LaCretia Smith
Las Vegas
Summary
Highly skilled and dedicated medical biller with a strong work ethic and professionalism. Thrives under pressure, efficiently handling high balances and aging claims with urgency. Demonstrates exceptional attendance, punctuality, and reliability. Positive attitude and attention to detail well-suited for fast-paced environments. Team player with leadership capabilities to effectively manage a staff of 12. Comprehensive knowledge of billing processes, adept at multitasking across various work queues, completing 45 accounts daily. Finds fulfillment in the role of a medical biller.
Overview
14
14
years of professional experience
Work History
Collection Specialist
UHS
10.2023 - Current
- Developed and documented collection procedures and policies to comply with UHS, regulations.
- Review insurance payments and updated accounts to reflect new balance.
- Analyzed Patients insurance plans to determine appropriate Iplan for reimbursement.
- Update insurance Iplans from uninsurance, hard-to-find, or re-located patients.
- Researched billing errors and discrepancies to initiate corrective action.
- Contacted Patients to discuss insurance coordination of benefits or accidents/injuries information request from insurance payer to resolve accounts.
- Collaborated with other departments to comply with insurance payer request to resubmit claim for payment.
- Documented Patients interactions of phone calls for future reference.
- Work on special projects to resolve delinquent accounts.
- Showcased strong analytical skills by identifying trends with insurance underpayment.
- Streamlined the collections process for increased efficiency through regular review and updating of procedures.
- Maintained detailed records of all collection activities, ensuring compliance with company policies and federal regulations.
- Monitor filp insurance Iplans to initiating primary billing, removing non existing iplans in efforts to minimize insurance confusion.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
Medical Collections Specialist
Hca Healthcare
02.2023 - 08.2023
- Collections/Appeals/Denials
- Calling patient for payments
- Set up payments arrangements
- Explain in detail to patients about the service render
- Send out patient statements and collection letters
- Update patients Info
- Following company Protocol and Procedures with EMTALA HIPPA and all government regulations that apply
- Entering Patients Demographics
- Optimized strategies for managing complex authorization challenges and appeals.
- Calling patient for insurance info
- Verifying insurance
Medical Billing/collection Specialist
Perform Practice Solution Physical Therapy
12.2021 - 01.2023
- Primary Medical billed for three Physical therapy clinics
- Approved and billed encounters
- Apply ERA's and Eobs payments
- Scanned Correspondence
- Track Claim Status
- Upload unpaid claims and A/R Reports
- Fix rejections and Denials
- File appeals
- Requested Authorization
- Apply copay
- Audit patient account
- Send patients Statements
- Submitted claims electronically and paper claims
- Maintain a denial status of less than 6% with payment collection of 92% of all claims billed.
Dental Collections
Pacific Dental Service
11.2020 - 10.2021
- Verifying insurance
- Collections/Appeals/Denials
- Calling patient for payments
- Set up payments arrangements
- Explain in detail to patients about the service render
- Send out patient statements and collection letters
- Update patients info
- Medicaid and Medicare Denials reports
- Updating Surgery Scheduling
- Billed all claims for payments
- Resubmitted corrected claims
- Aging, high balances and denied claims
Optum Care
Uson B & E Medical Billing and Charge Entry/ A/R follow up
06.2018 - 10.2020
- Following company Protocol and Procedures with EMTALA HIPPA and all government regulations that apply
- Entering Patients Demographics
- Understanding Authorization and appeals
- Calling patient for insurance info
- Verifying insurance
- Navicure and Next Gene experience
- Set up budget plans and processed Surgery copay's and payments
- Medicaid and Medicare Denials reports
- Updating Surgery Scheduling
- Billed all claims for payments
- Resubmitted corrected claims
- Aging, high balances and denied claims
- Working Correspondences
- Charges entry
- Referrals, X ray and MRI orders
Admitting Registrar
North Vista Hospital
03.2016 - 11.2017
- Provide excellent customer service at all times with meeting patients needs
- Maintain compliance with EMTALA HIPPA and all government regulations that apply to admission setting
- Provide and obtain all signatures required on forms and consents
- Verify insurance benefits associated with correct insurance carrier
Medicaid and Commercial Biller and Collector, Admitting Registrar and PBX Operator
North Vista Hospital
06.2015 - 03.2016
- Credential CT trainer for Epic
- Resubmitted corrected claims
- Calling patient for insurance info
- Verifying insurance
- Aging, high balances and denied claims
- Emdeon and Star system
- Update and change INS I Plan
- Work Medicaid RA
- Work Fail claims edit reports
- Upload Emdeon 837 and 835 files
- Billed all claims for payment
Biller and Collector
Cardiovascular & Thoracic Surgeons
02.2015 - 06.2015
- Verifying insurance
- Collections/Appeals/Denials
- Calling patient for payments
- Set up payments arrangements
- Explain in detail to patients about the service render
- Send out patient statements and collection letters
- Update patients info
Medical Billing Specialist
California Services Bureau
03.2012 - 04.2014
- A/R Commercial insurance private insurance Medicare
- Medicaid
- Work out of a Que or Spreadsheet
- UB 04 1500CM
- Process Appeals
- Patient Letters Requesting insurance information
- Process and Post Payments
- EOB, COB, Medical Records, TAR, Authorization
- Request Claim Status
- Prepare spreadsheet
- Account adjustment
- Canceled accounts
Billing Specialist
Bay Area Credit Services
04.2011 - 06.2012
- Post weekly payments
- Monitors discrepancies in patient accounts
- Track payments
- Research and analyzing unresolved payments accounts
- Process appeals
- Patient Letters
- Proficient in Microsoft excel and spreadsheet
- EOB, COB, Medical Records, TAR, Authorization
- Request Claim Status
- Tabulating charges and account adjustment
- Calculate discounts, interest proportions and percentages
- Canceled accounts
Education
Certificate - Medical Billing and Coding
Carrington College California
Antioch, CA04.2011
Skills
- Medical/Dental Terminology
- UB04/1500 CMS
- Judgment and Decision Making
- Telecommunications
- Knowledge of Nevada/California insurance
- EMR
- HIPAA certification
- Insurance contracts
- Time Management
- Patient Scheduling
- CPT/HCPCS
- 10 key/typing
- Telephone etiquette
- Epic System
- Medical Billing
- Medical Insurance
- ICD-9
- ICD-10
- Medical Coding
- Insurance Verification
- Medical Office Experience
- SMS
- Cerner
- MRO Medical Records
Timeline
Collection Specialist
UHS
10.2023 - Current
Medical Collections Specialist
Hca Healthcare
02.2023 - 08.2023
Medical Billing/collection Specialist
Perform Practice Solution Physical Therapy
12.2021 - 01.2023
Dental Collections
Pacific Dental Service
11.2020 - 10.2021
Optum Care
Uson B & E Medical Billing and Charge Entry/ A/R follow up
06.2018 - 10.2020
Admitting Registrar
North Vista Hospital
03.2016 - 11.2017
Medicaid and Commercial Biller and Collector, Admitting Registrar and PBX Operator
North Vista Hospital
06.2015 - 03.2016
Biller and Collector
Cardiovascular & Thoracic Surgeons
02.2015 - 06.2015
Medical Billing Specialist
California Services Bureau
03.2012 - 04.2014
Billing Specialist
Bay Area Credit Services
04.2011 - 06.2012
Certificate - Medical Billing and Coding
Carrington College California
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