Mary Guiles
Tullahoma,TN
Overview
28
28
years of professional experience
Work History
Patient Account Representative/Collections Specialist
Mid Plains Podiatry
04.2021 - Current
- Post payments and process refunds.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Electronically submit bills according to compliance guidelines.
- Reconcile statements with patient records.
- Listen to patients and negotiated solutions that meet creditor and debtor needs.
- Locate patients that have overdue accounts and solicited payment in compliance with fair debt collection practices.
- Contact patients after insurance was calculated to obtain payments.
- Analyze accounts for delinquencies and other ongoing issues.
- Work independently with minimal supervision.
- Generate and submit statements based upon established accounts receivable.
- Contact patients with past due accounts to formulate payment plans and discuss options.
- Identified, researched, and resolved, medical claims that went to patient balance wrongfully.
- Contact patients to discuss past-due accounts and negotiated payment plans.
- Develop and document collection procedures and policies to comply with government regulations.
Billing Specialist
Rogue River Family Practice Clinic
09.1999 - 04.2021
- Executed medical billing including submitting claims to insurance companies and researching and resolving denials and explanation of benefit rejections within billing cycle timeframe
- Verified Provider documentation, E/M and CPT coding on more than 400 claims per week
- Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans
- Posted and adjusted payments from insurance companies
- Scheduled and followed up on patient appointments, collected and processed patient payments
- Took messages from patients and promptly relayed to appropriate staff.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Performed targeted collections on past due accounts aged over 60 days.
- Processed and verified invoices to secure accuracy of billing information
- Worked with multiple departments to check proper billing information
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Performed targeted collections on past due accounts aged over 60 days.
- Handled account payments and provided information regarding outstanding balances.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments
- Monitored customer accounts to identify and rectify billing issues
- Researched and resolved billing discrepancies to enable accurate billing
Education
High School Diploma -
Grants Pass High School
Grants Pass, ORVocational School - Administrative Medical Assistant
Andon College
Modesto, CASkills
- ICD-10 coding
- CPT code and modifiers
- Submission of medical claims
- Account receivable
- Account Resolutions
- Patient collections
- Insurance Verification
- Front desk check in/out operations
- Payment Processing
- Scheduling appointments
- Personalized Financial Reviews
- Electronic and Paper Filing
Timeline
Patient Account Representative/Collections Specialist
Mid Plains Podiatry
04.2021 - Current
Billing Specialist
Rogue River Family Practice Clinic
09.1999 - 04.2021
High School Diploma -
Grants Pass High School
Vocational School - Administrative Medical Assistant
Andon College
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