Regina McWilliams
Veteran Administration, WCPAC
Henderson,NV
13
years of professional experience
Acquire a position where my 20 years of expertise, dedication, and core values can be valued to create a value-added service that increases an organization's growth & longevity.
Work History
Account Revenue Team Lead
6 Years 2 Months- Responsible for all accounts in a seven-state area. Reviews researches, analyzes all accounts receivable records and documentation, to ensure all data maintained is accurate, current and proper based on Agency regulations, policies, Federal Laws and Directives.
- Reviews and analyzes case information, remittance statements from third party payers and others, and the accounts receivable record relating to the debt, the Debtor, for making a recovery determination which protects the interest of the Government. Reviews and analyzes account information, interviews and obtains remittance statements, court orders, legal documents, insurance benefit coverage information to determine the best course of action. Uses judgment and experience to reconstruct incomplete files, devise more efficient methods for procedural processing, gather and organize information for inquiries and resolve a variety of problems. Details discrepancy and returns incomplete or discrepant information to requester for clarification. Works independently and is responsible for all collection functions. Maintains account receivable supporting documentation.
- 40Hrs./Week
Senior Billing & Coding Technician
1 Year 9 Months- Responsible for all accounts in a seven-state area. Performs verification of patients' insurance coverage for inpatient/outpatient services; enters information and maintains databases. Documents pre-admission requirements, and identifies patients requiring second opinions. Performs reimbursement billing activities, including consideration of professional and facility services, sharing agreements, Tricare, CHAMPVA, Medical, and Pharmacy billing. Validates claims for billing purposes ensuring eligibility and refers to questionable coding for review; monitor reports to assure all possible billable cases are processed, ensuring proper sequencing of diagnostic and procedural codes; tracks, reviews, and corrects denials. Performs third-party collections from insurance companies, and for accounts receivables including humanitarian, Department of Defense, Tricare, workman's compensation, ineligibility, etc. Performs research, resolves problems, and posts payments, adjustments, denial codes, and non-payment collections. Verifies accuracy of payments, resolving discrepancies, and closing and auditing accounts. Responsible for the integrity of the insurance databases, for updating information in the system, and generating reports. Communicates with insurance companies and patients answering questions/inquiries and explains health care services eligibility and entitlements to patients. Provides input for responding to Congressional inquiries.
- 40Hrs./Week
Provider Relations Specialist
1 Year 6 Months- Responsible for all accounts in the Maricopa County area. Verify insurance coverage for inpatient/outpatient services; Verify Benefits, policy number, pre-certification, and effective dates of coverage; Enter updated information, and maintaining the database; Generates monthly reports; Obtains required information and coordinates completion of forms with patients; Document pre-admission requirements and identifying patients requiring second opinions; Responds to patients questions, explaining eligibility requirements, insurance provisions, and billing and payment procedures; Ensure that all billable cases are identified and payment is approved; Validate claims for billing purposes ensuring eligibility and referring questionable coding for review; determining and verifying the accuracy of payments made; Auditing accounts, insuring payments are made in a timely manner and account payments are noted.
- 40Hrs. / Week
Senior Post Sales Logistic Lead
3 Years 2 Months- Responsible for all Commercial accounts at $5 million per year in business. Facilitate the exploration of needs, motivations, desires, skills and thought processes to assist the individual in making real, lasting change. Use questioning techniques to facilitate agent’s own thought processes to identify solutions and actions rather than taking a wholly directive approach. Supporting the agents in setting appropriate goals and methods of assessing progress in relation to their goals. relatively apply tools and techniques which may include one-on-one training, facilitating, counseling & networking. Encourage a commitment to action and the development of lasting personal growth and change.
- 40 Hrs. / Week
Skills
Attention to detail
Conflict resolution
Customer focus
Coaching and mentoring
Section name
References Available Upon Request
Timeline
Account Revenue Team Lead
Veteran Administration, WCPAC
05.2018 - 07.2024Read More
Senior Billing & Coding Technician
Veteran Administration, WCPAC
08.2016 - 05.2018Read More
Provider Relations Specialist
Aetna Insurance Company
02.2015 - 08.2016Read More
Senior Post Sales Logistic Lead
United Parcel Service
11.2011 - 01.2015Read More