Makaha Lacey
Philadelphia,PA
Summary
Talented Accounts Receivable Specialist with several years' experience in financial services, collections, compassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, reimbursement management and customer care management across diverse industries. Knowledgeable, analytical, and personable with excellent problem solving skills and strengths in areas of medical billing, hospital billing, provider billing, and collections. Proven to improve workflow efficiencies while maintaining high standards in customer service.
Overview
11
11
years of professional experience
Work History
Accounts Receivable Specialist
Children’s Hospital Of Philadelphia
King Of Prussia, PA
11.2023 - 11.2024
- Review of the accounts receivable reports and explanation of benefits to determine outstanding balances for follow up
- Perform payment disputes timely and in accordance with payer, contractual and regulatory guidelines
- Document all follow up activities into the patient’s medical record
- Review payments for accuracy
- Identify and report all issues and identified trends related to contractual compliance utilizing the payer issue process to management
- Complete payer projects as assigned and document all follow up activity
- Perform as necessary, eligibility checks, payer changes, crediting and resubmission of claims
- Assist in obtaining/maintaining department’s cash goals
- Provide all home care patient financial services functions in accordance with CHOP, CHHC policy and all regulatory and accrediting agency guidelines
- Perform other duties as assigned by management.
Accounts Receivable Associate
Alliance Cancer Specialists
Feasterville, PA
01.2020 - 11.2023
- Reviews remittance advices (RAs) and explanation of benefits (EOBs) of assigned payors/accounts
- Reviews accuracy of RAs/EOBs on a weekly basis; contacts payors to resolve inappropriate denials/rejections
- Follow up with payers and other appropriate parties to collect open balances in a timely manner and to ensure compliance with payer guidelines
- Works with other departments (ie: Case Management, Medical Records, Credit and Billing) to appeal legitimate denials
- Resolve patient accounts billed to insurance payers or directly to guarantor
- Conducts at least 60 daily telephone calls or accesses Payer website to insurances and/or responsible party to inquire on status of claims.
Accounts Receivable Supervisor
Alliance Cancer Specialists
Bensalem, PA
06.2017 - 12.2019
- Supervise accounts receivable office personnel of 7, which include work allocation, training, and problem resolution; evaluate performance and make recommendations
- Oversee the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
- Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and follow Federal, State, and Payer regulations, guidelines, and requirements
- Keep up to date with current coding, billing regulations and HIPPA / SOX compliance
- Manage the End of Month, End of Quarter, and End of Year A/R closings and financial audits
- Coordinated collection activity for past due accounts, denials/appeals, and reconciled EOB/RA's
- Facilitated successful internal and external audits through sound and thorough documentation
- Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs
- Received and submitted payments and applied amounts to patient balances
- Contacted patients to collect outstanding payments, negotiated installment methods and processed payments
- Followed up with insurance payors to resolve inappropriate denials/rejections
- Utilized daily audit information to update aging reports
- Processed and sent invoices, adjustments and credit memos to patients/payors
- Monitored past due accounts and pursued collections on outstanding invoices
- Organized and maintained documents, files and records.
Patient Financial Counselor
Temple University Hospital
Philadelphia, PA
01.2014 - 06.2017
- Provides financial, credit, debt management counseling and education services to patients
- Utilizes alternative means for obtaining coverage for uninsured or underinsured patients
- Responsible for performing complex insurance verification and eligibility determinations
- Completed administrative and clerical functions which includes complex investigative and problem-solving activities in support of minimizing the hospital's bad debt risk
- Arrange for debt repayment or establish repayment schedules
- Compiles amounts owed by the company to vendors, suppliers, or other organization/individuals
- Process payments daily to appropriate client accounts
- Records all delinquent accounts, incomplete files, and credit risks
- Maintain all payment, receipt, and other transaction records
- Answer client inquiries regarding account transactions
- Handling all requests for account corrections and/or transfers
- Adjust bills, take payments from patients as well as help apply for financial assistance and set up payment arrangements
- Educated patient on benefits and Eligibility
- Prepared admission registration and transfer paperwork as required
- Process and scan medical records
- Reviewed Data, corrected discrepancies, and reconciled accounts
- Handled follow- up questions from patients, resolved discrepancies or errors
- Take inbound calls for patients calling about ER visit- physician bills.
Education
Associate of Arts - Health Care Studies
Community College of Philadelphia
Philadelphia, PASkills
- MS Office Suite
- Authorization Appeals
- Insurance Verification
- Epic and other EMR systems
- Collection
- Medical terminology
- HIPAA
- Medical records
- Medical Billing
- Invoice statements
- Account reconciliation
- Accounts receivable
- Deposit verification
- Payment reviewing
- Research skills
- Data entry
- Scheduling and calendar management
- Administrative support
- Deadline driven
- Correspondence handling
- Advanced clerical knowledge
- Invoice processing and preparation
- Professional phone etiquette
- Filing and data archiving
Timeline
Accounts Receivable Specialist
Children’s Hospital Of Philadelphia
11.2023 - 11.2024
Accounts Receivable Associate
Alliance Cancer Specialists
01.2020 - 11.2023
Accounts Receivable Supervisor
Alliance Cancer Specialists
06.2017 - 12.2019
Patient Financial Counselor
Temple University Hospital
01.2014 - 06.2017
Associate of Arts - Health Care Studies
Community College of Philadelphia
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