Norman Lowe Email & Phone Number

Phoenix, Arizona, United States

 Run Reports & Research accounts to ensure outstanding balances are paid correctly & timely. Ensures that patient statements are sent with accurate information daily. Process accounts for external collections with HCI after we have exhausted all other internal collection options. Collect & post online payments, mailed in payments & over phone payments from patients. Process Patient & Insurance refunds when overpayments are found during weekly audits. Process bankruptcy request from Legal offices. Process Financial Hardship request’s either approving or denying these requests based off the Patient submitted paperwork alongside company criteria’s. Bill out 1500 & UB-04 Claims to Patient insurances in a timely matter; correcting any Red Claim Edits that may appear.

Phoenix, Arizona, United States

 Research and articulately communicate information regarding Veteran benefits, EDI services, claim status, and authorization inquiries to Providers in an inbound call center, while maintaining confidentiality. Resolve providers billing concerns; authorizations issues & provide general information about the program. Educate providers on how to submit claims to TriWest via mail or electronically; how to obtain authorizations from the VA; including ER & Urgent Care visits. Review CMS-1500 and UB-04 forms from provider alongside data in Facets when discrepancies arrive to determine if there was an error on TriWest/WPS or from the provider based on CMS/Medicare guidelines. I then educate the provider regarding their error or task the claim back to TriWest/WPS for review & correction when the error is not on the provider.

Phoenix, Arizona Area

 I Performed all accounts receivable functions on durable medical equipment; including qualification of appropriate documentation and billing to ensures compliance with all government, contract, and company policies and regulations. Checked eligibility and verification requirements Reviewed claims using basic understanding of insurance coverage and criteria to help determine appropriate steps to submit payable claims. Researched overdue accounts and followed up by mail and/or phone to insurance carriers or customers on delinquent payments. Run queries in excel. Created PivotTable’s to analyze worksheet data in Excel. Reviewed denied or unpaid claims to determine proper resolution. Resubmitted general claims with proper documentation for further carrier review on appeals. Responded to management inquiries regarding account status in a timely manner.

Phoenix, Arizona Area

 I managed Out-of-Network provider claim files & negotiated reimbursement payments on professional accounts. Checked eligibility and verification requirements. Reviewed claims using basic understanding of insurance coverage and criteria to help determine appropriate steps to submit payable claims. Researched overdue accounts and follows up by mail and/or phone to insurance carriers or customers on delinquent payments Run queries in excel. Created PivotTable’s to analyze worksheet data in Excel. Reviewed denied or unpaid claims to determine proper resolution. Resubmitted general claims with proper documentation for further carrier review on appeals. Investigated & resolved underpayments, pay out of order, payer to payer, insurance paid in error, recoupment request & other client specific issues. Responded to management inquiries regarding account status in a timely manner.

Scottsdale, Arizona

 I reviewed inpatient and outpatient accounts for claim denial and submitted clinical cases through Medhok; Work closely with clinical managers, staff and physicians to review denials to have the cases approved for re-adjudication or denied, sending the member a NOD letter with appeal rights. Checked eligibility and verification requirements. Reviewed claims using basic understanding of insurance coverage and criteria to help determine appropriate steps to submit payable claims. Processed Medicare Part D claims per CMS regulations using Medforce, alongside AS400 RxClaim systems. Run queries in excel. Created PivotTable’s to analyze worksheet data in Excel. Reviewed denied or unpaid claims to determine proper resolution. Investigated & resolved underpayments, pay out of order, payer to payer, insurance paid in error, recoupment request & other client specific issues. Responded to management inquiries regarding account status in a timely manner.

Real Estate, Property Management, Writing Contracts, Appraisals, Home Insurance.

Associate Of Arts And Sciences - Aas, Animation, Interactive Technology, Video Graphics And Special Effects

Certificate, Typing And Administrative Office Assistant, A

Trained in the following; Microsoft PowerPoint, Microsoft Word, Microsoft Excel, Microsoft Outlook, Windows O/S, Internet, Intermediate.

Diploma, General Studies