Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Terrecca S. McGhee

Bellflower,CA

Summary

Experienced Medical Biller and Collection Specialist successful at submitting clean claims, resolving disputes and billing inquiries. Detail-oriented individual with 15+ years of experience performing intricate billing procedures for multiple medical specialties. Ability to handle fast-paced work environments and proven willingness to take on any task to support the team and help business succeed. 13 years remote experience in a equipped home office setting.

*Fully-Vaccinated and boosted.

Overview

18
18
years of professional experience

Work History

Medical Reimbursement Specialist

Kabafusion
Cerritos, CA
01.2021 - Current
  • Oversee daily collections for specified payers, developing strategies to maximize collections and reduce aged accounts.
  • Work high dollar home infusion collections from monthly aging reports and AR manager.
  • Investigate claims to verify they were processed correctly according to our contracted rate.
  • Send incomplete or incorrect claims to supervisors or billing team for proper adjudication.
  • Maintain consistent knowledge of payors billing policies. Payor update, timely filing limitations, appeal and grievance procedures.
  • Take billing calls, questions and concerns from patients and third party carriers.
  • Update claim status and collection efforts in members account for follow-up documentation.
  • Identify discrepancies and carrier issues regarding billing and reimbursements.
  • Identify errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Complete and submit corrected claims, provider reconsideration, 1st and 2nd level appeals for denied claims.
  • Submit documentation requested from payor to support medical necessity. Medical records, delivery tickets, SMN, providers orders.
  • Maintain current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Coordinate communications between patients, billing personnel and insurance carriers.
  • Collaborate closely with other departments to resolve claims issues.
  • CPR+ Home Infusion Software experience.

Medical Billing and Collections Specialist

AVORS Medical Group Inc.
Lancaster, CA
05.2019 - 03.2020
  • Billing representative for Orthopedic Surgeons in a multi specialty practice performing all aspects of medical billing and collection specialist to maintain accurate and timely billing and collections procedures.
  • Performed charge entry duties to process claims within claims system electronic and manual 75-100 claims daily.
  • Researched procedure codes, modifiers and diagnosis codes to generate clean claims for processing.
  • Maintained claims records, monitored and controlled backlog.
  • Accurately posted insurance and patient payment daily manually and electronically.
  • Follow-up and corrected insurance claims minimum 65 per day.
  • Researched and processed refunds as needed.
  • Assisted patients with billing questions and concerns.
  • High Volume claim appeals.
  • Denial Management.
  • Insurance correspondence.
  • Understand Health Insurance websites and portals.
  • Meet department quality and production standards.
  • AdvancedMD software knowledge and EMR
  • Researched and completed projects in a timely manner.

Medical Billing Supervisor

Simple Solutions Management, Inc.
Long Beach, CA
07.2006 - 05.2019
  • Worked in office and remote for 13 years for a billing service in charge of 6 professional medical providers accounts within various specialties: Cardiology, Chiropractic, Chemotherapy, Neurology and Family Medicine billing.
  • Batched and prepared timely and accurate billing electronic manually.
  • Precisely completed appropriate claims paperwork, patient demographic and insurance benefits information.
  • Correctly coded and billed medical claims for various professional offices, hospitals and nursing facilities.
  • Verified patients eligibility and claim status with various insurance agencies.
  • Requested referrals and pre-authorizations, accurate TAR submission.
  • Performed payment posting (EOB), adjustments and write-off's, collection, A/R of accounts, claim denials and appeals.
  • Daily and monthly reconciliation of payments and charge batches.
  • Prepared patient statements and resolved patient issues regarding their billing and statements inquiries.
  • Organized information for accounts more than 120 days past due and transferred to a collection agency.
  • Prepared bad debt write offs as needed as well as insurance and patient refunds.
  • Properly maintain electronic medical records (EMR)
  • Ensure superior patient assistance by addressing patients concerns, demonstrating empathy and resolving problems in a timely matter.
  • Provided complete meeting support including preparing materials and taking notes.
  • Recruited and hired qualified candidates for vacant and new positions.
  • Completed bi-weekly payroll for 8 or more employees.
  • Met challenging quotas for productivity and accuracy of work.
  • Trained new employees on multiple medical billing programs and data entry software.
  • MediSoft and Intergy software knowledge.

Education

Certificate in Health Claims Examiner/Medical Biller - Healthcare

American Career College
Anaheim, CA
2006

High School Diploma -

Lakewood High School
Lakewood, CA
1996

Skills

  • Insurance Billing and coding
  • PPO/HMO/WC/Medicare/Medi-Cal Billing
  • Medical and billing terminology
  • ICD-9, ICD-10 and HCPCS coding
  • Excellent communication skills
  • Responsible, Flexible and Dependable
  • Accurate and detailed oriented
  • 60 wpm / 10 Key Proficient
  • Relationship and team building
  • Customer Service

Accomplishments

Recognized by management for providing exceptional service and awarded employee of the month for December 2019. Also recognized for increasing collections revenue while earning reputation for good attendance and hard work.

Timeline

Medical Reimbursement Specialist

Kabafusion
01.2021 - Current

Medical Billing and Collections Specialist

AVORS Medical Group Inc.
05.2019 - 03.2020

Medical Billing Supervisor

Simple Solutions Management, Inc.
07.2006 - 05.2019

Certificate in Health Claims Examiner/Medical Biller - Healthcare

American Career College

High School Diploma -

Lakewood High School

Similar Profiles

CREATE PROFILE
Terrecca S. McGhee