Shameka Walker

• Medicare Claims
• Account Review
• Appeals & Denials
• Medicare/Medicaid
• Insurance Follow-up
• Customer Service
• Billing
• UB-04 & CMS 1500
• Complete all business-related requests and correspondence from patients and insurance companies.
• Responsible for working on 40-70 Accounts Per Day
• Complete all assigned projects in a timely manner.
• Assist client and patients in all requested tasks.
• Communicate to management areas of concern or areas of improvement.
• Research and respond to all patient inquiries received by telephone and mail.
• Update patient demographic information and initiate account adjustments.

accounts an outside agency for collections.

• Utilized computer programs to create invoices, letters, and other documents.
• Prepared reports detailing billing actions, flags, and other key information.
• Responded to patient, family, and external payer inquiries.
• Monitored flags and resolved urgent items with accuracy and efficiency.
• Worked with outside entities to resolve issues with billing, claims, and payments.
• Reconciled statements with patient records.
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• Verify patient insurance eligibility & coordination of benefits.
• Analyzed complex explanation of benefits.
• Prepared billing statements for patients and vendors.
• Processing and completing medical records requests.
• Billing Medicare, medical and other commercial insurance via EMS & 1500 claim forms
• Processing EFT and other forms of Payments
• Identified researched and resolved billing variances to maintain system accuracy and currency.
• Negotiated Payment Agreements between multiple hospitals.
• Work effectively with medical payers such as Medicare, Medi-cal and commercial insurance companies to obtain timely and accurate payments.
• Responsible for correcting, completing, and processing claims for all payer codes.
• Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
• Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal.
• Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Verified signatures and checked medical charts for accuracy and completion.

• Responsible for charge and payment entry within Electronic Health Record. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication.
• Analyze and interpret that claims are accurately sent to insurance companies.
• Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
• Process appeals online or via paper submission.
• Communicate with billing and credentialing coordinator to identify and resolve audit review issues.
• Answer/respond to correspondence related to patient accounts.
• Process billing calls and questions from patients and third-party carriers.
• Negotiated to collect balance in full.
• Counseled debtors on payment options and arranged installment agreements.
• Researched accounts and completed due diligence to resolve collection problems.
• Assisted in implementing procedures and policies to facilitate timely payments.
• Negotiated re-payment plans by identifying causes of delinquent payments to assist in recovery of debt and meet realistic timeframes.