account representative par ii resume example with 12+ years of experience
Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA94105
:
Summary
Enthusiastic hardworking and reliable Medical Billing Professional with strong ability in appeals and collections. Bringing strong work ethic and excellent organizational skills, along with superior skills in working in both team-based and independent capacities.
Skills
Account follow-up and management
Submission of medical claims and Insurance collections
Data entry, Customer service, Reimbursements
Medical coding understanding
Claim review
MS Office
Medical billing and collections
Billing and collections best practices
Billing inquiry resolution
Proficiency with Cerner, Legacy, E-premis, MediSoft, Misys, MBS, RealMed, MDIV, and PPM medical billing
Bilingual fluency in Spanish
Education and Training
New Mexico State UniversityLas Cruces, NMExpected in ā āAssociate of Applied Science:Health Information Technology - GPA:
Currently taking online classes
Las Cruces High SchoolLas Cruces, NMExpected in 05/1994 ā āHigh School Diploma: - GPA:
Experience
Monarch Healthcare Management - Account Representative Par II Minneota, MN, 10/XXX7 - Current
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
Posted charges, payments and adjustments.
Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
Meticulously tracked and resolved underpayments.
Collaborated closely with other departments to resolve claims issues.
Entered procedure codes, diagnosis codes and patient information into Cerner and Legacy.
Submitted refund requests for claims paid in error.
Posted and adjusted payments from insurance companies.
Applied payments, adjustments and denials into medical manager system.
Streamlined day-to-day office processes to meet long-term goals.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Change Healthcare Corp. (Formerly McKesson Corp.) - Credentialing & A/R Specialist I City, STATE, 01/XXX2 - 10/XXX7
Tagged documents according to tiered access thresholds, updating packets, reviewing reports and forwarding items requiring approval or verification.
Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
Performed primary source verifications such as criminal histories, licenses and board certifications.
Checked applications for missing information and organized all paperwork.
Set up NPI numbers for providers and facilities and updated current profile information.
Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.
Handled wide range of special inquiries and certificates from customers, partners and government agencies.
Interfaced with customers to bring accounts current with suitable repayment plans.
Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
Kept accounts receivable tracking database current with relevant client information, collection and billing progress and program changes.
Evaluated open accounts to look for past-due balances and pursue collection strategies.
Methodically resolved active claims by analyzing possible discount violations, PODs, shortages, returns and related advertising.
Worked closely with delinquent account holders to collect and reconcile accounts through approved channels.
Horizon Mechanical Inc. - Receptionist City, STATE, 01/2009 - 12/XXX1
Greeted visitors, assessed needs and directed to appropriate personnel.
Directed clients to appropriate personnel to address concerns, resolve complaints or answer account-related questions.
Answered and directed incoming calls using multi-line telephone system. Took accurate messages for staff and management to facilitate open and speedy communication.
Sorted and distributed business correspondence to correct department or staff member, reducing dropped communications and enabling faster responses to key requests. Received incoming packages and mail, dispersed parcels and shipped outgoing items for team.
Delivered administrative support to team members, including making copies, sending faxes, organizing documents and rearranging schedules.
Oversaw office inventory by restocking supplies and submitting purchase orders.
Communicated with vendors to place and receive orders, request maintenance services and deliver instruction on behalf of office management.
Entered data in Quickbooks software to maintain all financial records to verify timely clearance of all credit and debit activities.
Tracked all crews utilizing GPS system and updating locations as needed.
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