VANESSA BAKER
Chicago,IL
Summary
Medical Services Professional with exceptional achievement record in securing resolutions to billing and accounts receivables issues. Strong negotiation skills. Able to sell solutions to outside parties. Noted for astute problem solving capabilities. Train staff in job skills with emphasis on developing initiative, energy, loyalty, dedication and high quality performance. Seek a position in a progressive environment where her medical, financial, negotiation and leadership skills will be maximized. Proficient in MGM, N-DAS, EmCare, EPIC, PCon, HBO Medical Pathway, MedAsset, Microsoft Office and all Medical Billing and Collection proprietary software and all script system and Athena One
Overview
20
20
years of professional experience
Work History
Medical Billing Collector
Medical Billing Collector Center For Internal Medicine
10.2024 - 01.2025
- Conduct timely and accurate follow up on unpaid insurance claims using insurance portals, secure email, secure chat, and phone calls
- Identify pending claims and determine next steps required to obtain reimbursement for claims.
- Use existing queries to review limited new denials for processing errors, appropriately assign a status based on review, correct any internal errors and resubmit claims as necessary.
- Follow up with insurance carriers, providers, or other stakeholders to gather additional information or documentation required for claims resolution.
- Monitor incoming messages from providers and respond to the provider or escalate the request to the appropriate team member.
- Identify claims with more complex issues and escalate them to the appropriate team member for resolution.
- All other duties as assigned.
- Communication:
- Communicate effectively with insurance companies, healthcare providers, and their billing staff to resolve claims issues and answer inquiries.
- Document all interactions and updates in the claims management system.
- Documentation and Reporting:
- Maintain accurate records of claim status, actions taken, and resolutions utilizing established policies and procedures.
- Prepare and submit reports on claim follow-up activities and status updates to management as requested.
Shopper
Instacart Shopper
06.2024 - 09.2024
- Buying grocery at different stores location through the chicago area
Reimbursement Specialist/Collector
Advocate Lutheran General Hospital / Spine Center
01.2023 - 06.2024
- Work retro authorization from all type insurance companies. Fax over Clinical notes Medical Records electronically to insurance companies.
- Work personal injury claims and worker's compensation claims with attorney insurance and patient and post payments also did fee schedules with Iwcc on website worker compensation.
- Follow with the payer insurance company regarding authorization and referrals.
A/R Medical Collections Specialist
Usa Vein Clinic
10.2021 - 12.2022
- Submitting Medical Claims to insurance company for payment
- Contracting insurance regarding claim status, and denials
- Outstanding payments, authorization explain benefits to patients
- Contact patient regarding outstanding co -payments and deductibles
- Submit appeals and medical records timely filing for denied claims and other documentations request to insurance company as needed
- Review EOB and payment check benefits through navinet mass health or any other websites prepare medical records if required.
- Perform high clerical duties including copying, faxing, and filing
- Takes parts in chat with email communication other guidelines related to the company.
- Demonstrates knowledge of services
- Professionalism and outstanding customer services.
- Handle multi-line language telephone calls on daily basic research resolved outstanding claim issus work with report management system
Reimbursement Specialist
Healthcare Information Service
11.2020 - 07.2021
- Specialist is to Analyze the billing process to determine appropriateness in payment responsible for handling all components of claims processing including coordination of disputed reject and delay claims and to review returned
- Resolve claim form edits from commercial medicare medicaid and w/c claims and other third party payers and problem solve
- Responsible for communication with all type of insurance coding processes to prevent future denials.
- Work with spreadsheet and top priority accounts on a daily basis.
Shopper
Instacart Shopper
06.2018 - 10.2020
- Buying grocery at different stores location through the city area there are local stores that the company has partnered with and delivering those item’s to the customer’s home.
- Also intercart partnered with binny’s stores as well for the customers.
A/R Representative Collector
Wolcott, Wood, & Taylor
01.2018 - 05.2018
- Resolve outstanding receivables with 3rd party payors or patients.
- Identifies denial trends and works to correct issues or errors.
- Works with a high volume of claims.
- Work off multiple ques to manage open A/R.
- Resolve claim form edits, rejected claims and patient or insurance correspondence.
- Exhibited superior organization skills to maintain high levels of productivity.
Financial Representative I
RUSH UNIVERSITY MEDICAL CENTER
06.2011 - 08.2017
- Manage Blue Cross/Blue Shield (BC/BS) accounts receivables to maximize reimbursements on outstanding, denied or disputed claims.
- Research thoroughly all documentation relevant to each case and analyze discrepancies.
- Prepare information for resolution.
- Contact BC/BS and negotiate due reimbursements.
- Monitor contractually agreed upon payments schedule.
- Create a permanent record of outcomes.
- Avoid lost payments through account management and fiscal analysis.
- Take ownership of special projects as assigned by senior management.
- Prepare volume, productivity and management reports.
- Establish collaborative working relationships with all internal departments.
Insurance Follow-up Representative
NORTH SHORE UNIVERSITY HEALTH CARE SYSTEM
03.2005 - 06.2011
- Prepared documentation regarding follow-up and collection activities and created files in the Patient Accounting System.
- Monitored and reported discrepancies, errors or denials.
- Contacted payee to resolve unpaid accounts.
- Keep records current to ensure outstanding payments submitted on time.
- Determine all data required, recorded and available.
- When necessary, resubmitted claims via Ecare System.
- Partnered with managers and other departments to complete tasks.
- Utilized Epic System to make records accessible for future reference.
- Advised senior management of problem accounts when intervention required.
- Verified patient information was current and updated when necessary.
- In cases of denied claims appeals, forwarded all information to the appropriate department.
- Ensured all Federal and State billing/collections regulations were in compliance.
Education
High School -
Woodfield High School
Greenwood, SCData Processing
WILBUR WRIGHT COLLEGE
Chicago, ILSkills
- Prioritize work
- Maximize reimbursements
- Effectively communicator
- Conflict resolution
- Staff training
- Research discrepancies
- Team leadership
- Close receivables
- Project management
Timeline
Medical Billing Collector
Medical Billing Collector Center For Internal Medicine
10.2024 - 01.2025
Shopper
Instacart Shopper
06.2024 - 09.2024
Reimbursement Specialist/Collector
Advocate Lutheran General Hospital / Spine Center
01.2023 - 06.2024
A/R Medical Collections Specialist
Usa Vein Clinic
10.2021 - 12.2022
Reimbursement Specialist
Healthcare Information Service
11.2020 - 07.2021
Shopper
Instacart Shopper
06.2018 - 10.2020
A/R Representative Collector
Wolcott, Wood, & Taylor
01.2018 - 05.2018
Financial Representative I
RUSH UNIVERSITY MEDICAL CENTER
06.2011 - 08.2017
Insurance Follow-up Representative
NORTH SHORE UNIVERSITY HEALTH CARE SYSTEM
03.2005 - 06.2011
Data Processing
WILBUR WRIGHT COLLEGE
High School -
Woodfield High School
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