Janet Smith
Winter Park
Summary
High-energy individual with effective communication skills. Effectively manage multiple, high- priority projects and take pride in providing exemplary patient/ customer service. Excel in interpreting policy benefits, analyzing/streaming insurance payments and denial trends. Possess a positive upbeat personality, initiative-taker, driven, and always willing to learn. The ability to contribute innovative ideas that drives company growth. High Customer service standards Meticulous attention to detail Claims investigation, Claims Resolution, Workers Compensation, Time Management, Team Player, and Deadline-Oriented
Overview
12
12
years of professional experience
Work History
Accounts Receivable Rep. II
Napa anesthesia Group PLLC
01.2022 - Current
- Monitors claim rejections for trends and issues; report these finding to Management
- Document billing activity on patient accounts; ensure compliance with all applicable billing and report any suspected compliance issues to departmental leaders
- Audit accounts and submit all levels of appeal for denied claims
- Analyzedexplanation of benefits claim forms,differentpoliciestodetermineany changes and healthcare terminology
- Accurately document follow up on the accounts to ensure accurate record of steps taken to collect on accounts.
Medical Billing Rep
NYU Langone Health
05.2020 - 11.2021
- Performedbillingtasks assigned by managementwhichmay includedataentry, claim review, charge review, accounts receivable follow-up, or other related responsibilities
- Provided input on system edits, processes, policies, and billing procedures to ensure maximization of revenues
- Identified payer, provider credentialing, and/or coding issues and address them with management
- Communicatedwith providers, patients, coders, or other responsible persons to ensure that third party payers correctly process claims
- Collaborated with coders to understand CPT and ICD-10 manuals, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures.
Billing Specialist/Team Lead
United Clinical Laboratory
11.2018 - 02.2020
- Managed a team responsible for performing important revenue cycle functions
- Monitor reports and work queues, ensuring charge submission and accounts receivable follow-up is occurring on a timely basis
- Identified, monitored, and corrected rejected electronic and paper claims
- Documented findings and conclusions on claims worked
- Adhered to documentation protocol, and quality assurance procedures
- Reconciled open accounts to clearly established patient responsibility and appealed if/when necessary.
Collection Specialist/Team Lead
Medpro Billing
02.2016 - 10.2018
- Supervised billing AR Representatives, which included work allocations, training, and evaluated performance
- Provided and/or coordinated provision of training for new and existing collection specialist
- Analyze billing and claims for accuracy and extensiveness; submitted claims to proper insurance entities
- Appealed complex denials through review of payer policies, coding, contracts, and medical records
- Utilize subject matter experts as needed
- Constructed appropriate corrections to system to satisfy/edit payer requirements and re- submit claims as needed.
Collection Specialist
Acc-Q-Data Inc
12.2013 - 02.2016
- Prepared and submitted claims to various insurance companies either electronically or by paper, using CMS-1500 claim form
- Contacted insurance companies for payments on claims billed
- Verified eligibility of benefits and obtained authorizations for treatment
- Called Patients for collection of payments and mailed out invoices.
Customer Service/Cashier
BJS Wholesale Club
02.2011 - 02.2013
- Executed acquisition 365, renewed, upgraded, and sold BJs membership
- Assisted customers with merchandise returns, exchanges, pick-ups, and general customer services inquiries
- Reviewed applications and assessed credibility on approvals for BJs credit cards
- Reconciled cash drawers and sales receipts
Education
License Certified Nursing Assistant License Claims Adjuster American Red Cross Basic Life Support Certificate -
Bachelor of Arts - Health Service Administration
Keiser University
2011
AS - Radiologic Technology
2005
Skills
- Claims Resolution
- Credit and Collections
- Attention to detailed
- Time management
- Analytical and interpretive skills
Timeline
Accounts Receivable Rep. II
Napa anesthesia Group PLLC
01.2022 - Current
Medical Billing Rep
NYU Langone Health
05.2020 - 11.2021
Billing Specialist/Team Lead
United Clinical Laboratory
11.2018 - 02.2020
Collection Specialist/Team Lead
Medpro Billing
02.2016 - 10.2018
Collection Specialist
Acc-Q-Data Inc
12.2013 - 02.2016
Customer Service/Cashier
BJS Wholesale Club
02.2011 - 02.2013
License Certified Nursing Assistant License Claims Adjuster American Red Cross Basic Life Support Certificate -
Bachelor of Arts - Health Service Administration
Keiser University
AS - Radiologic Technology
Similar Profiles
MELISSA PILALUISAMELISSA PILALUISA
Patient Support/ Insurance Verification Specialist at NAPA AnesthesiaPatient Support/ Insurance Verification Specialist at NAPA Anesthesia
ERIN SCHWARZERIN SCHWARZ
Certified Registered Nurse Anesthetist at Schwarz Anesthesia, PLLCCertified Registered Nurse Anesthetist at Schwarz Anesthesia, PLLC
R. Melissa HurdR. Melissa Hurd
CRNA at Anesthesia Medical Group P.C.CRNA at Anesthesia Medical Group P.C.
Manus McGinnisManus McGinnis
Computer Vision/Machine Learning Actor at MetaComputer Vision/Machine Learning Actor at Meta
Kerwin StohnerKerwin Stohner
Warehouse Worker at Hudson NewsWarehouse Worker at Hudson News