Summary
Overview
Work History
Education
Skills
Timeline
Generic

DORIS SENECAL

Lawrenceville,GA

Summary

Experienced in the healthcare revenue cycle, specializing in billing and account resolution. Skilled in streamlining processes and maximizing revenue for healthcare organizations. Committed to accurate billing practices and efficient resolution of account discrepancies. Eager to contribute to a dynamic team environment and drive success in healthcare financial operations.

Overview

27
27
years of professional experience

Work History

Account Receivable Clerk

OPTUM
02.2019 - Current
  • Worked as a follow up representative to Medicare secondary claims which included Medicare supplements as well as Medicaid.
  • Transitioned to billing the secondary claims as well as billing primary worker’s compensation claims.
  • Performed billing and follow up on hospital claims for commercial and Medicaid payers.
  • Posting insurance credit card payments as well as manual posting of live checks, book transfers and BNP's. (banked not posted)

PATIENT ACCOUNTS REPRESENTATIVE

PRESTIGE STAFFING
08.2018 - 10.2018
  • Worked various projects at a home health agency where my duties included:
  • Entered information onto patient accounts regarding specific project status and coded the accounts to move them from the representative’s work queues.
  • Notated accounts when the initial bill (RAP) was paid but the final bill had not yet dropped
  • Calculated reimbursement for final bills and requested adjustments as applicable
  • Checked claim status on various payer websites and contacted payers with payment discrepancies.
  • Main system used was Unity.
  • P: 770.200.3565

PATIENT ACCOUNTS REPRESENTATIVE

CONIFER HEALTH SOLUTIONS
07.2016 - 01.2017
  • Responsibilities included tracking Medicare HMO and Georgia Medicaid CMO hospital claims from time of billing through account resolution.
  • Applied contractual adjustments, called the various insurance companies for claim status and prepared and mailed appeals as necessary.
  • Worked special projects such as inventory over 60+ days.
  • Main system used was Epic.
  • P: 469.803.3000

PATIENT ACCOUNTS/MEDICAID REPRESENTATIVE

JOHNS HOPKINS MEDICINE ALL CHILDREN’S HOSPITAL
10.1998 - 03.2016
  • Responsibilities included receiving and processing telephone calls and correspondence on assigned accounts through completion.
  • Documented activities via information system.
  • Reviewed accounts in a timely fashion and contacted payers with payment discrepancies.
  • Wrote and submitted appeals as necessary.
  • Identified payer trends and escalated to manager as appropriate.
  • Researched and resolved credit balances.
  • Provided support to the Medicaid team by assisting with staff questions and providing guidance as to how to deal with issues as they arose.
  • Assisted with assigned payer projects.
  • P:727.898.7451

Education

High School Diploma -

HUTSONVILLE HIGH
HUTSONVILLE, IL

Skills

  • Experienced with healthcare management systems
  • Optimizes insurance claim payments through third-party communication
  • Account resolution and billing proficiency
  • Adherence to HIPAA standards
  • Skilled in independent and team-based work
  • Patient account documentation
  • Detail-oriented
  • Accounts reconciliation
  • Activity reporting

Timeline

Account Receivable Clerk

OPTUM
02.2019 - Current

PATIENT ACCOUNTS REPRESENTATIVE

PRESTIGE STAFFING
08.2018 - 10.2018

PATIENT ACCOUNTS REPRESENTATIVE

CONIFER HEALTH SOLUTIONS
07.2016 - 01.2017

PATIENT ACCOUNTS/MEDICAID REPRESENTATIVE

JOHNS HOPKINS MEDICINE ALL CHILDREN’S HOSPITAL
10.1998 - 03.2016

High School Diploma -

HUTSONVILLE HIGH

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