Hi, I’m
Nada Mahmood
Chandler,AZ
Summary
Skilled Patient accounts representative adept at collaborating with insurance companies and patients to resolve billing issues. Successful achieving positive results for claimants. Over 10 years working in Physicians, Health plan and revenue cycle environments.
Extensive background in Health care management, Revenue and claim assessment and audits. Provider and clinical facility credentialing verification. Currently preparing for ICD-10 coding CPC processes, certified in ADA dental coding processes.
Overview
15
years of professional experience
Work History
Satellite Healthcare
AR Collections Specialist II
11.2022 - Current
Job overview
- Enhanced department productivity with onboarding new staff on Dialysis processes and procedures.
- Worked 75 claims per day, Addressing bad debts in line with set protocols.
- Researched billing errors and discrepancies to initiate corrective action.
- Developed strong relationships with key contacts at insurance companies, Medical groups to expedite resolution of claim disputes or other account-related issues.
- Reduced delinquency rates by implementing effective collection strategies, identifying DOFR's, Authorization placement and maintaining consistent follow-up procedures.
- Supported company revenue growth by recovering outstanding debt through diligent monitoring and timely action on delinquent accounts.
- Streamlined collections process by creating and maintaining detailed records of customer account statuses and communications.
- Compiled and analyzed data for review by senior management of loan loss reports to measure portfolio performance.
- Collaborated with clinical staff to ensure proper documentation and coding for accurate billing.
- Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Fresenius Medical Kidney Care
Patient Account Representative
12.2019 - 11.2022
Job overview
- Tracked and resolved outstanding balances and aging for Government and Commercial government health plans. Consistently maintained 95% success rate from Health plans.
- Monitor AR to assure that aging is up to par.
- Streamlined Insurance verification processes for increased efficiency in managing patient accounts.
- Resolved discrepancies and maintained audit trail by gathering appropriate documentation throughout collection process for Out patient facility claims.
- Monitored and maintained state mandated billing guidelines such as; Division of FInancial Risk, Authorizations,
- HCPC codes to be entered accurately in practice management systems
- Worked successfully to reconcile denials with various health plan's provider relations to secure payments
- Promote special projects to enhance operations, assisted in providing and coordinating provider and clinical information to and from managed care.
- Work with outside entities to resolve issues with billing, claims and payments.
- Monitor flags and resolved urgent items with accuracy and efficiency.
Blue Cross Blue Shield/ HEALTH CHOICE Arizona, Care
Dental Benefit Examiner
08.2017 - 11.2019
Job overview
- Examined 70 dental claims per day.
- Reviewing dental treatment processing,
- Responsible for reimbursement and claims processing and applying billing principles consistent with government regulatory standards
- Evaluating medical necessity guidelines, Grievances and appeals, coverage eligibility and verification
- Processed referrals based upon AHCCCS and Medicare/Medicaid insurance plans
- Excelling computer skills on outstanding authorizations and accurately documenting events.
- Managing confidentiality per HIPPA and Patient/Member account creation.
- Enhanced applicant evaluations by implementing thorough research and analysis techniques.
- Managed high volume caseloads, prioritizing tasks to meet strict deadlines while maintaining attention to detail.
Private Dental Practice
Patient Care Coordinator/ Treatment Planner
07.2009 - 07.2017
Job overview
- Medical Reviews and Dental insurance benefit verification and
- Authorization
- Evaluated patient's financial status and established appropriate payment plans
- All aspects of billing, collections and e-claims
- Managed approximately 30 calls and patient communication per day, managed referrals.
- Monitored Provider's DEA status and ensured credentialing verification is performed for all contracted Health Plans.
Education
L S Coding And EducationTucson
AAPC Certified CPC Coding
11.2022
Chandler Gilbert Community CollegeChandler, AZ
Certificate of General Business
02.2001
Pakistan Embassy School JeddahSaudi Arabia
Associates Computer Science from Computer Science
09.1998
Skills
- Internet Savvy, Microsoft Office, Outlook, Excel, Adobe Acrobat, Typing
- ADVANCED MEDICAL TERMINOLOGY
- Medical/ Dental Billing and HCPC systems
- Claims Cycle/Collection Strategies
- AR Aging Reports
- Managed Care/ HMO/PPO
- CMS Compliance Assurance
- Hospital and Healthcare industry operations
Timeline
AR Collections Specialist II
Satellite Healthcare
11.2022 - Current
Patient Account Representative
Fresenius Medical Kidney Care
12.2019 - 11.2022
Dental Benefit Examiner
Blue Cross Blue Shield/ HEALTH CHOICE Arizona, Care
08.2017 - 11.2019
Patient Care Coordinator/ Treatment Planner
Private Dental Practice
07.2009 - 07.2017
L S Coding And Education
AAPC Certified CPC Coding
Chandler Gilbert Community College
Certificate of General Business
Pakistan Embassy School Jeddah
Associates Computer Science from Computer Science
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