• Primary contact/biller for all Medicare, Private Insurance and Specialty billing• Run reports to submit check requests for all GIP and Respite patients within facilities• Contact insurance companies regarding claims denials and appeals• Work high dollar A/R aging accounts, claim accept/reject reports• Run daily deposits for incoming payments and post to all company accounts• Pull report for all weekly A/P payments and prepare checks due to outside vendors• Help train other departments in verification policies/procedures for Medicare• Assist in interviews for college interns and potential employment candidates• Obtain initial prior authorizations, as well as maintain, for required Hospice services• Assist in maintaining the daily Census to include entering Medicare Notice of Elections

In my current role I do payment posting. This includes adjustments, discounts, prorates, prompt pay discounts, internal assistance write offs, etc. Previously my tasks included;•Verify insurance eligibility and audit patient registrations prior to billing•Correct any claims billing errors and resubmit or appeal•View claim rejection reports on Revenue Manager EDI system•Data entry to include updating patient demographics, identify/verify insurance eligibility•Contact insurance companies regarding claims denials and appeals•Work high dollar A/R accounts, claim accept/reject reports, Medicaid and CICP•Claims processing on UB/HCFA to primary/secondary insurance, daily correspondence•Validate physician privileges/orders, authorizations, and medical necessity.•Enter charges and diagnosis codes based on physician visits•Post payments to accounts to include adjustments•Help put new policies in place for several processes within the company•Train co-workers, supervisors/managers in processes of obtaining required information•Assist in interviews for potential employment candidates

•Work with United Healthcare to input notification/preauthorization numbers for radiology procedures requested by Medical Doctors Offices. •Maintain awareness of variations within insurance plan options and physician status as it pertains to services needed by the client.•Take requests for care management from physician offices or imaging centers.•Collect information within a focused screening process that does not require clinical review.•Ensure patient and physician information is correct before building case. •Build more than 85 cases per day by telephone or fax and audit cases for review.•Monitor other representatives to ensure their performance is within Company guidelines and redirect activities if necessary. •Train on average 35 new representatives yearly to ensure high quality of customer satisfaction and compliance with company standards and policy.

•Monitor front office; schedule appointments and bill for procedures performed.•Verify patient insurance, coverage, eligibility and consult with patients prior to surgical procedures. •Assist during an average of 15 surgical procedures & consultations per day.•Sterilize equipment, hand instruments/supplies to surgeon during procedure and monitor patient during/after surgery.

•Work with travel agents making travel arrangements for clients. •Input upgrades or downgrades in reservation based on the needs of the clients. •Assist in arranging air travel or package offers for clients.

•Plan and supervise teen social events, field trips and activities that appeal to 11-16 year old clientele.•Monitor teens after school; assist with home work and encourage participation in planned events.•Supervise groups with a ratio of 15 teens to 1 adult, during summer programs.

•Assist 50 to 60 companies and/or employees daily with building insurance claims.•Input general, auto and workers compensation insurance claims from companies.•Verify status of accounts and deadlines regarding required documents, sign up or withdrawal from policies