Amara Smith Email & Phone Number

United States

• Proactively following-up on outstanding physician claims in accordance with the medical system current standards (between 50 to 75 accounts daily). Identifying issues and trends that result in non-payment of claim due to internal/external review, elevating significant issues to the Team Lead. A/R Follow-up on unpaid claims for PSA (Provider Service Agreement) contracts with specialties including Gastroenterology, Plastic Surgery and Pulmonary. Collaborative efforts with the Coding and Auditing team to resolve coding and claims issues resulting in an increase in revenue and efficiency. Apply proficiency in extracting medical data and critical thinking to rectify unpaid claims and make necessary corrections to re-bill and/or appeal.

• Apply proficiency in extracting medical data and critical thinking to rectify unpaid claims and make necessary corrections to re-bill and/or appeal. Establish and present system and claims issues to department heads and software implementation staff to bring understanding to new clinical billing problems and form lasting resolutions. A/R Follow-up on unpaid claims first in Family Med/Internal Med, secondly OB/Gyn and Perinatology, and currently Oncology and Imaging departments after promotion. Exceeds quality and production standards. Increased revenue capabilities by identifying current and possible claims issues specific to each payer

• Responsible for overall operations and administration of medical office with 10-15 employees. Reviewed and oversaw financial analysis, activity reports, and other performance data to measure results and goal achievement. Hired, terminated, trained staff, assessed employee performance, and delegated responsibilities. Supervised receptionists, medical assistants, medical billers, and coders. Performed variety of administrative tasks such as schedules, staff meetings, payroll, and Human Resources policies and procedures. Ordered all clinic supplies and kept check on inventory levels• Reviewed 50-75 medical records per day to select appropriate coding sequences. Researched and compiled statistical data to support cost control and care improvement initiatives. Guarded against fraud and abuse by verifying all coded data accurately reflected services provided. Interacted with physicians and other healthcare staff to ask questions regarding patient services.• Oversaw billing operations for 3 urgent care clinics. Supervised and guided new billing staff on clinical guidelines and procedures and responded quickly to questions, which improved understanding of job responsibilities. Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping. Implemented best practice standards for billing resulting in substantial reduction of accounts receivable delays. Established efficient workflow processes. Monitored daily productivity and implemented modifications to improve overall effectiveness of personnel. Finalized contracts for providers in Medicare and private insurance plans. Also completed ERA/EFT enrollments during system transitions.