Summary
Overview
Work History
Education
Skills
Timeline
Generic

Marva Graham Peat

La Mesa,CA

Summary

HIGHLIGHT OF QUALIFICATIONS High standards of dependability and punctuality; Strong work ethic and desire to succeed, excellent phone demeanor and exceptional customer service skills. Able to work independently with initiative and exercise sound judgment. Extensive knowledge of medical terminology, obtained CNA / Medical Office certificates. Outstanding skills in medical billing EDI billing and payment posting, A/ R, A/P, medical collections, accounts representative, benefit coordination, benefit consulting and administrative assistant. Certificate received in Word Processing/Secretarial, bookkeeping and 10 keys by touch; Compose correspondence, reports and data entry. Computer Skills Word, Excel, PowerPoint, Microsoft Outlook, Quick Book, EMR, EPIC, Xifin , Brightree, Cloud, MediTech, Medical Management , Capable of handling multiple tasks in a busy environment with frequent interruptions. Ability to prioritize tasks, remain organized and manage time effectively. Effective in communication between personnel at various levels Government Security Clearance received June 2017 Authorized to work in the US for any employer

Overview

18
18
years of professional experience
8
8
years of post-secondary education

Work History

Anesthesia Payment Manager

Ventra Healthcare
San Diego, CA
10.2020 - Current
  • Developed strategic plans for day-to-day financial operations.
  • Designed and maintained financial models to identify and measure risks.
  • Collaborated with C-level executives and stakeholders to develop long-term financial plans.
  • Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
  • Created and managed financial models to evaluate corporate investments and acquisitions.
  • Implemented and regularly reviewed financial controls to generate accurate and reliable financial data.
  • Analyzed business processes to identify cost savings and operational efficiencies.

Medical Billing Manager

Southern California Liver Centers, INC
Coronado, CA
12.2017 - 04.2021
  • Performed as a practice expert for the department on all issues relating to billing and intake processing, managed and supervised a department of 5 Medical Billers, 6 Medical Assistants, 2 Authorization Specialist and 3 Front Desk intake Coordinators
  • Managed the billing/intake department day-to-day operations; perform duties such as procedure surgical coding, in-patient – out-patient, clinical coding, medical billing, charge entry, posted and reviewed payments received to appropriate patients accounts, balancing accounts receivable reconciling statements as needed, standardized the method in which work would be accomplished
  • Prepared financial and statistical report as directed, monitor and collected accounts receivables, monitored and reported delinquent accounts to the Practice Director
  • Prepared monthly financial statements to include preparing monthly balance sheets, income reports, etc as required
  • Managed and monitored data entry on all patients charges and refunds
  • Oversee and monitored computer billing, mailing, recording and collection
  • Daily Overseeing of all Medicare Part A&B, MediCal, Workers Comp, and Commercial insurance, billing, charges and supplies
  • Managed and negotiated payors Contracts and Credentialing
  • Implement written policies and procedures that govern accounting functions
  • Maintain billing and payment log and complete all crossover billing, as necessary
  • Maintained contact with the responsible parties involved as to payments due and the status of their accounts
  • Ensure quality and appropriate trainings was provided to newly hired and existing billing/intake staff through effect supervision and coordination of the training process, and by adhering to established company operating policies, procedures and systems, protocols, techniques, and standards
  • Coordinate time away requests of team members to ensure the daily functions of the department is not negatively affected
  • Carry out analysis of trends affecting coding, charges, accounts receivable, and collection, and assign manageable tasks to billing staff
  • Collaborate with other departments to get and analyze additional information about patients to be able to record and process billing effectively
  • Ensure the billing/intake department carries out all its activities in accordance with its overall protocol, and also that they complied with payer, State, and Federal requirements, regulations, and guidelines
  • Remain updated on HIPAA and all other health information management issues and regulations
  • Ensure strong team building and protocol in the billing and intake department by holding bi-weekly staff meetings
  • Give report of all concerns and issues of the department to the Director of Revenue for prompt necessary action.

Medical DME Billing Supervisor

Avondale HME
San Diego, CA
05.2017 - 10.2017
  • Supervised staff of six, responsible for weekly billing activities to ensure maximum efficiency; provided guidance and direction to staff covering all aspects of billing ensuring adherence to policies and procedures
  • Worked to facilitate individual and team development that drove positive results, Created reports analyzing all receivables to ensure accurate receipt of payments
  • Analyzed billing reports to rectify discrepancies with various insurance companies
  • Ensured supplies were billed timely and appropriately and rejections/errors researched and resolved to meet timely filing deadlines
  • Kept management informed of the status of accounts, errors, rejections, etc
  • On a daily, weekly and ad hoc basis
  • Prepared ad hoc analysis to determine billing performance and to direct the team focus to maintain expected claims volume and cash flow
  • Supervised the preparation of medical bills and invoices, the calculation of provider charges, and verification of patient insurance
  • Maintained insurance documents and contracts Daily payment posting and adjustments, managed daily work queues, trained new hire in the use of Brightree DME system, assigned and assisted daily work schedule/projects to staff, verified same & similar, ICD - 9, ICD-10, CPT, and/or HCPCS Coding Systems usage..

Senior Medical Biller

EA Health
Solana Beach, CA
03.2015 - 05.2017
  • Reviewed and analyze inactive claims and denials to perform the appropriate treatment necessary for reimbursement
  • Communicate directly with the Payor, via telephone as applicable, and take corrective measures to have claims reprocessed
  • File appeals with Payor in a timely manner and follow up to ensure receipt and processing
  • Managed daily work queues and assignments to meet department and/or Client requirements
  • Corrected and verified insurance information using various eligibility online portals and other tools
  • Highly knowledgeable in commercial/Medicare/Medicaid insurance plans and billing process from front end to back end, follow-up on denials and composed appeal
  • Excellent verbal and written communication skills, effectively interact with Payors and other team members
  • Identifies, documents, and communicates trends in recurring denials and recommends process improvements on system edits to prevent future denials
  • Work with management to identifying, researching, and resolving issues which may lead to inaccurate or untimely filing of claims, claim rejections, and/or other billing and collections issues which may arise
  • Achieved goals set forth by supervisor regarding error-free work, transactions, processes and compliance requirements
  • Communicated Client/Vendor/Payor trends to Supervisor while handling multiple priorities at one time, worked independently with minimum supervision managed and prioritize work queues and paperwork accurately under pressure of Client deadlines
  • Participated in staff meetings, trainings, and conference calls as requested
  • Maintains strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release

Medical Credentialing/Compliance Consultant

Perlman Clinic
San Diego, CA
01.2015 - 03.2015
  • Maintain regular cooperation and compliance with all regulatory, accrediting, and membership based organizations
  • Create and carry out various credentialing processes in relation to physicians, physician assistants, and various other healthcare professionals
  • Ensured that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws
  • Processed applications and reappointment paperwork, checking for full completeness and accuracy
  • Constantly collected and processed significant amounts of verification and accreditation information, constantly maintaining and updating accurate databases for both practitioners and facilities
  • Processed applications through CAQH, Mercy Physicians Medical Group
  • MIXED, San Diego Physicians Medical Group, etc
  • These databases include pertinent education, training, experience, and licensure content
  • Prepared records for regular auditing, as well as maintain close communication with all appropriate practitioners to ensure that records are up-to-date and consistent
  • Daily revenue review, medical claims processing, billing and collections.

Benefit Coordinator/Benefit Consultant

East Ridge Staffing INC
San Diego, CA
10.2014 - 01.2015
  • Created and Designed Benefit Coverage Application Step by Step Instruction Manuals to be distributed to internal employees that may qualify for state assistant Health Care
  • This manual was created in order to guide employees through the application and qualification process for Covered California and Access Nevada
  • Administer various employee benefit programs, such as group insurance, life, medical & dental, accident, disability, insurance pensions, investments, savings and HMO (Health Maintenance Organizations)
  • Coordinated human resources procedures to initiate benefit, provided benefit orientation enrollments, claims processing and billing of insurance
  • Assisted in the processing and maintaining of status reports and pay changes on computer and paper system
  • Prepare and maintain employee files, assuring accuracy, compliance and confidentially, unemployment claims, verifications, I9 and state regulations
  • Updated and maintain employee files regarding the tracking of raises and assisted in payroll
  • Coordinated with benefit deductions or additions in company payroll system, processed daily census reports.

Medical Billing Manager/Collection Specialist

Revenue Masters
Solana Beach, CA
01.2013 - 08.2014

Outsource Billing Representative/Collector

Xifin
San Diego, CA
09.2012 - 03.2013
  • Daily claims processing, resubmission of corrected claims, order entry, reviewing and processing all claim errors for clean claims 1st submission
  • Processed EDI payments from Medicare, Medicaid, posted cash receipt and adjustments
  • Processed revenue reports for weekly and month end closings, composed all levels of appeal letters
  • Negotiated Multi Plan agreements, called on past due accounts, contacted providers regarding requisitions received, in order to verify correct levels of Thyroid testing
  • Received payments and manages cash flow by applying payments on a timely basis and verifying and reconciling outstanding invoices
  • Tracked and resolved outstanding payment issues and generates weekly aging reports in a timely manner
  • Processes adjustments and change orders to ensure accurate inventory and receivable balances
  • Interfaces with warehouse to resolve shipping and invoicing discrepancies
  • Investigates and resolves customer inquiries
  • Monitored customer account details for nonpayment, delayed payments and other irregularities
  • Maintained accounts receivable patient files, entered expenses into accounting system as required, assists with auditors at year end including preparing schedules and providing supporting documents
  • Prepared special analysis and assumes other special activities as needed
  • Received and processed all insurance correspondence in timeliness, answered multiple phone line, heavy data entry.

Reimbursement Specialist

Bio Theranostics
Los Angeles, CA
02.2012 - 08.2012
  • Collected over $500,000.00 in past due accounts over 180 days +, daily contact with clients and patients, international and domestic to identify and resolve payments issues
  • Maintain clients account issues, regarding nonpayment, outstanding payments, write offs, offsets and refund request thru written or oral communication
  • Processed electronic payments, effectively, processed, researched and reconciliation payments
  • Processed month end closing reports, research, updated and maintained Sales Force demographics, and determined payment reasonability via client, insurance or patient.

Senior Medical Biller/Intake Coordinator

University Hospital
Newark, NJ
10.2010 - 10.2011

Senior Accounts Receivable Representative

Health Care Group
San Diego, CA
08.2009 - 09.2010
  • Process Medicare A&B billing, Supplemental insurance billing, Medical and Commercial insurance billing, retrieve authorizations and ETARS
  • Daily posting and reconciliation of accounts receivables, insurance payment, ancillary charges, pharmacy, therapy charges, adjustments and prepared daily deposits
  • Daily processing of claims for outside physicians, oversee resolutions of residents disputes on past due accounts
  • Responsible for mailing invoices and credits memos
  • Contacts residents regarding their overdue balances
  • Processed daily, weekly, monthly Census reports
  • Post skilled and residential monthly payments, refunds and adjustments
  • Process and maintain monthly statements for residents and patients
  • Process month end closings and balance reports
  • Compose appeal letter and follow up on outstanding accounts and denials.

Medical Biller/ Senior Accounts Receivable Representative

Interim HealthCare, HHC
San Diego, CA
08.2007 - 05.2009
  • Provided daily patient assessments to determine therapy treatment required for clinical, processed medical billing, on paper and electronic billing thru clearing house
  • Processed and managed all claims and correspondence for the following insurance company, Triwest Echo and HMO plans, UHC, Aetna, Kaiser, Cigna, Medicare Episodic Billing, Medical Tars, HMO, PPO, Commercial Claims, Workers Compensation, and
  • Self Pay
  • Composed 1st, 2nd and 3rd level appeals letters for payment
  • Managed daily accounts receivable reports and aging reports, posted daily payments and adjustments to accounts
  • Contacted insurance companies regarding, claims and eligibility status, via phone and web site
  • Worked special projects for accounts over 90+ days plus, very high success rate on collecting outstanding claims.

Business Office Assistant

La Mesa Healthcare Center, SNF
Los Angeles, CA
03.2007 - 08.2007
  • Process intake to determine if resident meet qualifications for Medical, SSI, or Indigent assistant, processed accounts Daily medical billing for (SNF) HMO, PPO 3r d party, Medical, Medicare, etc
  • Processed daily Census reports, processed accounts receivable, medical invoices, and monthly statements
  • Contacted payers regarding member's accounts authorizations and medical Tar's
  • Collected on past due A/R composed medical appeal letters, corrected claims, processed debits and credit reports, processed refund
  • Processed cash receipts and journals for month end closing.

Business Service Rep/Customer Service Rep Call Center

Triwest Healthcare Alliance
San Diego, CA
03.2005 - 02.2007
  • Processed authorizations, eligibility and referrals for military active duty, retirees, and reservist
  • Verified medical and dental benefits thru Tricare, Medicare part A & B, Delta Dental, and United Concordan
  • Knowledge of HIPPA privacy act
  • CPT and ICD9 codes
  • Knowledge of all military medical and dental benefits rates and allowable.

Education

BS - Health Administration

University of Phoenix
San Diego, CA
03.2018 - Current

Certification in Medical Coding -

California Medical College
01.2015 - 03.2018

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Escondido Charter High School

Skills

CPT Codingundefined

Timeline

Anesthesia Payment Manager

Ventra Healthcare
10.2020 - Current

BS - Health Administration

University of Phoenix
03.2018 - Current

Medical Billing Manager

Southern California Liver Centers, INC
12.2017 - 04.2021

Medical DME Billing Supervisor

Avondale HME
05.2017 - 10.2017

Senior Medical Biller

EA Health
03.2015 - 05.2017

Medical Credentialing/Compliance Consultant

Perlman Clinic
01.2015 - 03.2015

Certification in Medical Coding -

California Medical College
01.2015 - 03.2018

Benefit Coordinator/Benefit Consultant

East Ridge Staffing INC
10.2014 - 01.2015

Medical Billing Manager/Collection Specialist

Revenue Masters
01.2013 - 08.2014

Outsource Billing Representative/Collector

Xifin
09.2012 - 03.2013

Reimbursement Specialist

Bio Theranostics
02.2012 - 08.2012

Senior Medical Biller/Intake Coordinator

University Hospital
10.2010 - 10.2011

Senior Accounts Receivable Representative

Health Care Group
08.2009 - 09.2010

Medical Biller/ Senior Accounts Receivable Representative

Interim HealthCare, HHC
08.2007 - 05.2009

Business Office Assistant

La Mesa Healthcare Center, SNF
03.2007 - 08.2007

Business Service Rep/Customer Service Rep Call Center

Triwest Healthcare Alliance
03.2005 - 02.2007

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Escondido Charter High School
Marva Graham Peat