Tanesha Banks
Glenolden,PA
Summary
Accomplished Accounts Receivable Specialist with a proven track record at Main Line Health, adept in data analysis and trend analysis. Leveraged expertise in Microsoft Office and EPIC to enhance financial operations, achieving top performer status multiple times. Excels in teamwork and critical thinking, consistently surpassing collection targets by fostering effective communication and collaboration.
Overview
24
24
years of professional experience
Work History
Accounts Receivable Specialist
Main Line Health
Newtown Square, PA
09.2023 - Current
- Tracking insurance payments in EPIC and resolving payment issues
- Medical review through claim analysis, interpretation of data and medical record review
- Contributor of process improvements and identifier of trends versus issues
- Handle process improvements, appeals, denials, and account resolutions
Accounts Receivable Specialist
Universal Health Services
Wayne, PA
09.2020 - 09.2023
- Accurate and timely claims follow-up by assigned payer/s and defined aging criteria to meet or exceed collection targets and minimize timely filing write-offs
- Performs eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools and payer websites
- Effectively documents claim status and next steps in the Practice Management System (PMS) to expedite timely and accurate claims processing
- Meets or exceeds established performance targets (productivity and quality) established by the Accounts Receivable (A/R) Supervisor
- Identifies root causes and denial trends and works with the payers to reprocess claims for payment
- Extensive and current working knowledge of government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes
Accounts Receivable Representative
Azura Vascular Care
Malvern, PA
05.2016 - 09.2020
- Perform assigned responsibilities in compliance with company policies and procedures; meeting or exceeding goals within company-defined timeliness
- Principle responsibility is to maintain designated portfolio of customer accounts by contacting customers who have not met payment obligations
- Identify, analyze and research systemic issues that cause aged receivables and make recommendations for resolution
- Meet or exceed monthly cash forecasts and works to reduce Days Sales Outstanding (DSO) to meet business and departmental goals
- Maintain an audit trail by gathering appropriate documentation throughout the collection process and resolution
Medical Claims Examiner
AmeriHealth Caritas
Philadelphia, PA
09.2015 - 05.2016
- Reviewed and adjudicated medical claims based on contractual agreements and claims processing guidelines
- Monitors and tracks aged, pended and open reports to maintain timeliness in claims processing
- Reviewed and verified quality audit reports
- Inputs claims into system for appropriate tracking and processing
- Maintains thorough knowledge of claims processing systems, its databases and subsystems
Client Delivery Analyst
Medrisk
King of Prussia, PA
10.2014 - 09.2015
- Worked to resolve highly complex billing, claim processing and reimbursement issues
- Maintained A/R in assigned queue
- Contact insurance payers and providers via telephone, email or correspondence on aged claims for resolution
- Ensure confidentiality of all patient accounts by following HIPPA guidelines
- Report regularly to supervisor on payer trends identified
Appeals Management Coordinator
Executive Health Resources
Newtown Square, PA
06.2012 - 06.2014
- Responsible for processing cases and payer responses and communicating with clients
- Follow and complete department processes to maintain accurate and current open and closed reports for each client
- Ensure the accuracy and completeness of information entered into the Company's database
- Assist in the identification and correction of inaccurate and incomplete information
- Actively participate in the orientation of new staff members
Operations Specialist
Maximus Federal)
Bala Cynwyd, PA
08.2011 - 06.2012
- Performed data entry duties regarding patients’ personal information
- Assisted health care providers with Medicare case issues through email and telephone
- Analyzed Medicare cases completely to determine which category of healthcare services
- Filing, scanning and mail room duties
Issue Resolution Specialist/Billing
Iron Mountain
Royersford, PA
07.2010 - 06.2011
- Answer questions regarding various account concerns via telephone or written correspondence
- Explain policies, procedures and rate structures
- Process adjustments and refunds
- Researched and resolved account billing problems within the required service level agreement
Claims Adjuster
Yellowbook USA
King of Prussia, PA
01.2009 - 07.2010
- Conduct prompt investigations, and evaluated facts to negotiate settlement
- Demonstrate best judgment in the disbursement of adjustments and credits
- Provide effective and timely resolution of a range of customer concerns
- Managed multiple priorities and maintained effective results in a quota driven workplace
- Exercised strong interpersonal communication skills with customers
- Top Performer, December 2009, January 2010 and February 2010
- Inbound/Outbound call center environment
Branch Associate Supervisor/ Business Banker
Citizens Bank
Aldan, PA
12.2003 - 09.2008
- Responsible to meet quarterly goals by selling all financial products
- Daily cold calling and prospecting for new business
- Responsible for preparing branch to be audit ready
- Branch succeeded five out of five required sales goals for eight consecutive quarters
- Completed internship as Branch Manager January 2006 until May 2006
Account Manager
New Horizons Computer Learning Center
King of Prussia, PA
02.2006 - 05.2006
- Business to Business sales
- Accountable for 60 cold calls daily to meet monthly sales forecast and goals
- Developed individual leads and set appointments to meet with clients
Operations Supervisor
Commerce Bank
Media, PA
04.2001 - 12.2003
- Responsible for opening and closing of the branch
- Managed teller line according to corporate policies and procedures
- Prepared and updated daily reports and log books
Education
Bachelor of Science - Business Management & Finance
Penn State University
Media, PASkills
- Microsoft Office applications
- Data Analysis
- Reconciling Accounts
- Trend Analysis
- Project Management
- Date Entry
- Market Analysis
- Creative problem solving
- Critical Thinking
- Compliance
- Financial Analysis
- Teamwork and collaboration
- Effective communication
- HIPPA compliance
- Medicare and Medicaid regulations
- Medical Systems
- EPIC
- Cerner
- NextGen
- EMR
Other Employment
- National Marketing Services, Springfield, PA, Merchandising Manager, 2000 - 2001
- Bradlees Department Stores, Glenolden, PA, Sales Associate, 1996 - 2000
Timeline
Accounts Receivable Specialist
Main Line Health
09.2023 - Current
Accounts Receivable Specialist
Universal Health Services
09.2020 - 09.2023
Accounts Receivable Representative
Azura Vascular Care
05.2016 - 09.2020
Medical Claims Examiner
AmeriHealth Caritas
09.2015 - 05.2016
Client Delivery Analyst
Medrisk
10.2014 - 09.2015
Appeals Management Coordinator
Executive Health Resources
06.2012 - 06.2014
Operations Specialist
Maximus Federal)
08.2011 - 06.2012
Issue Resolution Specialist/Billing
Iron Mountain
07.2010 - 06.2011
Claims Adjuster
Yellowbook USA
01.2009 - 07.2010
Account Manager
New Horizons Computer Learning Center
02.2006 - 05.2006
Branch Associate Supervisor/ Business Banker
Citizens Bank
12.2003 - 09.2008
Operations Supervisor
Commerce Bank
04.2001 - 12.2003
Bachelor of Science - Business Management & Finance
Penn State University
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