Theresa Morgan
Mattapan,MA
Overview
26
26
years of professional experience
Work History
Billing Specialist
Downtown Physical Therapy & Rehab
Boston, MA
04.2022 - Current
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Resolved discrepancies between customers' remittances and invoices received.
- Answered customer inquiries regarding billings, payments, account status.
- Maintained accurate records of collections, adjustments and denials in the system.
- Processed credit card transactions through Point-of-Sale terminals or online systems.
- Developed financial reports detailing accounts receivable aging status.
- Submitted claims to insurance companies.
- Answered customer questions to maintain high satisfaction levels.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
Billing Coordinator
Bay State Physical Therapy
Randolph, Massachusetts
07.2007 - 04.2019
- Responsible for contacting assigned medical insurance companies on outstanding claim balances
- Responsible for e-mailing our different clinics regarding missing/incorrect information on patient accounts
- Responsible for completing primary and secondary aging reports every month of claim balances on patients accounts
- Responsible for phone coverage
- Work closely with the accounts payable dept. regarding write-offs
- Responsible for completing explanation of benefit denials of my assigned insurance companies in a timely manner
- Update patients information in our Medisoft system
Clinical Support Outreach Coordinator
Neighborhood Health Plan, NHP
Boston, MA
01.2004 - 07.2008
- In this role I am responsible for postpartum outreach calls to members who have been identified as delivered
- Do an initial assessment with members to identify if they have scheduled their six-week check-up with doctors, assisting members if they cannot get an available appointment time by contacting their PCP's office
- Do an initial screening of members to find out if baby is exposed to cigarette smoke, referring parents to smoking cessation counselors
- Update demographic information in Onyx which includes updating PCP's address & phone number, members address & phone number
- Create and mail postpartum reminder letters to members
Clinical Support Coordinator
Neighborhood Health Plan, NHP
Boston, MA
12.2002 - 01.2004
- Responsibilities include proving administrative support to case managers in team concept
- Duties include answering telephone requests and questions regarding services
- Responsible for external health service organizations and providers regarding NHP policies, procedures and guidelines
- Assist care managers with outreach to health centers regarding clinical questions and program support by maintaining frequent consistent contact with the health centers and its staff
- Maintain computer date entry of request for services
Administrative Assistant/Clinical Support Specialist
Neighborhood Health Plan, NHP
Boston, MA
07.2000 - 12.2002
- Responsible for collecting, sorting and distributing all incoming fax authorizations, request to Clinical Support Coordinators
- Assisted in answering incoming calls regarding managers
- Responded to external health services organizations and providers regarding NHP policies, procedures and guidelines
- Provided administrative supports to case managers
- Processed outpatient referrals, utilizing appropriate criteria, as requested
- Entered clinical information as directed by case managers
Data Quality Service Assistant II
Worker's Compensation Rating and Inspection Bureau
Boston, MA
06.1998 - 07.2000
- Reviewed error reports and took appropriate corrective action based on established procedures
- Entered and retrieved data reports
- Followed-up on all corrective requests
- Resolved mod effective dates and risk identification issues with the Interstate Rating Bureau
- Responsible for Underwriting Clerk I
Education
High School Diploma -
The English High School
Jamaica Plain, MA06-1996
Skills
- Interest calculations
- Document analysis
- Research
- Dispute Resolution
- Audit Support
- Invoice Processing
- Professional Skills
- Customer Service Skills
- Typing
- Medical Terminology
- Office Procedures
- Sales
- Microsoft Office
- Filing/Editing
- Microsoft Windows
- Excel
Timeline
Billing Specialist
Downtown Physical Therapy & Rehab
04.2022 - Current
Billing Coordinator
Bay State Physical Therapy
07.2007 - 04.2019
Clinical Support Outreach Coordinator
Neighborhood Health Plan, NHP
01.2004 - 07.2008
Clinical Support Coordinator
Neighborhood Health Plan, NHP
12.2002 - 01.2004
Administrative Assistant/Clinical Support Specialist
Neighborhood Health Plan, NHP
07.2000 - 12.2002
Data Quality Service Assistant II
Worker's Compensation Rating and Inspection Bureau
06.1998 - 07.2000
High School Diploma -
The English High School
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