Billing Supervisor and Auth Coordinator for Cardiology Specialty Group

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Home health

Examine claims for appeals and resolutions, PDR's and Claims analysis, some auditing of professional and hospital claims.

Hospital Collections for various hospital clients.

Medical Collections, on Hospital claims, appeals and adjustments, follow-up with insurance companies on unpaid hospital and professional claims

Medical Collections on all Peace Health Hospitals Oregon, Washington, and Alaska

Medical Billing and Collections Consultant.............Collect on unpaid and underpaid hospital claims for all KPC Hospitals.

Reimbursement Analyst for Medicare and Commercial Insurance claims

Claims auditing, customer service.

Create Appeals for Medicare Part D

Insurance collections and Self-pay collections on unpaid accounts. Follow-up calls to insurance and patients, appeals and customer service. Revenue Cycle, Claims Processing of UB and Professional claims.

Entering Professional claims into Rain tree/ Flexcare through EDI system. Credentialing new and current providers in the behavioral health network. Update patient and doctors information through EDI. Claims Consultant. Claims customer service. Verify claim status for providers for processing payments and denial of claims.

Recovery on Hospital Revenue, Management, Appeals,Insurance follow/up. Accurate documentation for all claims paperwork; and system entry, and other forms. Evaluated all benefits; eligibility; and ratings details. Maintained correspondence with all insurance companies.Able to identify, and resolve patient billing and payment issues. Oversaw, and Managed all claim denials and client appeals. Maintained and updated all patient and client information.Maintained and operated all company confidentiality procedures.

Recovery on Hospital Revenue, Management, Appeals,Insurance follow/up. Accurate documentation for all claims paperwork; and system entry, and other forms. Evaluated all benefits; eligibility; and ratings details. Maintained correspondence with all insurance companies. Able to identify, and resolve patient billing and payment issues. Oversaw,and Managed all claim denials and client appeals. Maintained and updated all patient and client information.Maintained and operated all company confidentiality procedures. Knowledge of Oncology, and Urology, and Surgical Billing and Collections Procedures. Experience with 835 payments. Knowledge of EOB's and Contracts.

Managed medical billing, collections, and revenue cycle for Tenet Healthcare facilities account. Reviewed billing and denial data to identify areas of opportunity; developed and implemented corrective actions, and resolved coding and payment errors. Maintained data integrity; updated patient information in database. Recovered $1 billion in 10 years; Increased revenue by 67%, decreased bad debt by 43%, while reducing operating costs by 37%. Contributed to reduction in workflow from 30 to two days by consolidating and automating processes. Leveraged web-based applications, including IDX and Automated Collection Environment (ACE) systems to automate billing, collections, and revenue cycle process flow; improved tracking and turnaround time. Cultivated relationships with insurance companies, including Aetna, Blue Cross/Blue Shield, Health Net, Medi-Cal, and Medicare to address and resolve unpaid and bad debt medical claims. Developed concept, gained senior management buy-in, and implemented a system to combine account and contract data in a web-based environment, which enabled access to contract terms and conditions, historical transactions, and outstanding issues. Negotiated annual contracts with clients; established terms, conditions, and fee structures.

Store all US weapons and gave classes on basic, immediate, and advance marksmanship. Drove heavy-wheeled vehicles. Performed various military duties.State Color and Honor Guard. Assisted Commander with training schedules.

Maintained and coordinated all medical records. Coordinated and conducted chart audits to maintain accuracy and patient confidentiality. Liaison resource person in the front and back office.Insurance verification. Worked with management in maintaining and storing medical records and complete chart audits. Experience in electronic and hard copy of medical records. Knowledge of all HIPPA and Patient confidentiality

Conducted medical billing and collections for workers' compensation, personal injury, and sports medicine claims. Assisted in maintaing various front office duties.Charting and maintaining medical records.