Kim Torres
La Habra,Ca.
Summary
Skilled professional with experience in collections, customer service and data entry. Exceptional interpersonal and problem-solving skills. Effectively mediates customer disputes and collects payment in timely manner.
Overview
35
35
years of professional experience
Work History
AR Collections Specialist
Medix Staffing Solutions
Santa Monica
09.2022 - 10.2023
- Responsible for making necessary telephone calls, electronic or written contact
- Contact payers to check claim status and reimbursement, contact parents to obtain accurate Insurance information
- Work denials daily, contact payer regarding carrier issues
- Update insurance claims appeal and rebills
- Manage high dollar revenue
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Work Daily Reports.
Collector Administrator II
Pediatrix Medical Group
Orange
09.2014 - 10.2021
- Responsible for making necessary telephone calls, electronic or written contact
- Contact payers to check claim status and reimbursement, contact parents to obtain accurate Insurance information
- Work denials daily, contact payer regarding carrier issues
- Send appropriate 'informational request' letters (e.g., Need COB)
- Utilize payer's websites as appropriate, Consistent follow-up on outstanding accounts by working Collection reports and correspondence
- Special projects when assigned
- Worked daily assigned reports - Summarized outstanding accounts not worked within the department's guidelines - Identified registered Commercial accounts that have been paid as Managed Care and may qualify for proper adjustment or appeal
- Identified specific denials posted from EOB's received
- Responsible for 330 days A/R report
- Work Credit Balances.
Customer service / A/R Collector
CalMed Recovery
Huntington Beach
04.1989 - 12.2012
- Solely responsible for handling over 40 accounts a day for patient balances and rebills
- Solely responsible for answering phone calls, follow up on insurance disputes
- Retained medical terminology and knowledge
- Strong knowledge of Insurance Verification, ICD-10 codes, and CPT codes
- Solely responsible of the management of Accounts Receivable including month end reports for doctors, patient's statements, collections, and insurance billing
- Knowledgeable in setting up patient accounts, audit accounts, dunning debtors, and list debtors with credit reporting agencies
- Cultivated positive and professional relationships with co-workers and patients.
Education
High School Diploma -
Cypress High School
Cypress, Ca06.1977
Skills
Insurance knowledge includes HMO, , Commercial, Managed Care, Medicare and Medi-Cal, Government Insurance verifications and authorizations Self-pay and Physician collections Windows 10, Microsoft Word, and Excel Excellent customer service and communication skills Knowledgeable on Office Ally, Waystar Electronic billing clearing house GPMS, Master Database, On Base, Insurance Payor Websites, Allscripts PMS , EClinical works, Phreesia and EHR Call center Ageing Reports
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
AR Collections Specialist
Medix Staffing Solutions
09.2022 - 10.2023
Collector Administrator II
Pediatrix Medical Group
09.2014 - 10.2021
Customer service / A/R Collector
CalMed Recovery
04.1989 - 12.2012
High School Diploma -
Cypress High School
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