Emerald Thompson
ModMed
Houston,TX
10
years of professional experience
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Work History
Healthcare Customer Service Representative /Medical Claims Processor
5 Years 2 Months- Manage a high volume of incoming calls from patients, healthcare providers, and insurance companies regarding insurance eligibility, claims status, and billing inquiries.
- Quickly and accurately determine patients' insurance coverage for specific healthcare services or treatments..
- Submit claims to insurance companies electronically or via mail, ensuring all required information is included and accurately entered.
- Handle inbound calls .Manage a high volume of incoming calls from patients, healthcare providers, and insurance companies regarding insurance eligibility, claims status, and billing inquiries.
Insurance Verification Specialist
1 Year 8 Months- Assist with the preparation and submission of insurance claims by providing accurate insurance information and documentation.
- Resolve discrepancies between insurance verification details and claims submitted to ensure proper processing and payment.
- Verify patient insurance coverage and eligibility prior to services being rendered to ensure accurate billing and coverage.
- Contact insurance companies and payers to confirm patient benefits, co-payments, deductibles, and out-of-pocket expenses. Obtain and document required pre-authorizations or pre-certifications for medical procedures or treatments.
Patient Account Specialist
2 Years 4 Months- Handle high volumes of inbound calls from patients regarding their accounts, including billing inquiries, payment plans, and account updates.
- Provide detailed information about patient accounts, including charges, payments, and insurance coverage.
Verify patient insurance coverage and benefits, including co-payments, deductibles, and out-of-pocket expenses. - Process and review insurance claims, ensuring accurate submission to insurance carriers and follow-up on unpaid or denied claims.
- Process patient payments, including co-pays, deductibles, and balance payments, through various payment methods such as credit/debit cards, checks, or online payments.
Medical Billing Coordinator
3 Years 3 Months- Review and verify medical bills and claims to ensure they are complete, accurate, and comply with payer guidelines.
- Address and resolve billing issues, including rejected or denied claims, by working with insurance carriers and healthcare providers.
- Prepare and submit insurance claims using billing software and electronic claim systems. Monitor the status of submitted claims and follow up with insurance companies to ensure timely processing and payment.
- Verify patient insurance eligibility and benefits prior to services being rendered to ensure accurate billing.
Education
High School Diploma
Skills
Remote Operations
Email Support
Medical Billing Support
Chat Support
Call Center Operations
Medical terminology knowledge
Insurance Verification
Appointment Scheduling
Customer Service
Inbound/Outbound Calling
HIPAA Compliance
Payment Processing
Data Entry
Claims
Eligibility Determination
Insurance Verification
Enrollment
Customer Interaction
Customer Relationship Management
Schedule Management
Timeline
Healthcare Customer Service Representative /Medical Claims Processor
ModMed
08.2021 - CurrentRead More
Insurance Verification Specialist
Walgreens
12.2019 - 08.2021Read More
Patient Account Specialist
Ciox Healthcare
08.2017 - 12.2019Read More
Medical Billing Coordinator
AppleOne
05.2014 - 08.2017Read More
West Side High School
High School Diploma
Read More