Patient Account and Insurance Specialist with 14 years experience in healthcare. Skilled in providing professional insurance assistance to patients and billing for providers. Personable and professional under pressure. Patient and empathetic with extensive background in conflict resolution and customer care.
Work History
Patient Account Representative
Wellmont Physicians Services
Kingpsort, tn
.1 2007 - .1 2007
Reviewed and analyzed insurance claims prior to sending to insurance for processing.
Followed up with the insured individuals regarding premium and deductibles payments.
Answered customer questions regarding denials, or payment agreements.
Substantiated legitimate claims and denied unjustified claims.
Sent delinquent account to collections and notified patient via written and verbal notifications.
Senior Claims Analyst/Adjustment team work at home
Cigna Healthcare
bristol, TN and Chattanooga, TN
.1 2000 - .1 2007
Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
Timely and accurately processed medical claims.
highly self motivated in an effort to meet production standard and process claims claims correctly. I averaged 98% accuracy, and for ten months straight i have 100% audits.
managed pends and back-flow to establish and maintain standards.
Performed follow-up actions necessary to ensure customer satisfactions.
Medical Insurance Specialist
Mountain Empire Eye Physicians
Bristol, TN
2015 - Current
Managed large volume of medical claims on daily basis.
Responded to correspondence from insurance companies.
Reviewed provider coding information to report services and verify correctness.
Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
Displayed consistent, positive attitude towards customers, peers and other personnel, even during high-stress situations.
Patient Account and Collections Specialist
Dermatology Associates
3183 west state street, Suite 1101 Bristol, TN 37620
01.2008 - 2015
Managed various general office duties such as answering multiple telephone lines, completing insurance forms and assisting clerical staff with any patient account issues.
Reviewed collection reports to determine the status of collections and the amounts of outstanding balances.
Monitored payments due from patients and promptly contacted patients with past due payments.
Researched and resolved accounts payable discrepancies such as insurance and patient overpays and credits.
Posted Patient payments received via bank Lock box, and Online bill pay systems.
Answered an average of 50 calls per day by addressing patient inquiries, solving problems and providing great customer service.
Investigated and resolved patient inquiries and complaints in a timely and empathetic manner.
Served as the main liaison between customers, management and doctors.
Communicated with attorneys and Bankruptcy courts to insure proper handling of accounts awaiting discharge from debtor.
Resubmitted corrected claims to insurance companies when error accrued, or more information is needed.
Education
certificate of completion - Medical Coding I and Coding II
kingsport Higher Education
High School Diploma - undefined
Tennessee High School
Bristol, TN
1998
Skills
years of Medical Insurance experience
Customer relations
Expertise in invoice and payment transactions
Account reconciliation
Creative problem solver
Exceptional communication skills
Medical terminology knowledge
Credit card processing
Proficient in cash management
MS Windows proficient
Quick learner
Trusted key holder
References
Ashleigh Owens (423) 426-2347
Mary Ann Gilles (423) 863-9357
Annette Meyers (423) 418-4362
Mark Finley (423) 306-9020
Timeline
Patient Account and Collections Specialist
Dermatology Associates
01.2008 - 2015
certificate of completion - Medical Coding I and Coding II
kingsport Higher Education
High School Diploma - undefined
Tennessee High School
Patient Account Representative
Wellmont Physicians Services
.1 2007 - .1 2007
Senior Claims Analyst/Adjustment team work at home
