Melissa Price
Denver,CO
Summary
Detail-oriented and offering 10+ years of experience in related roles. Exceptional abilities in conducting research, problem-solving and prioritizing simultaneous tasks. Leverages resourcefulness, critical thinking skills and superior work ethic for top job performance.
Overview
9
9
years of professional experience
Work History
Senior Billing & AR Specialist
OnPoint Medical Group
05.2022 - Current
- Managed monthly reconciliation schedules for assigned accounts.
- Responded to customer concerns, questions and billing errors on a daily basis (Email, Chat and Practice Communication Systems)
- Generated accounts payable reports for management review to aid in financial and business decision making.
- Processed payments via inbound or outbound calls with focus on accuracy and efficiency.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Patient Financial Representative
Solace Pediatric Home Healthcare
09.2019 - 08.2021
- Efficiently posted payments and adjustments in accounting system.
- Verified payment history to evaluate conformity with insurance contracts.
- Described general insurance regulations and practice insurance contracts to clients.
- Resolved complex insurance and customer payment issues by providing options or escalating problems to supervisors.
- Contacted guarantors to collect payments for past due accounts.
- Established financial arrangements for self-pay patients.
- Interviewed patients about payment plans, and provided applications for payment assistance.
- Researched billing errors and discrepancies to initiate corrective action.
- Established relationships with customers to encourage payment of delinquent accounts.
- Compiled and analyzed data for review by senior management of loan loss reports to measure portfolio performance.
Member Service Representative II
Navy Federal Credit Union
04.2017 - 09.2019
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Managed multiple system related to job duties.
- Responded to customer calls and emails to answer questions about products and services.
- Handled complaints with prompt, courteous service to uphold professional reputation.
- Learned and maintained in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions.
- Verified customer identification and documentation for compliant transactions.
- Learned internal systems and related service role duties to provide skilled team backup in handling customer demands.
- Educated and engaged customers with new bank products and services.
- Resolved customer issues through thorough dispute investigation.
- Maintained updated knowledge of internal processes and industry best practices to optimize service delivery.
- Cross-sold bank services and products to uplift customer investments.
- Trained new personnel regarding company operations, policies and services.
- Sought ways to improve processes and services provided.
- Increased efficiency and team productivity by promoting operational best practices.
Claims Research Specialist II
MedPro Solutions
07.2014 - 04.2017
- Monitored and updated claims status in claims processing system.
- Verified patient insurance coverage and benefits for medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Managed large volume of medical claims on daily basis.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Responded to correspondence from insurance companies.
- Researched and resolved complex medical claims issues to support timely processing.
- Processed insurance payments and maintained accurate documentation of payments.
- Reviewed provider coding information to report services and verify correctness.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
- Calculated adjustments, premiums and refunds.
- Coordinated with contracting department to resolve payer issues.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Education
Associate of Science -
Virginia College of Pensacola
Pensacola, FL07.2008
Diploma -
Pensacola Catholic High School
Pensacola, FL05.1988
Skills
- Accurate Payment Posting
- Strong Client Relations Skills
- Codes Reviewing
- Research and Due Diligence
- Account Reconciliation
- Aging Reports Analysis
- VA/Tricare Insurance
- HMO/PPO Insurance
- Medicare/Medicaid Insurance
- Workers Compensation Claims
Timeline
Senior Billing & AR Specialist
OnPoint Medical Group
05.2022 - Current
Patient Financial Representative
Solace Pediatric Home Healthcare
09.2019 - 08.2021
Member Service Representative II
Navy Federal Credit Union
04.2017 - 09.2019
Claims Research Specialist II
MedPro Solutions
07.2014 - 04.2017
Associate of Science -
Virginia College of Pensacola
Diploma -
Pensacola Catholic High School
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