Lori Silvers

Assist in answering incoming patient/client calls to the Customer Service Department.

Resolve complex account issues and escalated patient calls.

Assist patients from the beginning of the issue to the end of the issue to ensure a resolution by all parties.

Contact or work directly with patients regarding their self-pay balances for payment or payment arrangements.

Determine appropriate action to be taken and make independent decisions regarding adjustment and processing of open/unresolved billing issues.

Work directly with appropriate clinic Billing Managers and Patient Assistance Office Managers to correct and resolve patient complaints.

Perform audit of accounts to resolve discrepancies in account balances and ensure payments are in accordance with the respective contract, appropriate discounts, or applicable write-offs.

Contact the departments when there are issues regarding the patient’s coding or service

Contact the patient’s insurance company if there are any issues regarding benefits.

Contact the Follow Up department if there is a question regarding a denial or if an appeal is needed.

Contact the collection agencies if an account needs to be recalled from the agency or if there is any issue regarding payments.

Contact the Self-Pay or Insurance Posting Team(s) if there is any issue with posting.

Contact the Refund Team to ensure the patient and/or insurance refund is completed and sent out.

Work closely with Management to help identify and report trends pertaining to the Customer Service Work Queues.

Make recommendations regarding workflows and procedures.

Stay abreast of the latest developments and trends in medical billing, customer service and collections.

Attend seminars, webinars, and workshops and actively participates in Occupational Training and Development and Compliance educational activities.

Maintain knowledge of all university applicable rules, regulations, policies, guidelines that impact Billing Operations; seeks advice and guidance as necessary to ensure proper understanding of job functions.

Identify ways to improve work processes and provide recommendations for new or revised procedures, to enhance the collection and customer service process; implements and monitors results as appropriate in support of the overall goals of the department

Processed and sent invoices, adjustments, and credit memos to customers.

Contacted insurance providers to verify insurance information and obtain billing authorization.

Answered customer invoice questions and resolved issues discovered during invoicing and collection process.

Performed data import scanning or manual keying processes to verify invoice accuracy.

Investigated and resolved issues to maintained billing accuracy.

Researched and resolved billing inconsistencies and errors through individual and collaborative analysis.

Resolved reimbursement discrepancies by analyzing information and notifying manager.

Prepared manual billing data using related billing and service reports.

Input payment history and other financial data to keep customer accounts up-to-date in the system.

Submitted claims to insurance companies and researched and resolved denials and explanation of benefit rejections.

Resolved reimbursement discrepancies by analyzing information and notifying manager.

Researched and resolved billing inconsistencies and errors through individual and collaborative analysis.

Investigated and resolved issues to maintain billing accuracy.

Worked with outside parties to obtain payments and solve problems.

Submitted claims to insurance companies and researched and resolved denials and explanation of benefit rejections.

Review, research, and resolve coding denials. Make necessary Coding adjustments as required by plan reimbursement.

Prepare and submit claim appeals based on payer guidelines.

Identify denial, payment, and coding trends in a effort to decrease denials and maximize collections.

Interpret Managed Care contracts and or Medicare / Medicaid rules and regulations to ensure proper reimbursement / collection.

Conversed with people from different cultures daily, providing a high level of respect and patience with each interaction.

Explained eligibility details and affordability options to patients with kindness and respect.

Created and maintained accurate and confidential patient files according to regulatory mandates.

Adhered to HIPAA requirements to safeguard patient confidentiality.

Updated patient financial information to promote accurate record keeping.

Communicated with patients to gather intake data and verify chart information.

Completed pre-certifications for all radiology and surgical procedures.

Verified eligibility for all office visits, physical therapy, and surgical procedures.

Supported entire practice's staff, which boosted efficiency and improved overall process flow.

Motivated staff by offering direction and providing constructive feedback.

Communicated with patients with compassion while keeping medical information private.

Complied with OSHA and HIPAA regulations.

Cultivated close working relationships with the entire staff, including Physicians, Physician Assistants, and Medical Assistants.

Checked entire office and waiting areas regularly to provide clean and organized surroundings.

Created and maintained EMR systems to store data and develop reports.