Mary Katherine Hilliard
Titusville
Summary
Motivated patient account representative offering over ten years of experience. Highly effective in time management, conflict resolution, and communication skills. I provide attention to details while thoroughly reviewing all my work before submitting documents to the patients plan for approval of services. Organized and dependable while always willing to learn new processes and steps as knowledge is golden.
Overview
9
9
years of professional experience
Work History
Patient Account Representative
TRC Staffing/Fresenius Medical Care
10.2024 - Current
- Accomplishing daily productivity and quality result.
- Assisting management with unresolved/incorrect accounts and routing to the correct department.
- Actively participating in team meetings and group chats to help with answering questions and provide assistance.
- Working with payers and team members to resolve issues with billing, claims, and payments.
- Setting reminders to minimize claim denials and delays in payment for claims worked.
- Provide training to new staff members on the intricacies of client systems and guidelines.
- Providing inaccurate accounts to resolution.
- Creating spreadsheets for leadership of account(s) worked incorrectly to address with representatives.
Prior Authorization Specialist
Elevance Health/Bio Plus Pharmacy
05.2024 - 09.2024
- Obtaining prior authorization via verbal, payer portal, and/or hard copy fax to patient’s plan within twenty-four hours of receiving prescription from patient’s physician.
- Contacting payer sales representatives and offices to insure all information was obtained and approved for prescription to process via Bio Plus Pharmacy.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Tracked referral submission during facilitation of prior authorization issuance.
Unemployed
Unemployed
10.2023 - 05.2024
- Left prior company on good terms to help my late mother-in-law battle Cancer.
Account Representative
Select Medical
03.2023 - 10.2023
- Contacting insurance companies on unpaid claims.
- Submit legal appeals within the standard billing cycle.
- Filing state complaints against patients and insurance companies for any unpaid balances owed after the requested time frame while following state guidelines.
Revenue Account Cycle Analysis
Virtual Business Office/Boston Medical Center
03.2021 - 02.2023
- Analyzing data from the previous day to drop account for representatives to work.
- Reviewing unpaid claims, denials for no authorization, and appeals within standard billing cycle to complete next workflow and routing to next team or client.
- Coaching and developing representatives with updated and new processes for next steps.
- Following up with insurance company due to incorrect denials, backlogs, and contracts while pivoting data via Microsoft excel.
- Worked effectively in fast-paced environments.
- Provided one-on-one mentoring to help individuals reach their full potential within the organization.
Unemployed
Umemployed
08.2019 - 03.2021
- COVID took us on a journey with my husbands job.
Scheduling Coordinator
The Breast Place
11.2018 - 07.2019
- Contacting referred patients to schedule appointments and STAT imaging within a timely manner per diagnosis.
- Multitasking through patients charts and physician notes to get insurance details while scheduling surgery at locally hospital or surgery center.
Scheduling Coordinator
Carolina Eye Care Physicians
09.2016 - 10.2018
- Contacting and working diligently with patients’ insurance company for authorizations and benefits while explaining to the patient non covered specialty services vs. insurance covered services.
- Organizing timed excel spreadsheets with the physician and surgery center.
- Attending physician in and out of the operating room to explain detailed information to the patient and family members of services they will receive within the surgery room.
Education
High School Diploma -
Stratford High School
Goose Creek, SC06.2009
Skills
- Prior authorization processing
- Denial resolution expertise
- Appeals process management
- Soarian, Artiva, Epic, Allscripts, Athena Health, and McKesson
- Payment reconciliation management
- Insurance eligibility verification
- HIPAA regulations knowledge
- Experienced with Microsoft Office applications
- Timely follow-up communication
- Efficient medical billing management
- Accounts receivable analysis
- Medical terminology expertise
- Exceptional customer support
Timeline
Patient Account Representative
TRC Staffing/Fresenius Medical Care
10.2024 - Current
Prior Authorization Specialist
Elevance Health/Bio Plus Pharmacy
05.2024 - 09.2024
Unemployed
Unemployed
10.2023 - 05.2024
Account Representative
Select Medical
03.2023 - 10.2023
Revenue Account Cycle Analysis
Virtual Business Office/Boston Medical Center
03.2021 - 02.2023
Unemployed
Umemployed
08.2019 - 03.2021
Scheduling Coordinator
The Breast Place
11.2018 - 07.2019
Scheduling Coordinator
Carolina Eye Care Physicians
09.2016 - 10.2018
High School Diploma -
Stratford High School
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