Summary
Work History
Education
Work Availability
Skills
Timeline
Generic

KARISSA RAIFORD HOGAN

West Palm Beach,FL

Summary

Versatile Billing Coordinator bringing 11 years of healthcare experience. Familiar with confidentiality requirements, patient care standards and insurance claims processes. Flexible, reliable and goal-focused. As well as successful at efficiently handling client inquiries, billing and administrative tasks. Knowledgeable about preparing invoices, processing payments and pursuing past-due balances. Well-versed in Team-oriented, dependable and performance-driven.

Work History

Billing Coordinator

AdvantEdge Health Solutions
Remote, FL
02.2021 - 04.2022
  • Updated documentation, reports and spreadsheets with financial information.
  • Answered telephone inquiries with friendly demeanor and full knowledge of billing department processes.
  • Maintained detailed understanding of insurance plans and company requirements.
  • Entered details into accounts and tracked payments.
  • Identified, researched and resolved billing variances to maintain system accuracy and currency.
  • Generated and submitted invoices based upon established accounts receivable schedules and terms.
  • Worked effectively with medical payers such as Medicare, Medicaid, Commercial ,Auto, and Worker's Comp Insurances to obtain timely and accurate payments.
  • Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
  • Perform payment posting/reviews holds.
  • Managed efficient reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
  • Complete weekly reports on status of Hospital charity applications.
  • Performed targeted collections on past due accounts aged over 20 days.
  • Obtain payment for office visit’s and hospital procedures via Instamed, VM, and Patient Notebook software.
  • Responded to customer concerns and questions on daily basis.
  • Processed payment via telephone with focus on accuracy and efficiency.
  • Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.


Medical Scheduler -Contract

Employment Solutions Of Ny
Remote, FL
09.2020 - 01.2021
  • Answered telephone calls to offer office information, answer questions and direct calls to staff.
  • Answered phone calls and messages for medical facility, scheduling appointments and handling patient inquiries.
  • Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
  • Organized and maintained patient chart filing system to promote quick data finding for staff.
  • Inbound/Outbound calls on vaccine Helpline.
  • Researching County vaccine information to provide to patient.
  • Setting vaccine appointments listed in Five9 by county.
  • Obtain/verify patient demographics
  • Provide requirements and important information for appointment scheduled.
  • Provide empathy
  • Attention to details
  • Computer proficient
  • Register patients in county's system to receive first dosage vaccine.
  • Manage productivity time
  • Data entry
  • Attention to detail
  • Pre-screening to determine eligibility
  • Multitask/Multi screen proficient
  • Documentation of Patient's interactions
  • Provide assistance to Patients, Healthcare workers, and Provider's

Claim Processing Specialist, Temp

AppleOne Employment Services/Palladio
Remote, FL
05.2019 - 06.2020
  • Followed up with customers on unresolved issues.
  • Reviewed new files to determine current status of claim and to develop plan of action.
  • Escalated files with significant indemnity exposure to supervisor for further investigation.
  • Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
  • Verified client information by analyzing existing evidence on file.
  • Generated, posted and attached information to claim files.
  • Collected premiums and issued accurate receipts.
  • Adjudicate and administer claims Attention to details
  • Evaluate issues and provide best resolution.
  • Develop knowledge of terms and conditions of different plans administered
  • Build and maintain professional rapport with consumer's, service technicians, retailers and manufacturers
  • Utilize CRM for daily assignments.
  • Compose correspondence such as claim notes, e-mails, chat, and any other form of internal or external written communication
  • Effective organizational skills
  • Review documentation and determine what next steps would be. Strong analytical and critical thinking skills to collect and interpret data to solve problems

Pharmacy Claims Specialist

RxSense
Palm Beach Gardens, FL
12.2017 - 08.2019
  • Resolve/ Troubleshoot pharmacy claims
  • Educate patients on policy and benefits.
  • Determine policy coverage and calculate claims amounts.
  • Ability to multitask, prioritize, and manage time effectively
  • Reset patient account passwords in Rxsense CSP admin tool.
  • Processed /Posted policy premium payments.
  • Processed incoming drug orders by checking deliveries against paperwork and updating computer system.
  • Provide help desk assistance initiating a Prior Authorization, and Reimbursement in Legacy software.
  • Maintained records of prescriptions filled for patients by completing pharmacy log and updating customer accounts.
  • Aided patients through Salesforce and Snap engage for email and chat
  • Established and maintained patient profiles, updating organizational database with current information.
  • Patient intake for Mail orders prescriptions for Alliancerx, Rx Preferred, APPROX, ACUSA, EQUIPOINT
  • Aid retail, mail order, Hospice pharmacies in rebill of a claim over 90days in Rxsense admin tool.
  • Provide PBM assistance for multiple health plans (Advance hospice care, access Health Plan, Agentra Health, Shared Health Alliance, Health innovations, AllyRX, My Benefits Keeper, Etc.)
  • Assisted clients on adding new patients / removing termed patients.
  • Performed pre-certification and verification of insurance eligibility
  • Drug price lookup for RX savings cards using they're pricing tools.
  • Assisted Patient, Pharmacies, and Nurses Drug formulary lookup.
  • Strong phone contact handling skills and active listening
  • Add and Edit members medical plans and benefits.
  • Assisted patients with Singlecare,WebMDRx savings card, and dental saving plans through Dentalplans.com.
  • Processed and recorded new policies and claims.
  • Presented insurance options to customers in order to close sales on new policies.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.

Medical Records Clerk, Temp

Randstad/Quantum Medical
West Palm Beach, FL
02.2017 - 11.2017
  • Assist medical staff by providing them with information regarding patient data and medical records.
  • Verify authority of individuals requesting medical and patient information before retrieving data
  • Reconciliation Prepare and Maintain reports, and records.
  • Conduct random audits of medical charts to ensure their integrity and completeness
  • Maintains continuity of work operations by documenting and communicating actions, irregularities, and continuing needs.
  • Resolve issues pertaining to release of confidential information, misplaced information, or unhappy clients / patients
  • Create and maintain effective relationships with other facilities in a bid to exchange medical information
  • Ascertain that all administrative and health statistics are maintained for use by physicians and other medical professionals
  • Intake and Process orders for diabetic shoes and DME equipment.
  • Gather patient information by collecting demographic information from varieties of sources
  • Interacting with registration areas and physicians' offices
  • Retrieving information from automated printers.
  • Aid patient and client through email and chat.
  • Maintains record availability by processing charts into department; using chart mark-off procedures; facilitating chart location activities.
  • Maintains patient confidence by keeping patient records information confidential.
  • Follow up with Doctor's office on documents needed to complete processing of DME/ Diabetic supplies.
  • Uploaded physician progress notes, history and physicals into electronic medical records.
  • Processed medical records requests from outside providers according to facility, state and federal law.
  • Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.

Intake Program Specialist

MDVIP
Boca Raton, FL
02.2014 - 10.2017
  • Worked alongside other professionals to outline and implement program plans and objectives.
  • Maintained regular communication between departments and physicians via email and phone calls to coordinate program logistics.
  • Educate patients on benefits of becoming members of MDVIP affiliated practice by consistently tailoring MDVIP Program benefits to patients.
  • Established goals and created action plans to achieve goals.
  • Determined customer needs and developed program initiatives according to preferences.
  • Respond /Address email inquiries and enroll patients.
  • Patient intake enrollment into MDVIP affiliated practice of their current PCP.
  • Completed intake assessment forms and filed clients' charts.
  • Collected, verified, recorded and processed client demographics, insurance payments and referral information.
  • Determined needed and relevant interventions based on each client's cognitive abilities and current needs.
  • Accurately documents patient customer relationship management database (Salesforce) with outcome of interaction/outreach.
  • Partner with Doctor's office to schedule appointments and set up program meet and greet meeting.
  • Process/Post annual and monthly membership premiums (Credit Cards, Checks by phone, HSA, and FSA cards) for enrollment into MDVIP affiliated practice.
  • Collected customer feedback and made process changes to exceed customer satisfaction goals.

Education

Associate of Applied Science - Medical Insurance Billing

Ameritech College of Healthcare
Provo, UT

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Skills

  • Services Rendered Documentation
  • Claim Processing
  • Records Organization and Review
  • Invoice Documentation Management
  • Billing Dispute Resolution
  • Billing Data Verification
  • Billing Systems and Software
  • Customer Contact
  • Discrepancy Resolution
  • Medical Billing and Collections
  • Patient Account Reviews
  • Benefits Verifications
  • Microsoft Office 365
  • Physician Interaction

Timeline

Billing Coordinator

AdvantEdge Health Solutions
02.2021 - 04.2022

Medical Scheduler -Contract

Employment Solutions Of Ny
09.2020 - 01.2021

Claim Processing Specialist, Temp

AppleOne Employment Services/Palladio
05.2019 - 06.2020

Pharmacy Claims Specialist

RxSense
12.2017 - 08.2019

Medical Records Clerk, Temp

Randstad/Quantum Medical
02.2017 - 11.2017

Intake Program Specialist

MDVIP
02.2014 - 10.2017

Associate of Applied Science - Medical Insurance Billing

Ameritech College of Healthcare
KARISSA RAIFORD HOGAN