Medical Collections Specialist
Cardiology Associates Medical Group
01 2009 - 04 2024
- Performed data entry on GEMMS ONE EHR software
- Verified patient eligibility daily via Availity and Government-issued insurance, as well as Commercial Health Insurance web portals
- Informed scheduling department of any eligibility issues
- Corrected and updated ICD-9 and ICD-10 coding errors
- Worked denials for claims resubmission
- Resubmitted corrected claims on paper and electronically for payment
- Submitted appeals for denied claims
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
- Managed Accounts Receivable reports
- Contacted commercial and government insurance companies regarding claims that remained denied or unpaid for resolution
- Contacted patients via telephone and email regarding balances due
- Mailed patient accounts that were non compliant or 90+ days past due to our outside collection agency
- Checked patient charts for entry of medical documentation
- Updated patient insurance information
- Obtained patient medical records via MEDITECH EMR/EHR software
- Moderate to heavy incoming and outgoing calls
- Contributed to team growth by actively participating in peer mentoring initiatives designed to improve overall departmental skill sets and knowledge.
