Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Myriam Seide

Hampton,GA

Summary

Results-driven Billing Specialist known for outstanding productivity and efficiency in managing billing processes. Possess specialized skills in invoice generation, account reconciliation, and financial reporting. Excel at communication, problem-solving, and time management, ensuring seamless operations and client satisfaction. Highly skilled Billing Specialist with background in managing complex billing systems, ensuring accurate invoicing and maintaining financial records. Strengths include deep understanding of accounting procedures, proficiency in billing software, and ability to handle high volume workloads efficiently. Previous roles involved proactively resolving billing issues, improving internal tracking processes, and contributing to successful audits.

Overview

18
18
years of professional experience

Work History

Billing Specialist

Trilogy
, MS
01.2022 - Current
  • Reviewed medical records to ensure accuracy of billing information and patient data.
  • Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
  • Calculated billing charges, prepared and submitted claims to insurance companies.
  • Verified insurance coverage and identified third-party payers for billing purposes.
  • Monitored accounts receivable activity to ensure timely payment of invoices.
  • Resolved discrepancies between customers' remittances and invoices received.
  • Answered customer inquiries regarding billings, payments, account status.
  • Investigated incorrect billings and processed refunds as necessary.
  • Maintained accurate records of collections, adjustments and denials in the system.
  • Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
  • Assessed billing statements for correct diagnostic codes and identified problems with coding.
  • Executed account updates and noted account information in company data systems.
  • Checked claims coding for accuracy with ICD-10 standards.
  • Processed invoice payments and recorded information in account database.

Accounts Receivable Specialist

Alliance Rx Walgreen Prime Pharmacy
Orlando, FL
09.2019 - Current
  • Post payments, denials, contractual adjustments
  • Perform other assigned tasks and duties necessary to support the Accounts Receivable Department
  • Request authorization/ Retro authorization for services render
  • Work all type of denials and request from all payors, follow up on claims status, fill claims / rebill claims on a timely manner for a proper accounts receivable data
  • Created charts, sort data, budgets, store data using Spreadsheet and Pivot Tables
  • Make collection calls and/or correspondence to payers for bulk resolution of delayed payments
  • Reconciliation of accounts by processing customer refunds, review account for adjustments, resolve client/payor discrepancies and short payments
  • Accountable for reducing delinquency
  • Pursues collection activities to obtain reimbursement from payers and/or patients on outstanding accounts
  • Make collections call to payments regarding payment plans or setting up account on copay assistance programs or payment plans

Billing Analyst

Management Services Network LLC
Colorado Springs, CO
08.2018 - 07.2019
  • Work Medicaid, Medicare and other HMO's and PPO claims
  • Obtain authorizations for Children Medical Services
  • Identify trends and potential issues that could impact the Billing Department
  • Provide the highest level of customer service to all clients and provide solutions to any relative issues
  • Use of Spreadsheet, Pivot Tables, Excel, for creating and storing data
  • Manage collections and ensure all clients remain informed on their outstanding debts and deadlines
  • Manage the status of accounts and balances and identify inconsistencies
  • Verify patients eligibility/ File and refile claims daily/ Work rejection claims threw Availity
  • Work EOB's and responding to requests for information/ file appeals when needed

A/R Reconciliation Rep

Alliance Rx Walgreen Prime Pharmacy
Orlando, FL
08.2017 - 07.2018
  • Post payments, denials, contractual adjustments
  • Work all type of denials and request from all payors, follow up on claims status, fill claims / rebill claims on a timely manner
  • Make collection calls and/or correspondence to payers for bulk resolution of delayed payments
  • Reconciliation of accounts by processing customer refunds, review account for adjustments, resolve client/payor discrepancies and short payments
  • Used Excel, Spreadsheet and Pivot Tables creating / sort data, budgets, store data
  • Accountable for reducing delinquency
  • Perform other assigned tasks and duties necessary to support the Accounts Receivable Department
  • Request authorization/ Retro authorization for services render
  • Pursues collection activities to obtain reimbursement from payers and/or patients on outstanding accounts
  • Produce Monthly patient statements

Reimbursement Specialist

Accredo Speciality Pharmacy
Orlando, FL
10.2015 - 01.2016
  • Responsible for billing & collections activities required for reducing the company's bad debt
  • Resolves outstanding claims by regularly contacting health plans
  • Escalates delinquent and/ or complex claim to Sr
  • Resubmit improperly paid/denied claims to the carrier for proper payments in a timely manner
  • Daily contact with patients, insurance companies and local pharmacies to obtain authorization for prescriptions
  • Prepare and review claims to ensure billing accuracy according to payer's requirement, including but not limited to codes, modifiers, pricing, date and authorization
  • Pursues collection activities to obtain reimbursement from payers and/or patients on outstanding accounts
  • Verify insurance coverage for potential new patients

Reimbursement Specialist

Sheridan Health Corp
Fort Lauderdale, FL
09.2013 - 07.2015
  • Process correspondence related to assigned contracted and/or non-contracted carriers including selfpay accounts
  • Manage the up-keep of denial reports and ensuring accounts are properly documented
  • Research denied and improperly processed claims by contacting assigned carriers to insure proper processing of said claims
  • Resubmit improperly paid/denied claims to the carrier for proper payment in a timely manner
  • Identify and correct any claim processing (data entry, verification, coding and/or posting) errors
  • Ensure accounts are properly documented
  • Submit Adjustment
  • Prepare and review claims to ensure billing accuracy according to payer's requirement, including but not limited to codes, modifiers, pricing, date and authorization
  • Obtain and archive copies of medical records when required

Account Receivable Rep

Medics Ambulance Services
Pompano Beach, FL
01.2007 - 01.2012
  • Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
  • Follow up on unpaid claims within standard billing cycle time frame
  • Check each insurance payment for accuracy and compliance with contract discount
  • Call insurance companies regarding any discrepancy in payments if necessary
  • Identify and bill secondary or tertiary insurances
  • All accounts are to be reviewed for insurance or patient follow-up
  • Research and appeal denied claims
  • Answer all patient or insurance telephone inquiries pertaining to assigned accounts
  • Set up patient payment plans and work collection accounts

Education

Bachelors Of Science - Business Administration

City College
FL
12.2011

Skills

  • Ability to type a minimum of 60 wpm
  • Excellent verbal and written communication skills
  • Microsoft Office
  • Spreadsheets
  • Insurance Verification
  • Problem-solving skills
  • Ability to work in a team environment
  • Computer literate
  • Microsoft Excel
  • Pivot Tables
  • Effective communication abilities
  • Knowledge of EOB'S
  • Knowledge of authorizations
  • Knowledge of referrals
  • Microsoft Outlook
  • Payment posting
  • Billing cycle management
  • Claims Processing
  • Statement processing
  • Collections
  • Billing systems and software
  • Audit Procedures
  • Medical billing and collections
  • Claim submission
  • HIPAA Compliance
  • Billing dispute resolution
  • Accounts receivable expertise

References

References available upon request.

Timeline

Billing Specialist

Trilogy
01.2022 - Current

Accounts Receivable Specialist

Alliance Rx Walgreen Prime Pharmacy
09.2019 - Current

Billing Analyst

Management Services Network LLC
08.2018 - 07.2019

A/R Reconciliation Rep

Alliance Rx Walgreen Prime Pharmacy
08.2017 - 07.2018

Reimbursement Specialist

Accredo Speciality Pharmacy
10.2015 - 01.2016

Reimbursement Specialist

Sheridan Health Corp
09.2013 - 07.2015

Account Receivable Rep

Medics Ambulance Services
01.2007 - 01.2012

Bachelors Of Science - Business Administration

City College

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Myriam Seide