Taylor Avon
Southwest Skin and Cancer
St. George,UT
12
Years of experience
12 years of experience with medical billing, prior authorizations, insurance verification, customer service, collaborating with healthcare providers, insurance companies, and customers, attention to detail and problem-solving skills, working revenue reports and appealing denials. I am a recent graduate of California Baptist University with my degree in health administration and management.
Work History
Medical Billing Specialist
1 Year 3 Months- Processed and submitted insurance claims using advanced billing software to ensure timely reimbursement.
- Coordinated with insurance providers to verify coverage, facilitating seamless patient billing experiences.
- Reviewed patient records for accuracy, resolving discrepancies to maintain compliance with healthcare regulations.
- Oversaw all aspects of pre-collection and collection calls/accounts, fostering effective communication with clients to resolve outstanding balances.
- Achieved efficient processing of prior authorization requests to the VA, improving patient referral timelines. Delivered timely submission of prior authorization requests to the VA, enhancing access to specialist care.
- Facilitated communication by answering calls and addressing patient needs with professionalism and care.
- Processed refund requests and monitored credit balances. Assisted in tracking and managing credit allocations.
Patient Services Representative, HUC and Insurance Verification
7 Months- Executed patient check-in procedures, validating insurance information and collecting due payments for efficient registration.
- Assisted customers with inquiries and provided support to enhance satisfaction. Requested and processed payments on schedule. Conducted thorough insurance verification for client accounts.
- Assisted in scanning operative reports for billing purposes. Supported scanning of history and physicals for physician reference.
- Performed anesthesia billing alongside essential clerical tasks, maintaining organized records and efficient workflow.
- Maintained accurate patient records using electronic health record systems for streamlined operations.
- Managed patient inquiries, resolving issues efficiently to improve satisfaction levels.
- Facilitated communication between patients and healthcare providers to enhance service delivery.
Medical Billing Specialist/Auditor
2 Years 9 Months- Submit Medicare, Medicaid, PDGM and commercial claims to proper payor ID and utilize the clearinghouse to see if any batches had any errors and resubmit with corrections if so.
- Processed medical claims for accuracy, ensuring timely submissions and compliance with regulatory standards.
- Reviewed and verified patient information, identifying discrepancies to enhance billing accuracy.
- Collaborated with healthcare providers to resolve billing inquiries and discrepancies efficiently.
- Analyzed billing data to identify trends, recommending process improvements for increased efficiency.
- Posted and adjusted payments from insurance companies.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Identified and resolved patient billing and payment issues.
- Diligently worked aging claims via reports and conducted follow-up on all claims while recording data and submitting billing notes for each claim.
- Contacted patients regarding outstanding balance and attempted to collect or set up a payment plan.
- Conducted monthly verification of patient insurance coverage to ensure billing accuracy.
- Initiated prior authorization requests with medical insurance companies to secure necessary approvals.
- Executed claims appeals as needed to ensure reimbursement.
- Audit patients' charts and verify that the consents are correct, emergency preparedness forms are correct, patient orders are all signed by the provider, make sure that the history and physical is signed and within appropriate date range, make sure that the face-to-face is completed, and that eligibility is uploaded as well as prior authorization when applicable, verify that there is a signed order of care, make sure that visit frequencies match the orders and that missed visits have coordination notes.
SUD Billing Coordinator
1 Year- Review counselor progress notes to ensure billing is accurate before submitting procedure codes in the Avatar billing system.
- Assisted program administrators with admissions and discharging clients.
- Identified billing error trends, collaborated with program managers, administrators, and counselors to expedite corrections and prevent future errors.
- Ran client insurance eligibility for all regional clients, correcting and updating information as necessary to ensure accurate billing.
- Reviewed revenue reports, made necessary corrections, and resubmitted claims to ensure timely reimbursement.
- As a Super User-train staff in MyAvatar and Welligent EHR systems when needed.
- Work closely with the San Bernardino County Department of Behavioral Health and MHS compliance manager to ensure staff is informed of any recent changes of billing codes, procedures, etc.
- Provide support for program administrators with admissions and discharging clients when needed.
Office Assistant II
2 Years 3 Months- Provided technical support for county's Electronic Medical Records system, enhancing user experience and system reliability.
- Entered admissions, discharges, and prior authorizations; verified client eligibility and collaborated with contracted providers to resolve denials efficiently.
Education
BA - Health Administration and Management
Skills
Revenue cycle management
Claims processing
Insurance verification expertise
Insurance plan knowledge
MyAvatar/ELMR-Super User
Welligent- Super User
HomeCare HomeBase
Medisoft
Brightree
Fastrack
QuickBooks
Microsoft Office Suite
Data entry accuracy
Care coordination systems
HIPAA Certified
Timeline
Medical Billing Specialist
Southwest Skin and Cancer
04.2025 - CurrentRead More
Patient Services Representative, HUC and Insurance Verification
Intermountain St. George Surgery Center
06.2024 - 01.2025Read More
Medical Billing Specialist/Auditor
Zion’s Way Home Health and Hospice
02.2021 - 11.2023Read More
SUD Billing Coordinator
Mental Health Systems Inc
02.2020 - 02.2021Read More
Office Assistant II
Riverside County
11.2017 - 02.2020Read More
California Baptist University
BA from Health Administration and Management
Read More