Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. I'm also a hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
• Accurately bill BCBS of SC, Medicaid, self-pay/uninsured, accepted federal grant programs, and commercial dental insurance, processing claims in accordance with payer requirements and organization policy
• Regularly audit claims and EHR documentation for accuracy and Federal, State, and facility policy compliance
• Aid member clients filing claims for non-accepted plans in compliance with CDM MUSC policies.
• Post and allocate payments, electronic remits, and paper explanation of benefits (EOBs).
• Submit pre-treatment estimates according to CDM MUSC policy and upon member client request •Provide treatment plan and estimated cost review upon request
• Process fee adjustment request according to CDM MUSC policies
• Escalate requests that do not meet policy adherence to Clinical Affairs for determination
• Correct claim and charge errors; audit for verification which includes but is not limited to audit of coding, payments, and EHR to identify and rectify any missing or incorrect charges.
• Correct transaction entry errors within HER
Assist with the collections of receivables for guarantor and any third-party payers by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends.
• Identify and address significantly overdue accounts according to state and facility policies
• Issue correspondence related to balances, including patient account statements
• Thoroughly research and resolve credit balances.
• Process refunds according to CDM MUSC and SC State policies
• Prepare and drop Billing Office deposit
•Perform deposit reconciliation for all of CDM MUSC deposits according to separation of duties.
• Answer phone calls from patient and responsible parties regarding account balances and/or other account related matters.
• Maintain complete and accurate billing and accounts receivable records
• In office consultations for providers and patients