Michelle Cheek

• Audit insurance and patient accounts to determine whether a refund is needed. Request refunds and process once check has been issued.

• Updated patient records accurately to ensure seamless coordination between departments and minimize delays in treatment or billing.
• Review patient accounts for collections. Prepare accounts to go to Collection Agency
• Adjust patient accounts for in house collections

This was a Temp Agency my assignment was done at Confluent Health as a Collector

Monitors outstanding account balances to determine the next step in the collection process.
• Follows up on claims and claim denials to ensure maximum reimbursement for services provided.
• Reviews accounts receivable activities and calls on outstanding balances or claims.
• Generates appropriate paperwork, including insurance claim forms (original and re-filed) and collection letters.
• Reviews insurance payments (Explanation of Benefits – EOB’s) to determine whether reimbursement is accurate. Navigate portals to send claims for adjudication.
• Investigates and appeals denied or underpaid claims.
Responds to all inquiries received from patients and payors either by telephone or written request.
• Tracks and resolves discrepancies.
• Follows-up on unpaid insurance claims after denial to obtain settlement of claim.
• Audit insurance and patient accounts to determine whether a refund is needed.
• Provides clear communication and customer service on collection issues to external customers and internal business partners.
• Helps patients develop patient payment plans.

• Work on RCM team for collections for PT,OT, Speech Therapy
• Obtain claim status with insurance companies by web portals or by phone. PPOs and government Payers.
• File appeals
• Patient collections- get accounts ready for collections
• Contributed to positive cash flow by identifying opportunities for improvement in the accounts receivable process.

• Billing and collections for home infusion hemophilia pharmaceutical company
• Bill paper and electronic claims to government payors and PPOs
• Collect AR from insurance companies
• Obtain medical records.
• Obtain Authorizations

• Billing for hospital
• Inpatient and outpatient services
• Bill with ub04 electronically and paper claims
• Work claim edits
• Audit accounts for proper payments
• Appeal for underpayment
• Process refund for overpaid claims and patient payments
• Refund patient credits by credit card or check
• Review EOBs for proper payment posting and correct patient responsibility.

• Collect A/R for a pharmaceutical company for patients with Hemophilia
• Call various insurance companies for claim status, eligibility, and authorizations
• Appeal claim denials
• Assist in billing

• Answer phones, file, and fax
• Responsible for scheduling appointments with home owners
• Obtain Plans and download them to OST
• Write up Painting Proposals
• Assist with Accounts Payable.

• Work off an aging report to collect on past due accounts for DME, Sleep Studies, and Physicians services
• Process appeals to insurance companies on denials Call various insurance companies on status of claims and appeals
• Process credit card payments for patients
• Assign accounts to go over to collection agencies
• Train new staff
• Obtain patient records on an online system.

• Work off an aging report to collect on past due accounts
• Collect on all workers comp claims
• Process appeals for denials to insurance companies
• Call various insurance companies on status of claims and appeals
• Process credit card payments for clients
• Assign accounts to go over to collection agencies.

• Collector & Collector II- Work under the supervision of the Reimbursement Recovery Supervisor
• Review and work Ascent reports and EOBs to verify patient services are coded correctly and payment has been applied properly
• Analyzes and audits accounts for correct balance, proper follow-up and complete reimbursement
• Meet regularly with Supervisor to discuss improvements to remedy correctable problems relating to reimbursement
• Identifies misapplied payments, requesting payments adjustments/transfers or refunds
• Pulls appropriate documentation, take proper action and documents through computer, IDX
• Processes past due accounts for referral to outside collection agencies ensuring all calls, claims, tracers have been issued according to adopted policies and procedures
• Accepts/establishes payment arrangements, take payments over the phone and in person, creating appropriate receipts and documentation
• Team Lead- Work under the Supervision of the Work Compensation/ Reimbursement Recovery supervisor
• Train and monitor the work of employees serving as a resource person by answering questions and assisting others with special or complex problems
• Perform the work of a Collector/ Biller on a daily basis
• Review and authorize/approve A/R account transactions
• Assist with reviews or audits complex or problematic accounts
• Enter on- line PCS regarding follow-up
• Identifies and processes incoming mail
• Assist with review/posting of refund requests and transfer requests correcting and coaching staff for improved submission
• Update insurance information as needed utilizing on-line eligibility
• Claims Examiner II/TES Operator- Run all the required TES reports as schedule indicates and, as requested, and assist the customers in interpreting data
• Monitor all TES work files to determine if edits are being worked in a timely manner
• Report any processing delays to CFPB or to the Client Service Manager
• Responsible for researching and working TES edits online following documented edit protocols, CPT/CCI payer specific guidelines and completed work sheets submitted by coding staff
• When resolving edits have to develop and organize documentation supporting the action to resolve the issues
• Work with Claims Managers operator regarding Claim Manager edits issues
• Discuss system status with physician groups and Client Service Managers
• Referral Specialist- Obtain authorizations/pre-certs from Insurance companies private and HMO's for Outpatient procedures and clinical services
• Obtain Medical records to send to insurance companies and PCP offices
• Enter Authorizations and send Requests for corrections on authorizations
• Insurance Verification
• Assist patient and clinics with authorizations Reviews/corrects registration/insurance data utilizing all available sources to obtain correct information
• Verify CPT/ICD-10 codes are correct