Sandy Smitty
Medical Account Representative
Woodbury,Tennessee
Summary
Positive, organized, and detail-focused with knack for understanding and addressing patient needs. Possesses foundational knowledge of billing procedures and healthcare regulations, with skills in data entry and customer service. Committed to ensuring accurate patient accounts and effective communication with clients.
Overview
16
16
years of professional experience
Work History
Appeals Specialist
Community Health Systems, CHS
10.2024 - 01.2025
- Demonstrated exceptional attention to detail when evaluating medical records in order to identify discrepancies or inconsistencies that could impact an appeal''s outcome positively or negatively.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Generated, posted and attached information to claim files.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
HIM Representative
Robert Half / R1 RCM MBS
07.2024 - 08.2024
- Collected, arranged, and input information into database system.
- Gathered, organized and input information into digital database.
Patient Account Representative
Keystone Professional Solutions
04.2009 - 06.2024
- Posted payments and processed refunds.
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
- Electronically submitted bills according to compliance guidelines.
- Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
- Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
- Responded to patient, family, and external payer inquiries.
- Utilized computer programs to create invoices, letters, and other documents.
- Contacted patients after insurance was calculated to obtain payments.
- Reconciled statements with patient records.
- Responded to customer inquiries and provided detailed account information.
- Generated and distributed monthly customer statements.
- Researched billing errors and discrepancies to initiate corrective action.
- Maintained office inventory and organized supplies for efficiency and expected needs.
- Developed strong relationships with key contacts at insurance companies to expedite resolution of claim disputes or other account-related issues.
- Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
Education
Associate of Applied Science - Medical Coding And Billing
Daymar / Draughons Junior College
Murfreesboro, TN08.2008
Skills
- Organizational growth
- HIPAA compliance
- Effective communication
- Professionalism and ethics
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Appeals Specialist
Community Health Systems, CHS
10.2024 - 01.2025
HIM Representative
Robert Half / R1 RCM MBS
07.2024 - 08.2024
Patient Account Representative
Keystone Professional Solutions
04.2009 - 06.2024
Associate of Applied Science - Medical Coding And Billing
Daymar / Draughons Junior College
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