Martha Taylor
Austin,TX
Summary
Friendly insurance professional experienced in investigating and processing insurance claims. Hardworking and communicative individual excels at interpreting policies and negotiating payment solutions. Recognized for providing optimum service to policyholders and quickly identifying fraudulent claims.
Overview
25
25
years of professional experience
Work History
AR/Claims Resolution Specialist
AR
01.2007 - Current
- Review, update, and work closely with Coding staff to identify trends and ensure claim is clean when processed when denials received
- Familiarity with ICD-10/CPT and HCPCS as well as Insurance Payor Portals to review denials and perform appeals is and when needed
- HIPAA complaint
- Continuously monitor and evaluate claims to ensure compliance with internal company policy as well as healthcare regulations
- Contact insurance carriers on a daily basis to follow up on past due amounts on outstanding claims regarding denials
- Enter detailed notes in patient chart
- Upload and submit information to payors via portal/fax/ or paper when needed
- Identifies issues and reports to my direct supervisor to help ensure corrections can be made promptly
- Continuously met company requirements with minimal supervision both while working in office and remotely
- Experience in Tiger and EPIC
Cash Posting Specialist
HCA
01.1999 - 01.2007
- Process patient payment and Insurance payments, Refunds, Recoupments and credits for patient accounts
- Post Medicare Remits
- Reconcile deposits
- Research payments and or recoupment for proper resolution
- HIPAA compliant with company and healthcare regulations
- Work with management to identify trends that indicate potential issues
- Ability to work with multiline phone system
- Experience with Tiger EPIC and EMR
- Enhanced efficiency by streamlining cash posting processes and implementing automated systems.
- Reduced errors in cash postings by conducting thorough audits and reconciliations on a regular basis.
Education
High School Diploma -
Roy Miller High School
Corpus Christi, TX06.1982
Skills
- EPIC proficient
- Team player
- Excellent time management skills
- Conflict Management
- Data analytics
- Trained Teammates
- Health Stream
Timeline
AR/Claims Resolution Specialist
AR
01.2007 - Current
Cash Posting Specialist
HCA
01.1999 - 01.2007
High School Diploma -
Roy Miller High School
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