Traci M. Barr

Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.

Assessed and conducted negotiations within authority limits to settle claims.

Checked documentation for appropriate coding, catching errors and making revisions.

Reviewed incoming claims for accuracy and completeness in accordance with policy provisions.

Investigated, evaluated, and negotiated settlements of assigned claims.

Maintained timely and accurate records of all claim activity.

Analyzed medical reports, bills, legal documents, or other information related to claims.

Participated in special projects as assigned by management team.

Provided excellent customer service throughout the entire claims process.

Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.

Communicated with other departments to establish action plans and manage open claims to closure.

Resolved claims by approving or denying documentation, calculating benefits due and determining compensation settlement.

Supervised children and participated with children in activities.

Established positive relationships with students, parents, fellow teachers and school administrators.

Assisted teachers with lesson preparation and curriculum implementation.

Contributed to positive, educational setting by delivering gentle discipline and promoting student success.

Tutored and assisted children individually and in small groups to help master assignments and reinforce learning concepts.

Helped students master assignments and reinforced learning concepts presented by teachers.

Prepared lesson materials, bulletin board displays, exhibits and demonstrations to assist teachers in classroom preparation.

Graded assignments and tests and documented results into filing systems.

Organized student performance and enrichment activities to facilitate learning.

Ensures that claims are processed accurately through review and audit functions to ensure timely payment. Responds to inquiries regarding claims with under payment or non-payment. Responds to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner. Interfaces with external and internal customers to ensure optimal efficiency of service. Monitors aging of claims to ensure timely follow-up and payment. Coordinates, monitors, and manages the follow-up on unpaid claims. Ensures follow-up and reimbursement appeals of unpaid and inappropriately paid claims. Ensures appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts. Maintained confidentiality and integrity of patient data. Researched rejections, investigating problems to appeal claims. Advised supervisors and clinicians of billing deficiencies to support charge capture. Identified opportunities for coverage access to address reimbursement barriers. Enforced adherence to several states and federal reporting regulations by performing regular compliance audits. Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability. Worked with billing department to reduce contract implementation errors. Verified clients' Medical insurance claims coverage by coordinating with providers. Determined medical necessity, using individual insurance carrier regulations. Coded patient care records to provide accurate information for billing. Verified technical reimbursement questions for providers, billing and coding staff. Checked claims coding for accuracy with ICD-10 standards. Enforced compliance with organizational policies and federal requirements regarding confidentiality. Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology. Trained new team members on company policies and accounting systems to keep team operations productive and efficient. Was named TOP collector over 9 months in a row.

Overseen morning huddles. Quickly responded to staff and client inquiries. Thoroughly investigated past due invoices and minimized number of unpaid accounts. Recorded and filed patient data and medical records. Carefully reviewed medical records for accuracy and completion as required by insurance companies. Acquired insurance authorizations for procedures and tests ordered by the attending physician. Prepared prescription refill requests on behalf of the physician. Quickly responded to staff and client inquiries regarding CPT codes. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative. Confirmed patient information, collected copays and verified insurance. Completed appeals and filed and submitted claims. Posted charges, payments and adjustments. Applied payments, adjustments and denials into medical manager system. Submitted refund requests for claims paid in error. Carefully prepared, reviewed and submitted patient statements. Tracked and resolved underpayments. Consistently informed patients of their financial responsibilities prior to services being rendered. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans. Performed quality control of the data entry system to verify that claims and payments were posted correctly. Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials. Efficiently performed insurance verification and pre-certification and pre-authorization functions. Performed daily, weekly, and monthly reports. Balanced daily deposits. Performed other administrative tasks, including filing, answering phones and marketing.

Audited each insurance claim and researched for underpayments. Negotiated with insurance companies for settlement of payments. Collect insurance claim data for review to ensure timely resolution on existing and outstanding issues. Evaluated each insurance claims to determine which claim requires an appeal. Consistent follow-up with insurance companies to discover the determination and the appeal progress level. Send out letters to patients requesting Authorization to appeal their claim on their behalf. Write appeal letters to insurance companies to resolves denials. Obtained Retro-Auth for claims to be processed correctly and paid. Resolve patient and facility complaints in NetSuite. Served as a mentor/trainer for the collection team. Supplied team support to other collectors. Assisted in Auditing collector’s productivity. Conducted Direct Pay project. Worked with Advanced MD software.

Developed and implemented office policies and procedures.

Managed the daily operations of the business office including accounts payable and receivable, payroll, budgeting, purchasing and inventory control.

Performed administrative tasks such as filing documents, updating databases, preparing reports and responding to inquiries.

Created presentations using Dentrix Software for patient treatment plans.

Provided customer service support by answering questions related to billing, scheduling appointments and other general inquiries.

Assisted in developing marketing strategies and campaigns for new products or services.

Collaborated with management team on short-term and long-range planning initiatives.

Maintained up-to-date records of all financial transactions including invoices, receipts and expenditures.

Analyzed data from various sources to identify trends or patterns that could be used to improve operational efficiency.

Prepared monthly financial statements for review by senior management team members.

Processed payments made via credit cards or direct deposits into appropriate accounts.

Provided technical assistance with software programs related to accounting functions.

Defined and understood team member responsibilities to enhance group efficiency and performance.

Increased overall efficiency and improved morale by implementing employee incentive programs.