Followed up with the insurance carriers to make sure all services were reimbursed
- Worked with Workers Comp carriers and PIP insurance
- Worked closely with attorney’s involving PIP claims
- Represented the office in court to obtain judgements against delinquent accounts
- Recouped $1 million dollars for the practice 4 out of 5 years that I worked for the practice
- Filled in at the various practices in case of absences of staff, making appointments and getting patients ready for their appointment
Patient Advocate
Concentra
Frederick, MD
06.1997 - 09.1999
- Worked with the patients when claims were sent for repricing by the insurance carrier
- Explained the process to the patient and how much of the negotiated price the patient actually owed
Customer Service
Mail Handlers Insurance
Rockville, MD
06.1989 - 06.1997
- Answered between 80 and 125 phone calls per day from insurance enrollees or provider offices
- Answered questions regarding the processing of claims and correcting any errors in the processing of the claims
Precertification Appeal
Mail Handlers Insurance
Rockville, MD
06.1989 - 06.1997
- Answered phone calls and correspondence regarding claims that had been denied for no precertification
- Resolved problems with the providers to get the claims paid in a timely manner
Special Correspondence
Mail Handlers Insurance
Rockville, MD
06.1989 - 06.1997
- Worked on complex problems that were billed to the insurance company
- Primarily dealing with OPM (Office of Personal Management), Senators and Congressman
Claims Processing
Mail Handlers Insurance
Rockville, MD
06.1989 - 06.1997
- I processed a minimum of 500 medical and dental claims per week for payment to the providers
Education
Montgomery College
Rockville, MDHigh school or equivalent -
Portage Area High School
Portage, PASkills
- Insurance Verification
- Data entry proficiency
- Patient account management
- Medical billing procedures
- HIPAA Compliance
- Medical terminology knowledge
- Correspondence Writing
- Investigative research
- Automated Document Scanning
- Aging reports analysis
- Payment Processing
- Account Investigation
Phonenumbers
301-253-6910, 301-640-9265
Timeline
Medical Collection Specialist
Children’s National Medical Center
01.2013 - Current
Collections Rep.
Maryland Heart
08.2004 - 11.2009
Medical Billier / Collections
David Plotkin, MD
01.2004 - 08.2004
Office Manager
Dr. Inder Chawla, MD
09.1999 - 01.2004
Patient Advocate
Concentra
06.1997 - 09.1999
Customer Service
Mail Handlers Insurance
06.1989 - 06.1997
Precertification Appeal
Mail Handlers Insurance
06.1989 - 06.1997
Special Correspondence
Mail Handlers Insurance
06.1989 - 06.1997
Claims Processing
Mail Handlers Insurance
06.1989 - 06.1997
Montgomery College
High school or equivalent -
Portage Area High School
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