Nebraska Countryman

• Streamlined the billing process by implementing efficient medical coding practices, resulting in reduced errors and improved revenue collection.
• Ensured timely submission of claims by accurately preparing and submitting medical bills to insurance companies within specified deadlines.
• Improved cash flow by effectively following up on unpaid claims and resolving discrepancies between billed and received amounts.
• Maintained accurate patient records, updating demographic information and insurance details as needed for a seamless billing process.
• Reviewed remittances in order to collect payments;

• Changed format of electronic and paper claims as required by third party insurance payers;

• Received electronic remittances from all insurance;

• Entered information regarding medical billing in a prescribed manner;

• Prepared reports based upon medical billing activities;

• Coordinated Medicaid, Medicare and private pay billing;

• Maintained financial records related to billing for Medicaid, Medicare, patient billing and third-party insurance including HMO’s;

• Answered provider questions regarding medical billing procedures and/or problems;

• Answered family and/or residents’ questions regarding medical billing issues;

• Electronically submitted files to Medicaid, Medicare, and private insurance;

• Manually prepared and sent insurance forms to various insurance companies;

• Verified data entered by comparing with provider billings;

• Prepared county vouchers for payments for services provided;

• Identified and coded general ledger accounts for bills rendered for services;

• Verified insurance coverage with insurance company; and obtained insurance authorization for services to be rendered

• Managed a non-emergency medical transportation company providing service in six New York counties: Monroe, Wayne, Seneca, Ontario, Oswego and Cayuga.
• Provide service to three levels of customers: the paying agencies, the individual service providers, and the patients/consumers.
• Initiate business relations and procedure contracts by submitting proposals to Office of Mental Health and specific hospital finance departments.
• Complete payment reimbursement while following ICD-10 guidelines.
• Coordinate ongoing ride requirements with hospital/outpatient social workers.
• Plan daily and weekly logistics; assign/dispatch up to 10 drivers for as many as 30 long-distant rides per day; includes assigning specific drivers for special-needs patents.
• Troubleshoot and resolve issues/complaints.
• Participate in audits by regulatory agencies including the Medicaid Inspector General’s Office and the New York State Insurance Fund (NYSIF)