YONIKA FAGAN
Atlanta,GA
Summary
Motivated and dependable professional with years of expertise in a fast-paced environment utilizing excellent Client Relations and Service Satisfaction. Proficient in medical billing and accounts receivable, with a proven track record of success in compliance, office management, administrative duties and leadership. STRATEGIC AND CREATIVE THINKER with solid background in delivering decisive, action-driven leadership. Demonstrates expert insight and proficiency in teaching, coordinating, monitoring, evaluating and communicating with clients. RESULTS-ORIENTED PROFESSIONAL with proven capacity to manage and coordinate operations and administrative support, using initiative, resourcefulness and good judgment. PERFORMANCE-DRIVEN TEAM PLAYER with excellent interpersonal skills and attention to detail, optimally utilizing all channels of communication to assist operations.
Overview
13
13
years of professional experience
Work History
Medical Billing Accounts Receivables Specialist
Getix Health
02.2024 - Current
- Process and submit claims to insurance companies and government payers, ensuring timely and accurate billing for healthcare services.
- Manage accounts receivable by following up on unpaid claims, denials, and patient balances, reducing outstanding balances.
- Review and correct claim rejections or denials, preparing appeals when necessary to secure proper reimbursement.
- Accurately post payments and adjustments in billing software, maintaining precise account records for patients and insurance payers.
- Conduct thorough reviews of patient account ledgers to resolve discrepancies and ensure compliance with financial policies.
- Communicate effectively with insurance companies and patients to resolve billing inquiries and disputes in a timely manner.
- Maintain compliance with HIPAA regulations and payer guidelines while handling sensitive patient financial information.
- Generate detailed monthly aging reports to track overdue accounts and prioritize collections efforts.
- Collaborate with healthcare providers, coding teams, and insurance representatives to optimize billing procedures and streamline revenue cycle management.
Biller
IPA Pain Management LLC
09.2021 - 01.2024
- Reviewed clinical documentation and notes for accurate coding and entry into the billing system.
- Managed assigned projects from inception to completion.
- Conducted weekly reconciliations and submitted reports reflecting work completed and areas of opportunity. Submit recommendations towards process improvement in order to enhance overall efficiencies.
- Reviewed and updated charges accurately and quickly.
- Conducted weekly audits and collaborate with leadership regarding changes in workflow.
- Met/exceeded all key performance metrics as established by organization and maintained performance standards. Review insurance claims for correct ICD-10 and CPT codes.
- Processed short or non-payments for reconsideration.
- Assisted management team in developing solutions to improve quality of service.
- Identified trends of coding related denials and provided training to staff on proper code selection.
Medical Biller
Atlanta Medical Center
01.2016 - 01.2020
- Assists in developing/managing relationships with targeted hospitals and healthcare providers.
- Interacts with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
- Enters and updates client’s medical files and responsible for overall provider contract and amendment loading and processing using NDB and Pulse database systems.
- Responsible for maintaining documentation for all hospital/provider contracts and assisting with providing information for audits.
- Able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.
- Develops and negotiates contractual agreements with new health care providers and institutions within state and federal regulatory guidelines.
- Works with and provide support to Provider Data Specialists on contractual issues and to assure smooth and efficient operations.
Medical Billing Specialist
APS Billing
01.2013 - 01.2016
- Maintained the highest levels of accuracy and patient confidentiality, quickly identified and resolved medical billing, coding and insurance discrepancies.
- Worked hand in hand with front office staff to ensure that the proper information was received for claims processing.
- Reviewed patient bills for accuracy and completeness, and obtained any missing information.
- Responsible for cash management, supply ordering, and customer service relations.
- Followed the guidelines and be in compliance with local, state or federal laws and regulations.
- Reviewed accounts for possible assignment and made recommendations to the Billing Supervisor, also prepared information for the collection agency.
- Worked collections which included mailing of correspondence, working with patients to establish promissory notes for payment and if necessary forwarded accounts to collection agency.
- Oversaw and ran necessary reports to ensure that all statuses were worked in a timely manner and helped in any capacity necessary.
- Maintained and updated all files including insurance companies, diagnosis, procedure, fees/profiles.
- OTHER POSITIONS HELD:
- MARTA/LEGAL ADMINISTRATIVE ASSISTANT/2008-2012
- ADAMS DATA MANAGEMENT/DATA ENTRY OPERATOR/2006-2008
Education
Businsss Administration -
Atlanta Technical College
Atlanta, GA06.2019
Skills
- Microsoft Office
- Organizational Skills
- Teamwork & Collaboration
- Medical Billing
- Quality Control & Assurance
- Written/Verbal Communication Skills
- Administrative Support
- Invoice processing
- Payment tracking
- ERP systems
- Accounts receivable management
- Claims processing
- Accounts receivable
- Dispute resolution
- Microsoft Excel
- Collections
- Payment posting
- Codes reviewing
Timeline
Medical Billing Accounts Receivables Specialist
Getix Health
02.2024 - Current
Biller
IPA Pain Management LLC
09.2021 - 01.2024
Medical Biller
Atlanta Medical Center
01.2016 - 01.2020
Medical Billing Specialist
APS Billing
01.2013 - 01.2016
Businsss Administration -
Atlanta Technical College