Sylvia Houston Email and Phone Number
Harlingen, TX, US
Sylvia Houston's Location
Harlingen, Texas, United States, United States
Sylvia Houston's Contact Details
Sylvia Houston work email
- Valid
- Valid
- Valid
Sylvia Houston personal email
n/a
About Sylvia Houston
Experienced Reimbursement Analyst with a demonstrated history of working in the hospital & health care industry. Skilled in Educational Assessment, Microsoft Word, Contact Centers, Healthcare, and Debt Collection. Strong finance professional with a High School focused in General Studies, Business Classes from Sylmar High School.
Sylvia Houston's Current Company Details
Noridian Healthcare Solutions, Llc
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Reimbursement Specialist I
Harlingen, TX, US
- Website:
- bcbsnd.com
- Employees:
- 328
Sylvia Houston Work Experience Details
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Reimbursement Specialist INoridian Healthcare Solutions, LlcHarlingen, Tx, Us
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Reimbursement Specialist INoridian Healthcare Solutions, Llc Apr 2024 - PresentUnited States -
Reimbursement SpecialistHbcs Mar 2022 - May 2024United States• Able to identify and report trends in carrier payments.• Verify coverage through various provider portals, update COB if needed.• Responsible for follow-up with payers and other third party payers for ensuring timely claims submission through various clearinghouses• Proficient in comprehending and applying payer contract conditions and reimbursement methodology.• Able to resolve accounts including, but not limited to, secondary billing, reconsideration and formal appeals process, patient liability.• Complete knowledge of healthcare revenue cycle, claims processing including, collecting, medical terminology: ICD-10, CPT and HCPC Codes, DRG, as well as UB-04 and 1500 claim forms.• The ability to analyze and resolve problems, as well as the ability to identify payer reimbursement discrepancies and understand EOB denial codes, including but limited to: co18, co47, co22, co97, coding issues, billing errors, missing information, mismatch.• The ability to update multiple systems while interacting with third parties including live chat through provider portals.• Able to assist in patient or customer service with self-pay accounts• And the ability to self-manage in a remote work environment meeting productivity expectations. -
Reimbursement SpecialistPrime Healthcare Foundation -Hbsi Jan 2019 - Mar 2022Harlingen, TexasPromoted:• Responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Also, but not limited to experience with payers, Anthem BlueCross/BlueShield, Commercial Aetna, Humana, United Healthcare, Cigna, Kaiser, HMO, PPO, POS, Dual Plans, Affordable Care Act/Marketplace Plans, VA, TRICARE, Workers’ Compensation, Traditional MCD Ancillary, Oscar, CareSource, Medicaid Plans: Molina, AetnaBetter Health, AARP, Christian Ministries, Self Pay account resolution. • Utilize many complex and varying regulations, guidelines and systems- including Meditech and EPIC to analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables per our contracts or expected reimbursements in place non-par providers.• Proactively work with payers and in-house resources, such as billing & coding to identify and resolve issues that hinder optimal and correct account payment. • Utilize and apply the appropriate regulations in order to assure compliance in payment practices• Submit reconsiderations and appeal meeting timely filing deadlines.• Perform other related duties as assigned.
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Reimbursement AnalystPrime Healthcare Oct 2017 - Mar 2022Harlingen, TexasPrime HealthCare, HBSI., Harlingen, TexasReimbursement Analyst• Responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Also, but not limited to experience with payers, Anthem BlueCross/BlueShield, Commercial Aetna, Humana, United Healthcare, Cigna, Kaiser, HMO, PPO, POS, Dual Plans, Affordable Care Act/Marketplace Plans, VA, TRICARE, Workers’ Compensation, Traditional MCD Ancillary, Oscar, CareSource, Medicaid Plans: Molina, AetnaBetter Health, AARP, Christian Ministries, Self Pay account resolution. • Utilize many complex and varying regulations, guidelines and systems- including Meditech and EPIC to analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables per our contracts or expected reimbursements in place non-par providers.• Proactively work with payers and in-house resources, such as billing & coding to identify and resolve issues that hinder optimal and correct account payment. • Utilize and apply the appropriate regulations in order to assure compliance in payment practices• Submit reconsiderations and appeal meeting timely filing deadlines.• Perform other related duties as assigned.
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Talent Acquisition CoordinatorQualfon/Center Partners May 2016 - Oct 2017Harlingen, Texas• Assisted in the ramp up for multiple BPO projects by playing a lead role in recruitment and onboarding.• Assisted with the implementation of HR processes and procedures.• Worked with all levels of management including Trainers, Supervisors, Managers, Site Managers and Site Directors to effectively meet business needs.• Continually grew pipeline through online job postings, online targeted email and call campaigns.• Responsible for main recruiting excel workbook and daily recruiting reports.• Recruited candidates for entry level positions by marketing openings, sourcing, prescreening resumes, administering assessments, conducting prescreen interviews, scheduling interviews for hiring managers, conducting background checks, onboarding through Taleo and making offers to prospects.
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Accounts Transaction CoordinatorHni Healthcare Mar 2015 - Jan 2016Harlingen, Tx• Responsible for posting cash and credit card payments for all payers including government, Medicare/Medicaid, Commercial Accounts.• Ability to post payments electronically and via lock box• Sorting correspondence such as EOB’s, letters and denials • Entering the denials into the system• Researching payment information on payer websites• Forwarding correspondence to billing groups -
Administrative Assistant/Credentialing Coordinator AssistantManpowergroup/Hni Healthcare, Inc. Oct 2014 - Mar 2015Harlingen, Texas• Assisted in coordinating, monitoring, and maintaining the credentialing and re-credentialing process of doctors.• Assisted in facilitation all aspects of credentialing, including initial appointment, reappointment, expirables process which included but no limited to, DEA, DPS, Medical Licenses’ as well as clinical privileging for Medical Staff, Allied Health Professionals, and all other providers outlined in the Health System Entity Medical Staff Bylaws, policies, or related contracts.• Assisted in compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. • While working under the supervision of the Credentialing Manager, responsible for accuracy and integrity of the credentialing database system and related applications.
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Patient Access Representative IiValley Baptist Health System Apr 2012 - Aug 2014Harlingen, Texas• Obtained patient signatures when necessary• Performs billing and bookkeeping functions, including collection of copays/coins and providing receipts, posting and balancing daily sheets and day end reconciliation to assure accuracy• Prepare daily deposits when necessary• Updates insurance information, patients demographic, when appropriate and verifies eligibility and release insurance for payment to hospital.• Verify enrollment of HMO, PPO, HSA, POS, HDHP, and co-pays, coinsurance, deductibles.• Prepares and maintains medical records as necessary.• Obtains Consent for Medical Treatment and Release of Medical Records Information.• Provides each patient with a copy of the Privacy Notice and obtains patient’s signatures, confirming receipt, and maintains the original in the Medical Record, which includes providing each patient with a copy of the Patient Bill of Rights and patient signature to confirm receipt.• Work in an organized, efficient manner so as to keep a smooth and orderly flow of patient moving in and out the medical office. -
Human Resources GeneralistAdvance Call Center Technologies, Inc. Jan 2010 - Feb 2012Harlingen, Texas• Identified staff vacancies and recruited, interviewed and selected applicants• Employment and compliance to regulatory concerns and reporting• Handled under-staffing, disputes, terminating employees and administrating disciplinary procedures• Served as a link between management and employees by handling questions, interpreting and administering contracts and helping resolve work-related problems.• Responsible for updating spreadsheets on an hourly basis.
Sylvia Houston Skills
Customer Service
Type 55 Wpm
10 Key
Debt Collection
Cash Posting
Fax
Microsoft Word
Electronic Payment Processing
Call Centers
Microsoft Excel
Healthcare
Human Resources
Teamwork
Windows
Recruiting
Job Fairs
Onboarding
Screening Resumes
Interviewing
Applicant Tracking Systems
Talent Pipelining
Networking
Accounts Payable And Receivable
Volunteering
Educational Assessment
Sylvia Houston Education Details
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Sylmar High SchoolGeneral Studies, Business Classes
Frequently Asked Questions about Sylvia Houston
What company does Sylvia Houston work for?
Sylvia Houston works for Noridian Healthcare Solutions, Llc
What is Sylvia Houston's role at the current company?
Sylvia Houston's current role is Reimbursement Specialist I.
What is Sylvia Houston's email address?
Sylvia Houston's email address is sy****@****are.com
What schools did Sylvia Houston attend?
Sylvia Houston attended Sylmar High School.
What skills is Sylvia Houston known for?
Sylvia Houston has skills like Customer Service, Type 55 Wpm, 10 Key, Debt Collection, Cash Posting, Fax, Microsoft Word, Electronic Payment Processing, Call Centers, Microsoft Excel, Healthcare, Human Resources.
Who are Sylvia Houston's colleagues?
Sylvia Houston's colleagues are Dillon Allison, Diane Johnson, Brienne Handegard, Magnuson, Charlotte, David Allen, Kristina Stenseth, Ahfi, Ashley Hopson.
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