Janice Walton
Aurora,CO
Summary
Detail-oriented and methodical Billing Specialist offering 5+ years of experience in related roles. Exceptional abilities in conducting research, problem-solving and prioritizing simultaneous tasks. Leverages resourcefulness, critical thinking skills and superior work ethic for top job performance.
Successful at efficiently handling client inquiries, billing and administrative tasks. Familiar with contracts and other documents affecting billing processes. Prepares professional, polished statements, and business correspondence.
Overview
10
10
years of professional experience
Work History
Service Coordinator
CMS Nextech
2022.12 - 2024.04
- Schedule & create work orders for preventative maintenance
- Schedule & create work orders for service repairs & replacements
- Dispatch technicians to emergency service calls
- Review & process work orders and purchase orders
- Procure parts for scheduled repairs
- Track down parts for emergency repairs
- Provide estimated costs for repairs when requested by the customer
- Review field generated paperwork and prepare for invoicing by the administrator.
- Served as a primary point of contact for clients, addressing inquiries, providing updates, and ensuring overall satisfaction with services rendered.
- Managed a high volume of client requests, ensuring timely and effective service delivery.
- Developed strong relationships with clients by providing consistent updates on shipment statuses and addressing concerns promptly.
- Streamlined communication between drivers, customers, and management for improved customer satisfaction.
- Managed approximately 65 incoming calls, emails and faxes per day from customers.'
Billing Representative
Children's Hospital Colorado - Patient Financial Services
2021.06 - 2024.02
- A/R Billing, following up and Denials
- Maintain and updates denials management data
- Responsible for conducting root-cause analysis of Denials and Reimburse, discrepancies
- Contacting payors to advocate and accelerate payments
- Accurate and Timely claims submission to payers both paper and electronic
- Works with payers to verify processing and payment of claims
- Maximizing cash collections and resolving aged accounts through informed, consistent and follow up activities
- Possesses up to date knowledge of payer claim processing rules, reimbursement policies And regulations
- Using EPIC System to note changes and follow up
- Availity, UHC and other portals to access claim information.
- Verified accuracy of accounts payable payments, resulting in 95% reduction in payment errors and check reissues.
Collections Management
Breg
2022.03 - 2022.04
- Manage claims process including intake, claim submittal, and accounts receivable activities for Breg’s in-house billing programs
- Process and facilitate pre-certification and data input processes for claims
- Contact insurance carriers to verify coverage of certain items
- Key and input claim information and coordinate with physicians’ personnel regarding documentation
- Analyze aging to prioritize collection activity and determine appropriate action to be taken to collect and resolve accounts
- Contact third-party payers, physicians’ personnel, sales representatives, and patients to resolve billing, reimbursement, and payment problems
- Contact patient to notify, collect, and establish terms of payment
- Review third-party payments to determine correct level of reimbursement
- Serve as Write appeals for denied claims to third-party payers
- Maintain related files and records in accordance with company and regulatory requirements and practice.
- Improved company''s cash flow management with timely invoicing, collections, and payments tracking.
- Managed approximately 30 incoming calls, emails and faxes per day from customers.'
Billing Specialist/ Patient Accounts
STRIDE COMMUNITY HEALTH
2020.12 - 2021.04
- Responsible for bills and collecting payments for services rendered from avariety of payer sources
- Responsible for timely and accurately coding, billing, claim denials, and payment posting
- Work aged receivables utilizing A/R reports/functionality in revenue cycle management and interpret explanation of Benefits (EOB) for denials and reimbursement underpayments
- Correct COVID-19 codes and rates if necessary
- Verify Guarantor Insurance thru Availity and Medicaid Portal
- Enter temporary ID from UCH into EPIC from spreadsheet
- Submit clean claim thru EPIC system
- Communicate with coworkers by using Teams Communication in outlook
- Post payments in EPIC entering check #'s and Batch information, log information on spreadsheet after posting check.
- Verified accuracy of accounts payable payments, resulting in 25% reduction in payment errors and check reissues.
Admission Coordinator
VISITING NURSE ASSOCIATION
2016.09 - 2020.10
- Answers incoming calls and provides information regarding hospice, palliative and/or home health care programs and admission criteria to external and internal customers
- Provides information to patients, families and facilities to explain care options including in home, long-term care, assisted living care and/or hospice inpatient facility settings
- Effectively works with discharge planners and referral sources
- Works closely with business Development and/or Clinical team/staff to ensure timely patient care
- Receives and documents complete referral information, schedules assessment using computer based appointment systems, determines insurance coverage, and helps coordinate admission process
- Collects and verifies insurance coverage information and forwards to appropriate hospice staff as requested
- Meets with families and patients to provide Explanation of Benefits on a periodic basis
- May verify insurance coverage, order durable medical equipment, and forwards to appropriate hospice staff as requested
- Acts as ambassador providing tours and general information about services provided by hospice, palliative and/or health care programs.
- Managed approximately 75 incoming calls, emails and faxes per day from customers.'
Billing Lead Account Representative - Payment Poster
TOUCHSTONE IMAGING
2014.04 - 2016.08
- Claim follow up calling Insurance Companies
- A/R working new and aging accounts
- Correct claims and rebill to Ins companies
- Submit reconsideration forms and Appeal
- Process denial by reviewing by zero EOB's
- Posting Time of Service payment from Facilities
- Posting manual payment from Ins companies and patient statements
- PFS Financial Group Insurance Representative
- Claim Follow up calling Insurance Companies
- Meet company quota touch 75 accounts daily
- Organizes and processes rebills, medical records, itemized statements and other requests
- Prepare request for adjustment write off or contractual adjustment
- Manages all incoming correspondence related to connected accounts
- Mail claims out to Insurance Companies
- Pursue accounts to meet filing deadlines, obtain missing authorization and minimize bad debt.
- Achieved timely payments from clients by sending reminders, negotiating payment terms, and resolving disputes promptly.
- Monitored outstanding invoices and performed collections duties.
Education
Associate - Applied Management -
NATIONAL AMERICAN UNIVERSITY COLLEGE
Denver, CO06.1997
Skills
- Insurance Verification
- Invoice Processing
- Claims Processing
- Billing systems and software
- Data entry proficiency
- HIPAA Compliance
- Claim submission
- Denial Management
- Payment posting
- Medical coding knowledge
- Telephone communication
- Notetaking and documentation
Timeline
Service Coordinator
CMS Nextech
2022.12 - 2024.04
Collections Management
Breg
2022.03 - 2022.04
Billing Representative
Children's Hospital Colorado - Patient Financial Services
2021.06 - 2024.02
Billing Specialist/ Patient Accounts
STRIDE COMMUNITY HEALTH
2020.12 - 2021.04
Admission Coordinator
VISITING NURSE ASSOCIATION
2016.09 - 2020.10
Billing Lead Account Representative - Payment Poster
TOUCHSTONE IMAGING
2014.04 - 2016.08
Associate - Applied Management -
NATIONAL AMERICAN UNIVERSITY COLLEGE
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