Melissa El-Hayek
Clinton,MA
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
11
11
years of professional experience
Work History
Medical Billing Specialist
UMass Memorial Medical Center - Memorial Campus
12.2023 - Current
- Managed communication with insurance companies and utilized payor web-sites to ensure prompt payment for outstanding accounts.
- Reviewed rejected payments from designated payors and plans, taking prompt action to validate rejections and resolve any outstanding invoicing issues.
- Calculated and posted adjustments according to third party reimbursement guidelines and contracts.
- Made necessary adjustments to payor and plan information for secondary insurers or responsible parties.
- Corrected missing data, registration errors, and other inaccuracies.
Medical Biller
Benjamin Grajales, MD
Leominster, MA
09.2022 - 12.2023
- Followed up with insurance companies to resolve claim denials.
- Checked prior authorization requirements for procedures and initiated authorizations electronically when necessary.
- Efficiently processed and recorded electronic and paper EOBs.
- Managed billing and follow-up for all Self-Pay accounts.
- Verified data entry to ensure accuracy of imported/keyed data.
- Conducted comprehensive reviews of patient insurance information to ensure accuracy and completeness of claims submissions.
- Efficiently submitted electronic claims to multiple insurance carriers.
Patient Access Representative
Umass Memorial Health Alliance
Leominster, MA
01.2018 - 09.2022
- Entered lab, radiology, and basic ancillary service appointments into schedules
- Obtain and enter the computer-based patient registration/scheduling system, insurance, and other related patient information.
- Assesses and directs patients' financial needs to appropriate financial counseling.
- Collection of patient liabilities, including deductibles, copays, coinsurances, self-pay payments, verifying insurances, and calling payers.
- Ensured compliance with HIPAA privacy rule standards to protect patient privacy by securing patient information and confidential medical records.
- Entered patient demographic and insurance data into computer database to establish the patient's medical record.
- Maintained composure and effectively resolved challenging circumstances.
- Received patient deductibles and co-pay amounts and provided solutions to fulfill remaining financial obligations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Trained new staff on hospital processes and procedures.
- Resolved patient billing issues in line with established guidelines.
- Facilitated communication between patients and various departments and staff.
- Engaged with patients to provide critical information.
Service Clerk/Book Keeper
Shaws
Leominster, MA
01.2014 - 01.2018
- Greet customers with an upbeat attitude.
- Perform general accounting duties.
- Maintain financial records.
- Cash checks and money transfers.
- Keep accurate records of daily transactions with detail, and make sure the balance is correct.
- Greeted incoming customers and answered questions about available services.
- Maintained and organized the service reception area and checkout counters.
- Interacted with customers by phone, email, or in person to provide information.
- Drove customer loyalty and consistent sales through friendly service and knowledgeable assistance.
- Responded to telephone inquiries about products, services, prices, availability.
Education
Certified Medical Biller - Medical Billing
Mount Wachusett Community College
Gardner, MA05.2022
GED -
Quinsigamond Community College
Worcester, MA06.2012
Skills
- Microsoft Office, Customer
- Database Systems
- Information Updates
- Critical Thinking
- Data Analysis
- Time Management
- Medicare and Medicaid Processes
- Billing Codes
- Claims Review
- Obtaining Authorizations
Timeline
Medical Billing Specialist
UMass Memorial Medical Center - Memorial Campus
12.2023 - Current
Medical Biller
Benjamin Grajales, MD
09.2022 - 12.2023
Patient Access Representative
Umass Memorial Health Alliance
01.2018 - 09.2022
Service Clerk/Book Keeper
Shaws
01.2014 - 01.2018
Certified Medical Biller - Medical Billing
Mount Wachusett Community College
GED -
Quinsigamond Community College
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