Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
19
19
years of professional experience
Work History
Terms & Conditions Analyst
Conifer Health Solutions
Frisco, TX
01.2020 - Current
Efficiently completed all command center CIDS for facility with high accuracy.
Managed aged accounts over three days while overseeing high-value accounts daily.
Generated impact and credit reports upon request to facilitate informed decision-making.
Assisted coworkers with CIDS during absences or when additional support was required.
Reviewed accounts daily to monitor proactively and resolve issues.
Patient Account Representative
Emanuel Medical Center/TENET
Turlock, CA
01.2019 - 01.2020
Verified insurance eligibility through web and phone communications.
Ensured timely submission of claims with complete documentation.
Reviewed credit balances and issued refunds to patients or insurance companies.
Managed Aged Trial Balance report in Excel to process accounts promptly.
Maintained equipment conditions by clearing jams, replacing toner, and requesting repairs.
Followed up on inquiries from patients and insurance companies efficiently.
Trained new employees on departmental systems, policies, and workflows.
T&C Coordinator
Conifer Health Solutions
01.2018 - 01.2019
Remote Reviews Zero Expected Report and resolves pricing issues by researching Nthrive and Payor Plan codes and correcting pricing issues.
Reviews Credit reports and resolved issues by submitting adjustment requests if necessary to correct credit.
Trained in Command Center functions, updating plan codes, submitting requests to rebill, and requests to NPAC to transfer payments.
Works other daily and month end reporting queries and reviews for improperly adjudicated acts.
Assists other NIC function areas with other processes as needed.
Creates and maintains system tables for specific coding, billing and appeals addresses.
Healthcare Billing/Follow-up Supervisor
Emanuel Medical Center
Turlock, CA
01.2017 - 01.2018
Responsible for all aspects of day-to-day supervision and leadership of Patient Account Representatives, but not limited to Performance Management metrics of collections, productivity, quality and aging.
Completes monthly Quality reviews as well as mid-year and year-end Performance Reviews.
Complete spreadsheets in Excel to resolve payer issues.
Monitor Staff scheduling and adherence to time and attendance protocol.
Responsible for all aspects of A/R Management, including but not limited to maintaining workload balance, ensuring maximum efficiency.
Train, develop, motivate and assist subordinates in reaching new levels of skills and knowledge.
Patient Accounts Representative
Emanuel Medical Center
Turlock, CA
10.2006 - 10.2017
Responsible for verifying insurance eligibility via the web or by phone.
Assured claims are sent with appropriate documentation and are submitted, followed up in a timely manner.
Review credit balances on accounts and issue refund to Insurance Company or the patient based on Company policies.
Work Aged Trial Balance report on Excel to assure that all assigned accounts are worked timely to avoid administrative adjustments.
Properly operates and maintains the conditions of equipment by performing tasks such as clearing paper jams, replacing toner cartridges and calling for repairs.
Follow up on phone calls that were received by either patients or insurance companies in a timely manner.
Train new employees in systems policies and workflows per Department policies.