Haven Ramirez Email & Phone Number

o Builds repour with new clients as assigned.o Examines denied and underpaid claims to determine reasons for discrepancies from expected reimbursement.o Worked claims by payer with specific reasons for suspected underpayments and analyzes the given denial reasonso Works with management to identify trends and address root cause of denialso Helps pinpoint strategies for reducing A/Ro Effectively handles all communications, including telephone, electronic, and paper correspondence from payers and departments within the business officeo Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and teammates along with tracking progresso Maintains a thorough understanding of federal and state regulations, as well as specific payer requirements and explanations of benefits, to identify and report billing compliances issues and payer discrepancieso Reports all identified compliance risks to appropriate leadershipo Other duties and responsibilities as assigned.o Worked payers for Medicaid and Medicare.

Temple, Texas, United States

o Creates and submits claims, via electronic or by mail, customer service and receivables for the assigned department.o Ensures accurate, compliant & timely submission of insurance claims and resolution of incoming phone inquiries to provide accurate and efficient reimbursement. o Review claim and account data and makes applicable corrections to ensure claims meet all payer specific compliance guidelines and accounts are accurate.o Reviews record documentation, on-line notes and/or seeks input from other departments & physicians to secure appropriate data in a timely manner.o Applies appropriate adjustments following Scott & White policy & procedures. o Accurately rebills claims with applicable corrections in a timely manner.o Provides additional information or documentation as requested.o Correctly verifies insurance eligibility through carrier and/or patient contact.o Investigates discrepancies between various systems as needed. And updates as required/needed.o Follows internal procedures for timely claims submissions with payer specific deadlines.o Use of GE Centricity, Ivans for Medicare, TMHP for Medicaid, Sequoia, Papers, ePremis, Invision, Web Queries, EPIC, eFR, DataArk, & HealthLogic.o Worked payers Medicaid, Medicare, Indigents, State and Local, and VA.

Cosmetology, Barber/Styling, And Nail Instructor

Diploma Of Education, General Studies