Sharron Welch
Rialto,USA
Summary
I have over 20+ years experience in medical eligibility/benefits verification, billing and collections areas. My experience and expertise has been in all coverages: government, private-group health plans,- including managed care plans and PPO plans, workers compensation, travel insurance plans regarding international coverage(s) and letters of agreement-as negotiated.
As a Liaison Financial Service Representative- I've worked the front and back ends of hospital (facility) financial services. This included reviewing prior admit information and researching and correcting any denied (billed) accounts for rebilling and recovery purposes.
Overview
13
13
years of professional experience
Work History
Financial Service Representative
City of HOPE NAT'L MED CENTER
10.2008 - 12.2021
- Completed assigned work queue of all pt accounts of all coverages for: preadmit, coverage verification & approval and determine pt financial responsibility prior to admission.
- Notify patients as required; Notify all departments as required.
- Completed financial clearance for emergency transferred pt’s prior to admission.
- Liaison to the billing and collections department of denied claims for denial determination- related to coverage and/or benefits.
- Assist in determining if denied claim can be corrected and returned for processing.
Education
AA - BUSINESS ADMIN & MANAGEMENT
CHAFFEY COMMUNITY COLLEGE
RANCHO CUCAMONGA, CA06.1992
Skills
- Skilled in verification and review of all insurance plans for professional & hospital/facility services
- Government: Medicare, Medi-Cal and Tri-Care
- Blue Cross/Blue Shield plans-local and out of state
- Private plan carriers: managed care/HMO plan Workers Comp & personal injury
- Workers Comp and personal injury
- International & travel plans
- Letter of agreement for specialized and/or for out-of-area services
- Medical terminology, medical coding, and pt financial responsibility review/determination
- EOB review for correction to rebill/resubmit; Payment/reimbursement analysis for correct rate and follow-up with payor for timely reimbursement on claims
Timeline
Financial Service Representative
City of HOPE NAT'L MED CENTER
10.2008 - 12.2021
AA - BUSINESS ADMIN & MANAGEMENT
CHAFFEY COMMUNITY COLLEGE
Similar Profiles
Arnel DejanArnel Dejan
Physical Facilities Coordinator and Maintenance at DepEd-Talisay City-Lawaan Nat'l High SchoolPhysical Facilities Coordinator and Maintenance at DepEd-Talisay City-Lawaan Nat'l High School
Sararose AlcalaSararose Alcala
Medical Assistant III at City of Hope National Medical CenterMedical Assistant III at City of Hope National Medical Center
Fan MengFan Meng
Postdoctoral Fellow at CITY OF HOPE NATIONAL MEDICAL CENTERPostdoctoral Fellow at CITY OF HOPE NATIONAL MEDICAL CENTER
Jose SaldanaJose Saldana
Level 3 Security Officer at Inter-con Security ServicesLevel 3 Security Officer at Inter-con Security Services
Aimee WalshAimee Walsh
IT Service Desk Analyst at EIS Legacy, LLC.IT Service Desk Analyst at EIS Legacy, LLC.