Dynamic Billing Analyst with extensive experience at WellStar Health Systems, proficient in medical coding and revenue cycle management. Proven track record of resolving discrepancies and enhancing billing accuracy, contributing to a significant reduction in denial rates. Exceptional attention to detail and strong interpersonal communication skills drive successful collaboration across teams.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Billing Analyst/Charge Entry Specialist
Medix Staffing
NASHVILLE, TN
10.2024 - Current
Accurately and efficiently enter patient encounter information, including diagnoses, procedures, and services, into the billing system
Ensure all patient-related charges are entered correctly and promptly
Verify the accuracy and completeness of medical records and billing information
Understand and apply relevant coding guidelines (e.g., CPT, ICD-10) to ensure accurate charge entry
Identify and resolve discrepancies or errors in charge entry data
Respond to inquiries from other departments regarding coding, billing, and reimbursement issues
Maintain accurate and organized records of patient encounters and charges
Become proficient in using billing software and other relevant systems
Maintain a high level of accuracy and attention to detail in all aspects of the job
Ensure that all charges are entered in a timely manner to facilitate prompt billing and payment
Processed invoice payments and recorded information in account database.
Completed efficient drop and bulk filing to maintain well-organized and easily accessed systems
Executed account updates and noted account information in company data systems.
Analyzed data from customer accounts to identify discrepancies.
Prepared weekly, monthly, quarterly, and annual reports on billing activity.
Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
AR Specialist II
WellStar Health Systems
Atlanta, GA
03.2023 - Current
Review and analyze healthcare facility claims to identify issues and trends, enhancing overall revenue flow
Collaborate with cross-functional teams to address payment, coding, and editing discrepancies
Reconcile and resolved specific payor accounts, identifying and reporting inefficiencies
Process insurance denials and appeals, tracking denial trends to reduce future occurrences
Maintain compliance with government regulations and contractual obligations, ensuring accurate billing practices
Consistently meet or exceeded departmental productivity standards
Assisted in developing and updating accounts receivable procedures.
Established new accounts in accordance with company policies and procedures.
Ensured compliance with financial policies and regulations.
Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs.
Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
Handled accounts payable and receivable, including invoicing and payment processing.
Prepared aging reports to identify past due accounts.
Managed timely invoicing of clients and ensured accurate billing details.
AR Specialist II
Children's Healthcare of Atlanta
ATLANTA, GA
01.2016 - 03.2023
Perform daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual
Ensure that special billing needs by payor are performed to prevent denial of claims and delay in payment
Prepare and submit all final bill claims, secondary claims, rebills, and late charges on a daily, maintaining claim status
Perform routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement
Verify insurance Eligibility
Bill and correct Medical Claims
Analyze and interpret medical documents, contracts, receipts, notes, and other correspondence
Research Medical EOB'S/Remittances for manager care for Managed Care Payers
Research claims denials, Initiate appeals, review, and correct provider contractual adjustments
Work correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts
Take appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances
Submit reconsiderations & administrative review requests to payers to dispute claim denials
Assisted in developing and updating accounts receivable procedures.
Received and recorded cash, checks and transfers.
Wrote and submitted reports on industry trends, prompting managers to develop business plans.
Assisted in developing strategies to increase customer satisfaction levels.
Assessed company operations for compliance with safety standards.
Created training materials for new hires on the company's procedures and policies.
Coordinated with other departments to ensure efficient workflow processes.
Maintained positive working relationship with fellow staff and management.
Set specific goals for projects to measure progress and evaluate end results.
Utilized various software and tools to streamline processes and optimize performance.
Billing & Collection Specialist
Expeditive Healthcare
01.2015 - 12.2016
Company Overview: Contractor
Slash Denial resolution time by 85% returned over6.5 million dollars in profitable revenue
Processed claims for third party, commercial and government payers for coordination of benefits from assigned work ques and tasks lists
Effectively documented claim status and next steps in the Practice Management System (PMS) to expedite timely and accurate claims processing
Processed and corrected medical insurance claims
Resolved coding trends and billing issues
Contact insurance entities for payment issues and follow-ups
Initiate appeals for denial aged accounts beyond 90 days
Contractor
Patient Account Representative
Promise Healthcare
01.2011 - 12.2015
Company Overview: Contractor
Follow up on Insurance and patient aging
Re-submit insurance claims, as necessary
Responsible for accurate and timely claims follow-up by assigned payer/s and defined aging criteria to meet or exceed collection targets and minimize timely filing write-offs
Effectively documented claim status and next steps in the Practice Management System (PMS) to expedite timely and accurate claims processing
Worked with payer to determine reasons for denials corrects and reprocesses claims for payment in a timely manner
CEO/Head of Human Resources at TRA Lakewood, Inc, Diamond RDA, Inc, Life Is Joy, Inc, Keisha Business, TRA Covington, IncCEO/Head of Human Resources at TRA Lakewood, Inc, Diamond RDA, Inc, Life Is Joy, Inc, Keisha Business, TRA Covington, Inc