Yolanda Garner Email and Phone Number

Medical billing specialist, Currently credentialing, professional healthcare coding, claims and appeals, disputes retractions and auditing from medical insurance, also obtain authorizations for MRI and prescriptions

Performs day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services (PBS) location•Serves as a member of the billing and follow-up team at a PBS location responsible for billing and follow-up of government and non-government accounts•Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions•Performs daily activities as part of the billing and follow-up team in support of the revenue cycle process for an assigned PBS location•Documents claims billed, paid, settled, and follow-up in appropriate system(s)•Identifies and escalates issues affecting accurate billing and follow-up activities•Adheres to proactive practices which include contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner•Communicates with appropriate hospital departments to clarify billing discrepancies and obtains demographic, clinical, financial, and insurance information•Performs all routine follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays•Tasks will be routed to the correct workflows with the objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and accurate manner

• Ensure store office functions are completed accurately and on time using accounting packets; communicates all cash variances to the Assistant Customer Service Manager• Maintain knowledge of office procedures including cash reports, register checkups, deposits, Western Union, money orders and Coinstar• Ensure work station and front end area of the store has a neat and clean presentation• Maintains proper knowledge of all sales associate register functions and Front End accounting services• Report any register malfunction to the Customer Service Manager or, in the absence of the MOD, place service calls in an efficient manner• Performs the task of the customer lead as needed to ensure service standards are maintained• Maintain alertness and calls for assistance when needed to service customers per service standards• Adhere to all company guidelines, policies and standard practices• Observe and correct all unsafe conditions that could cause associate or customer accidents• Successfully complete computer based training (CBT) and training aid courses• Perform all other duties as assignedRequirements• Effective communication and customer service skills• Ability and willingness to learn multiple tasks and technical requirements of the job• Ability to perform the technical requirements• Ability to use computers and other communication systems required to perform job functions• Use hands to frequently/continuously handle currency (paper and coin) as well as operate a variety of equipment such as cash register, lottery machine (where applicable), scanner, computer, and calculator• Meet established volume activity standards for the position• Have sufficient visual ability to check ID cards, checks, invoices and other written documents

Resolve credit balances resulting from insurance companies which may require phone calls.Resolve credit balances resulting from patients.Investigate account balances and determine if collections from insurance or patient can still be made based upon timely filing guidelines.Verify accounts to be written off.Submitting appeals to insurance companies have claims reprocessed. Posting payments to claims that have been reimbursed.Updating patients account that apply for financial assistance and review documentation.Signing up providers for different web portals to asist in day to day activities of claims processing.Submitting Medical records via web portal or secured fax to insurance companies as per their request.Answering phone calls ,taking payments from pts at time of call.

* Submit medical claims using Emdeon & CMS1500’s * Maintain confidentiality; adheres to all HIPAA guidelines/regulations * Liaison with online insurance companies using CiMO, Paradox, & FoxPro billing * Applies CPT and ICD-9 codes accurately at check out. * Process electronic referrals and prior authorizations for procedures, medications etc. * Enter patient demographics and update as necessary in the computer system to maintain accuracy for billing purposes. * Verify/Interpret patient’s insurance eligibility and benefits. * Collect and process co-pays and balances; prove out the days totals * Clerical support to Front Desk Coordinator and other Managers * Process and mail invoices to patients without insurance * Answered multi-line telephone

* Submit medical claims using Emdeon & CMS1500’s * Maintain confidentiality; adheres to all HIPAA guidelines/regulations * Liaison with online insurance companies using CiMO, Paradox, & FoxPro billing * Applies CPT and ICD-9 codes accurately at check out. * Process electronic referrals and prior authorizations for procedures, medications etc. * Enter patient demographics and update as necessary in the computer system to maintain accuracy for billing purposes. * Verify/Interpret patient’s insurance eligibility and benefits. * Collect and process co-pays and balances; prove out the days totals * Clerical support to Front Desk Coordinator and other Managers * Process and mail invoices to patients without insurance * Answered multi-line telephone

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