Elizabeth Nguyen

As a Patient Account Specialist II working at Orange County Global Medical Center (now KPC Healthcare Inc.) since 2005, I am responsible to handle all financial billings matters for CBO Business Office. On a daily basis, my job consist providing customer service over the phone and in-person, answering busy phone calls and doing filings as necessary. In addition, I work on collections, pursue insurance payment on claims, appeal for underpayment, pursue patient for unpaid balances, research missing payments, skip trace (not hard core collection) patient by reviewing records for other contact numbers to contact patient, re-classing to correct insurance plan, contacting insurance companies and calling patient to demand payments and assist with unidentified accounts. I also review EOBs and correspondence, billed claims to insurance, analyze payments and contracts to see if insurance paid claim correct rate, handle specialist projects, assist upper management and supervisor with other duties, and training new employees. It is evident that my manager is working on a process of promoting me to a higher lead position within my department.

Being bilingual in Vietnamese, part of my job is to interact with the public from all ethnic background to determine their payment for services. I have excellent communication skills and can work well with Vietnamese population client group. I have a firm and thorough understanding of hospital and State guidelines such as Medi-Cal, Medicare, CPT and ICD-9 codes as well as other health benefit programs.

Occasionally, I came across some difficult situations such as patient is being rude and agitated over the phone or in-person, he/she would not listen, does not want to pay, I stay firm yet direct and able to calm the patient down without upsetting him further. When dealing with insurance companies, they sometimes refused to send claim back for reprocess, I have to inform insurance that they would violate contract agreement or claim billed as set by the California State Insurance Department in order to get them cooperate with us. As a result, I was able to overturn old claims that is over 2 to 3 years old and paid with interest.

I am a team player and I can work well under pressure with my co-workers and different levels of management. I take my job seriously and I give 100% and above. I can work independently with minimum supervision. I work hard to avoid backlogs and assist my team so that claims are processed in a timely manner.

Provide collection, pursue insurance for underpayment, contact insurance and demand for claim to be paid based on contract, call patients to set payment plan on balances due, review patient information or records to see if any other contact information, submit appeal to insurance for underpayment, review and analyze contract rates, set up arrangements with insurance and patient for balance due, fax appeal to insurance, answer and take phone calls from patient and insurance, assist with projects as needed.