Teresa Forson
Little Elm,TX
Summary
Accurate professional performs all aspects of medical billing, including coding, charge entry, transmission, correction, and resubmission. Brings several years of experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials.
Overview
29
29
years of professional experience
Work History
Medical Office Supervisor
Cook Children's Physician Network
Plano, Texas
08.2020 - Current
- Oversaw daily operations of the medical office, including handling customer inquiries and complaints.
- Managed inventory of medical supplies and equipment, ensuring adequate stock levels at all times.
- Processed payroll information for all medical office personnel using an automated system.
- Resolved conflicts among staff members in a timely manner while maintaining professional standards.
- Performed administrative duties such as filing documents or ordering supplies when needed.
- Scheduled appointments, oversaw check-ins and resolved patient concerns in high-volume [Type] practice.
- Provided exceptional patient experience through friendly and compassionate communications.
- Registered patients and scheduled appointments.
- Collected information, verified insurance and collected co-payments for patients as part of check-in process.
- Managed office inventory and completed new purchases.
- Delegated work to staff, setting priorities and goals.
- Reviewed reports on employee attendance, productivity and effectiveness to evaluate performance.
- Recruited, interviewed and selected employees to fill vacant roles.
Medical Biller and Coder
Plano Pediatrics
Plano, Texas
10.2005 - 08.2020
- Submitted claims to insurance companies electronically or by mail.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Verified accuracy of patient information and insurance data in billing system.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Provided customer service support to patients regarding billing inquiries.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Ensured timely filing of all claims within established guidelines.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Filed and submitted insurance claims.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained positive working relationship with fellow staff and management.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Reviewed and interpreted insurance explanation of benefits statements and applied to patient accounts.
- Reviewed Explanation of Benefits statements from insurance carriers for accuracy.
- Posting customer payments by recording cash, checks and credit card transactions.
- Ensuring timely collection of outstanding balances from customers.
- Negotiated payment plans with customers to ensure timely repayment of debt.
- Processed payments through various methods such as credit cards, online banking and cash transactions.
Medical Insurance Specialist/Receptionist
Dr. Timothy Beste
Lewisville, Texas
10.2004 - 01.2006
- Managed incoming calls from patients regarding their medical needs or concerns.
- Organized and tracked patients' appointments, referrals to specialists and follow-up visits.
- Ensured that all necessary paperwork was completed for insurance claims and reimbursements.
- Resolved complex insurance issues by communicating with providers, patients, and third-party payers.
- Provided guidance on medical reimbursement issues such as coding, claim forms, and fee schedules.
- Performed administrative tasks such as filing paperwork, preparing reports, answering phones, scheduling appointments.
- Accurately processed large volume of medical claims every shift.
- Posted payments for insurance companies, including Medicare and Medicaid, by accurately entering data into the system.
- Processed incoming payments from patients and insurance companies in a timely manner.
- Balanced daily cash postings with deposits to ensure accuracy of information entered into the system.
Medical Front Office Supervisor
Womens Centre OB/GYN
Denton, TX
10.1997 - 07.2001
- Supervised and managed all front office staff, including hiring and training new employees.
- Assigned tasks to front office staff members and monitored their performance.
- Developed policies for patient check-in and check-out procedures.
- Provided customer service to patients by addressing inquiries, concerns, and complaints in a timely manner.
- Facilitated smooth communication between medical staff and patients via phone or email.
- Performed administrative duties such as filing documents, ordering supplies.
- Monitored inventory levels of medical supplies used in the front office.
- Implemented strategies to increase efficiency within the practice's workflow processes.
- Issued work schedules, duty assignments and deadlines for office or administrative staff.
- Recommended solutions related to staffing issues and proposed procedural changes to managers.
Front Office Receptionist
Dr. Cindi Marsden OB/GYN
Denton, Texas
08.1995 - 02.1997
- Answered phone calls, transferred calls, took messages, and provided information to callers.
- Scheduled appointments for clients and recorded all client data into the system.
- Assisted with administrative tasks such as filing documents, photocopying, faxing.
- Organized office supplies and maintained inventory levels.
- Received payments from customers and processed credit card transactions accurately.
- Responsible for opening and closing the office on time each day.
- Verified accuracy of billing statements prior to sending them out to customers.
- Answered office phone and emails to schedule appointments, answer questions and document information.
- Greeted visitors and verified reasons for visit and appointment information.
Skills
- Thirty years experience knowing all aspects of the front office from answering phones to front office manager
- Twenty five plus years as a medical insurance specialist Analyzing claims including posting,processing, appealing and resolving claim denials Working A/R and collections reports
- Skilled with EOBs,modifiers,medical terminology, CPT and ICD-10 coding especially with Pediatrics
- Knowledgeable in EPIC software
Timeline
Medical Office Supervisor
Cook Children's Physician Network
08.2020 - Current
Medical Biller and Coder
Plano Pediatrics
10.2005 - 08.2020
Medical Insurance Specialist/Receptionist
Dr. Timothy Beste
10.2004 - 01.2006
Medical Front Office Supervisor
Womens Centre OB/GYN
10.1997 - 07.2001
Front Office Receptionist
Dr. Cindi Marsden OB/GYN
08.1995 - 02.1997
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