Yolanda Givens
La Plata,MD
Summary
Focused patient care professional accustomed to prioritizing and delivering basic patient care. Offers over twenty years of experience in the medical field.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Patient Care Technician
Charles Regional Medical Center
02.2024 - Current
- Monitored vital signs and reported changes to nursing staff, ensuring timely medical interventions when necessary.
- Assisted nurses with essential tasks, streamlining workflow and increasing efficiency in the healthcare setting.
- Enhanced patient satisfaction by providing compassionate and attentive care.
- Assisted in training new Patient Care Technicians, sharing knowledge and best practices to ensure consistency in care delivery.
- Performed EKGs, accurately and efficiently for prompt analysis by healthcare professionals.
- Maintained clean and safe environment to promote patient safety and comfort.
- Contributed to a positive patient experience by keeping rooms clean, organized, and well-stocked with supplies.
- Assisted in transferring patients, beds and patient care equipment to other rooms adhering to necessary safety precautions.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
Accounts Receivables Specialist (Remote)
Capitol Area Health Network
12.2021 - Current
- Follow up of outstanding A/R for all payers and/or including Self-Pay and/or including resolution of denials as it relates to the clearinghouse
- Responsible for handling all correspondence related to insurances, contacting insurance carriers, other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability
- Responsible for working EDI transactions and ERA files, including reconciling carrier submissions, edits, and rejection reports
- Ability to research and resolve accounts appearing on Aging Insurance Report directed by management
- Making appropriate decisions on accounts to be worked to maximize reimbursement
- Meet productivity standards as outlined in client metrics
- Identify any issues or trends and bring them to the attention of management
- Work on special projects as assigned
- Other duties as assigned
Billing Manager (Remote)
Capitol Area Health Network
07.2022 - 05.2024
- Managed a team of dedicated medical billers, medical coders, payment posters, accounts receivable representatives, patient account collections specialist focusing on professional development opportunities and maintaining a positive work environment conducive to high levels of productivity.
- Maintain current knowledge of compliance regulations for reimbursement and claims processing
- Analyzed reports to identify areas for improvement in the overall billing process, leading to increased revenue collection rates.
- Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
- Streamlined claim appeals process by creating clear documentation guidelines and templates for staff use.
- Optimized cash flow by regularly reviewing aging account balances and implementing tactics for timely collections from patients or insurers.
- Oversee and streamline billing and collections processes
- Plan and implement quality assurance for all processes
- Prepare and deliver effective presentation to senior management/board of directors as needed
- Lead discussions with payer (public and private) to reach positive coverage decisions
- Work to overcome reimbursement barriers, identifying payer trends, and design strategies to address challenges of reimbursement across payers, indications, and settings
- Create and manage all processes connected to the review and processing of all electronic reports to enable the successful completion of the billing process
- Collections and follow-up on denials from insurance companies as well as patients
- Report trends and make suggestions regarding payer issues to ensure proper reimbursement
- Complete monthly reports for government payers as required
- (Medicare quarterly reports/Medicaid reports)
- Develop and utilize computer reports and output
- Complete quality review audits to ensure organization is in compliance with billing/coding guidelines
- Training of employees to ensure that they are up to date on current billing/coding accounts receivable mandates and policies
- Conduct routine staff meetings regarding billing planning and implementations
- Assist in standardizing the methods in which work will be accomplished
- Assist in preparing financial and statistical reports as directed (month end reports)
- Conducted performance reviews and implemented improvement plans.
- Supported Director of Billing with special projects and additional job duties.
- Developed policies and procedures for the medical billing department, establishing a strong foundation that supported growth and operational success within the organization.
- Collaborated with cross-functional teams to resolve billing-related issues swiftly, minimizing negative impacts on overall operations.
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Maintained up-to-date knowledge of industry regulations and compliance requirements, ensuring the department remained compliant at all times.
- Improved medical billing processes by streamlining workflows and implementing efficient systems.
- Enhanced revenue cycle management by overseeing timely and accurate claims submission.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
- Monitored compliance with industry regulations to mitigate risks associated with audits and penalties.
- Collaborated with providers and staff to ensure accurate coding for billing purposes.
- Trained team members on best practices in medical billing, ensuring consistent high-quality work across the department.
Certified Ambulance Coder
All American Ambulance And Transport
11.2019 - 12.2021
- Entered charges for non-emergency and emergency transports through TraumaSoft
- Worked with third party payers, Medicare, Medicaid and Commercial payers
- Assisted customers with billing inquiries
- Assisted insurance companies with pertinent information for claim processing and payment
- Communicated with sending facilities when additional information was required for billing purposes
- Worked rejections through Waystar Clearinghouse
- Assisted call takers and other staff with pertinent information when required
- Assisted the Billing Manager with various projects
Accounts Receivables Specialist
Community Of Hope
12.2017 - 04.2019
- Charge entry
- Payment posting
- Worked 55-60 claims daily
- Worked with third party payers, Medicare, Medicaid and Commercial payers
- Complete and worked monthly A/R reports
- Processed billing for medical, dental and mental health patients
- Assisted insurance companies with pertinent information for claim processing and payment
- Worked rejections through Change Healthcare Clearinghouse
- Worked with Practice Managers and front desk personnel with billing inquiries when needed
- Worked and completed birth logs and reports
- Worked projects when required by the department
- Worked with Medicaid Contacts to complete monthly suspend reports
Billing Specialist
Greater Baden Medical Service
07.2015 - 06.2017
- Inputted CPT and ICD-10 codes for billing in CPS12 (GE)
- A/R follow-up
- Worked collections for Medicare patients and commercial payors
- Assisted patient with billing questions
- Completed missing data reports
- Payment posting
- Worked with front desk personnel at the sites to assist them with any billing questions
- Assisted patients with Ryan White insurance
- Assisted patients with Sliding fee scales (low-income families)
- Worked with third party payers, self-pay, Medicare, Medicaid products, Commercial payers
- Assisted Supervisor with projects when needed
Billing Representative/Assistant Office Manager
Pullman & Ariza Pediatrics
05.2012 - 02.2015
- Inputted CPT and ICD-9 codes for billing in Nextgen
- Verified demographic and insurance information
- Assisted billing company with inquiries
- Contacted parents for past due balances
- Completed missing data reports
- Assisted patients with billing questions
- Assisted insurance companies with pertinent information for claim processing and payment
- Assisted front desk when required
- Collecting co-pays and self-pay monies
- Completed referrals when required
- Answered incoming calls from hospitals with newborn information
- Scheduled appointments
- Completed daily payment log from front desk
- Completed bank deposits
- Sorted and distributed mail
- Ordered supplies
- Assisted doctors with payroll using ADP system
- Completed CADQ for providers
- Completed all aspects of Re-credentialing for doctors
- Managed front desk staff of four
Billing Representative
United Radiology
10.2010 - 05.2012
- Verified insurance and authorizations for Pet Scans, CT scans, sonograms and other state-of-the-art tests
- Assisted patients with billing questions
- Processed HCFA claims and other documents according to HIPPA compliance
- Corrected CPT codes and ICD-9 Codes for resubmission to insurance companies
- Completed and worked monthly A/R reports
- Processed billing for Radiology and Cardiology patients
- Inputted patient demographic information into Medics system
- Assisted insurance companies with pertinent information for claim processing and payment
- Worked edits for claim submission using RealMed EDI System
Hospital Associate
Pediatrix Medical Group
06.2008 - 10.2010
- Inputted patient demographic information into OBR system
- Inputted and updated insurance information into OBR System
- Processed HFCA claims and other documents according to HIPPA compliance
- Corrected CPT codes and Diagnostic Codes for re-submission to insurance companies
- Contacted parents for pertinent information for billing purposes only
- Reviewed and completed monthly census for Newborn Nursery and NICU
- Completed billing for Shady Grove Adventist Hospital and Washington Adventist Hospital
- Reviewed and worked weekly reports
- Obtained authorizations and pre-certifications for labor and delivery, NICU babies when required
Billing Representative/Financial Counselor
Columbia Fertility Associates
05.2006 - 06.2008
- Processed HFCA claims and other documents according to HIPPA compliance
- Worked and transmitted EDI reports (WedMD)
- Worked with third-party payers to collect on outstanding claims
- Inputted and updated insurance information into Intergy System
- Added pertinent information to Intergy System for “pop-up” message during patient registration including but not limited to pre-authorization and referral requirement
- Created A/R Follow Up Daily Workflow Sheet (completed daily)
- Corrected CPT codes and Diagnostic Codes for re-submission to insurance companies
- Created reports and other documents using Excel and Microsoft Word
- Answered incoming calls in billing queue about bills and EOB's
- Posted payments from insurance companies and patients
- Obtained authorization for surgeries, MRI, CT Scan, HSG
- Verified insurance including deductibles, coinsurance, copays
- Counseled patients on cost of IVF (In Vitro Fertilization, IUI's (Intra Uterine Insemination) and other forms of treatments; collected all self-pay monies
Education
Associate of Applied Science - Nursing
College of Southern Maryland
La Plata, MDCertified Nursing Assistant Program
The Nursing Academy
12.2023
Diploma -
Wheaton High School
06.1999
Skills
- Medical billing and coding
- Ambulance billing and coding
- A/R follow up
- Insurance Knowledge
- Claim denial and resolution
- Excellent customer service and communication skills
- Payroll
- Microsoft Office
- Management experience
- Electronic Medical Records
- Collections Experience
- Team Direction
- Audit Support
- Training and Mentoring
- Process Improvements
- Payment Posting
- Team Leadership
- Claims Processing
- Account Reconciliation
- Accounts Receivable Management
- Time Management
- Denial Management
- Insurance Verification
- Revenue Cycle Management
- Problem Solving
- Interpersonal Communication
- Interviewing
- Basic Life Support
- Critical thinking
- Vital Signs
- Medical Terminology
- CPR Certification
- Caregiver Relations
- Administering Medications
- Vital signs monitoring
- Patient Observation
- Blood Glucose Testing
- Infection control standards
- Catheter Care
- ADL support
- Feeding Assistance
- Professional Bedside Manner
- Data Collection
- Mobility Assistance
- Information Protection
- Infection prevention
- Medical Equipment Operation
- Hospice and palliative care
- HIPAA Compliance
- Patient-focused care
- Certified in CPR/AED
- Medical terminology knowledge
- Electronic Charting
- Responding to emergencies
- Collecting vital signs
- Transporting patients
- Oral Hygiene
Certification
- CNA - Certified Nurse Assistant (Maryland Board of Nursing MBON) License No. CNA20240047
- Basic Life Support (American Heart Association) Expires 12/2025
Timeline
Patient Care Technician
Charles Regional Medical Center
02.2024 - Current
Billing Manager (Remote)
Capitol Area Health Network
07.2022 - 05.2024
Accounts Receivables Specialist (Remote)
Capitol Area Health Network
12.2021 - Current
Certified Ambulance Coder
All American Ambulance And Transport
11.2019 - 12.2021
Accounts Receivables Specialist
Community Of Hope
12.2017 - 04.2019
Billing Specialist
Greater Baden Medical Service
07.2015 - 06.2017
Billing Representative/Assistant Office Manager
Pullman & Ariza Pediatrics
05.2012 - 02.2015
Billing Representative
United Radiology
10.2010 - 05.2012
Hospital Associate
Pediatrix Medical Group
06.2008 - 10.2010
Billing Representative/Financial Counselor
Columbia Fertility Associates
05.2006 - 06.2008
Associate of Applied Science - Nursing
College of Southern Maryland
Certified Nursing Assistant Program
The Nursing Academy
Diploma -
Wheaton High School
- CNA - Certified Nurse Assistant (Maryland Board of Nursing MBON) License No. CNA20240047
- Basic Life Support (American Heart Association) Expires 12/2025
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