Accurately process daily EDI Enrollments, all vendor loading and D471 / D3 forms in an accurate and efficient manner, while researching information for accurate processing of provider data. Process W-9 forms and D471 edits, handle change-gear requests from contracting specialists, monitor and process vendor dictionary cleanup reports and ensure smooth business practices by maintaining fluid communication. Resolve returned check issues in a timely manner. process vendor entries from the… Show more Accurately process daily EDI Enrollments, all vendor loading and D471 / D3 forms in an accurate and efficient manner, while researching information for accurate processing of provider data. Process W-9 forms and D471 edits, handle change-gear requests from contracting specialists, monitor and process vendor dictionary cleanup reports and ensure smooth business practices by maintaining fluid communication. Resolve returned check issues in a timely manner. process vendor entries from the Claims Department in dictionary 471, resolve vendor payment discrepancies from the Finance Department, load PCP’s in D3 and request PCP’s preparation for capitation. Show less

Developed and implemented training to individuals with developmental disabilities in the areas of self-care, communication, self-direction, independent living, mobility and learning in accordance with the Individual Service Plan (ISP), to enhance individual skill development, health, freedom and personal dignity. Provided assistance with all activities of daily living, including bathing, grooming and dressing, monitoring client appearance to ensure each was appropriately presentable, while… Show more Developed and implemented training to individuals with developmental disabilities in the areas of self-care, communication, self-direction, independent living, mobility and learning in accordance with the Individual Service Plan (ISP), to enhance individual skill development, health, freedom and personal dignity. Provided assistance with all activities of daily living, including bathing, grooming and dressing, monitoring client appearance to ensure each was appropriately presentable, while supervising individuals during meals by serving family style and eating with residents.Assisted individuals during in-house activities by conducting therapeutic activities, such as physical exercises, occupational arts and crafts and recreational games.Trained and supported individuals in daily tasks, such as cleaning of living areas, personal laundry responsibilities, meal preparation and community outings. Reported the development of individuals by observing and documenting individual health care issues, consistently providing senior medical personnel with all pertinent information needed to assess care plans.Attended Certified Habilitation Aide classes upon employment and met training requirements in accordance with current applicable Federal, State and local standards. Show less

Managed pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services.Contacted physicians to resolve issues regarding prior authorization and referral forms, researched patient visit history to ensure compliance with Medicare and completed the Medicare secondary payer questionnaires.SARA CARDEN PAGE 2Performed consistent patient follow-up procedures in a timely and courteous manner to… Show more Managed pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services.Contacted physicians to resolve issues regarding prior authorization and referral forms, researched patient visit history to ensure compliance with Medicare and completed the Medicare secondary payer questionnaires.SARA CARDEN PAGE 2Performed consistent patient follow-up procedures in a timely and courteous manner to confirm and obtain missing demographic information in vision IDX, while quoting/collecting patient payments and instructing patients concerning where to present at time of appointment. Performed electronic eligibility confirmation, utilizing HDX, worked closely with facility departments and internal departments of the CBO to investigate and resolve issues associated with patient and insurance company inquiries and acted as a competent and professional liaison between patients, employees and senior management Show less

BillingPosted payments, adjust write-offs and charge corrections, wrote appeals for claim processes and secured patient payment arrangements.Called for pre-authorizations, verified insurance coverage and updated all information in accordance with company policies and procedures.

Called insurance agencies concerning pre-authorizations and pre-certifications, while providing outstanding customer service and entering all pertinent data into the facility’s computerized system.Recorded and logged home health referrals and called to obtain approval and the number of visits approved for services, while acting as a competent and professional patient accounts representative, answering billing and insurance questions as the initial liaison with the public via phone and in… Show more Called insurance agencies concerning pre-authorizations and pre-certifications, while providing outstanding customer service and entering all pertinent data into the facility’s computerized system.Recorded and logged home health referrals and called to obtain approval and the number of visits approved for services, while acting as a competent and professional patient accounts representative, answering billing and insurance questions as the initial liaison with the public via phone and in person. Show less

Posted denials and rejects into the billing system and produced written responses and conducted personal contacts to patients to identify charges.Filed claims and appeal letters, while interpreting diagnosis and procedural codes administered by physicians.

Ensured the efficient running of all office functions, including the handling of payroll, phones, A/R, A/P, collections and general accounting procedures. Cared for all issues and disputes arising among employees and ordered supplies the company needed in order to perform its daily operations. Maintained vendor relationships and provided important information to all pertinent employees to ensure smooth business operations.