Account Resolution Specialist Resume Example Company Name

ACCOUNT RESOLUTION SPECIALIST

Professional Summary

Medical Billing Specialist - Collector - Project Management

Skill Highlights

Proficient in MS Office Products (Word, Excel, Power Point & Access) Proficient in Operating Programs: Epic, Xclaims, Code Correct, SMS, Lawson, Lotus, QMS

Professional Experience

Account Resolution Specialist08/2014 to CurrentCompany NameCity, State

Managed collection operations in MS4 which included ensuring that charges were billed correctly on patient accounts. Accountable for any additional information to be obtained and forwarded to payer (insurance). Resolving Medicaid/ Medicaid Managed Care and some Commercial Insurance accounts including Parkland Healthfirst, Superior, Molina Healthcare, Amerigroup and CHIP products. Also, Proficient in adjudicating Medicaid Managed Care and Commercial Insurance accounts.
Served as role model. Providing professional, effective problem-solving and wide-ranging assistance which includes coaching and mentoring peers. Communicated with staff, management and other hospital departments as required, to maintain efficient operations. Analyzed problems and elevated to department and/or external leadership as appropriate.

Continuously fostering relationships between internal and external clients including physicians and insurance carriers by providing the highest level of customer service, and resolving claim issues and concerns in a timely manner. Educated clinic departments and physicians about any billing and collections, in addition to providing additional training as necessary. Ensuring that charges are billed correctly; that any additional necessary information is obtained and forwarded to the appropriate payer. Appealed any claim denials, if appropriate; and payments are received and posted; and residual accounts are pursued and resolved.

Collections Coordinator II01/2005 to 08/2014Company NameCity, State

Project Manager for the implementation of Psychology Billing. Was responsible for leading the planning and implementation of the project, facilitated the definition of project scope, goals and deliverables, planned and scheduled project timelines, tracked project deliverables using appropriate tools, provided direction and support to project team, quality assurance, consistently monitored and reported the progress of the project to all stakeholders, and presented reports defining project progress, problems and solutions.
Developed working relationships and communications with external and internal departments. Coordinated and provided status to all involved teams regarding the Project Improvement Team Initiative.
Train and assist new collectors with non-routine and routine procedures and serve as a resource to other collection coordinators.
Edit and process claims efficiently, identify errors and rejects, resolve billing problems. Review all assigned accounts to ensure that all information, codes, and other relevant information is correct and charges have been billed within guidelines. Maintain weekly contact with Medical Records staff, Billing staff, and Financial Counselors to obtain or clarify billing information.
Ability to communicate with others in a clear, understandable and professional manner on the phone, via email and in person.
Excellent organizational skills which includes notes and up to date status on issues. Ability to escalate issues when resolution is not being reached.
Consistently demonstrates professional motivation, steadiness and dedication and the ability to develop and maintain successful, long-term, relationships with key industry/client contacts. This includes excellent oral communication, presentation and writing skills.
Proficient in all Microsoft Office (Word, Excel, PowerPoint and Outlook).
Demonstrate organizational, problem solving and analytical skills.
Established the ability to work in a team environment that requires quick turnaround and quality output.

Assistant Program Director01/2001 to 01/2005Company NameCity, State

Worked closely with Program Director to develop and enhance program curriculum.
Oversee and distribute work to leadership team and other volunteers.
Building and maintaining good professional relationships with clients.
Verifying and ascertaining that all the policies of the organization were in ordinance with the guidelines being set by the governing agencies and the state.
Performed various administrative duties.

Single Point of Contact Representative/Team Lead01/1997 to 01/2001Company NameCity, State

Trained and developed new associates.
Monitoring, organizing, and coaching team on a day to day basis.
Carrying out team meetings and actively participating in weekly and monthly meetings.
Documenting general reports on each team member's performance and targets as well as ensuring they exceeded their goals.

Education and Training

B.A.: Psychology2013University of North TexasCity, State, US2013 - Present University of North Texas Dallas, TX Pursuing B.A. in Psychology

University of PhoenixPreviously Attended University of Phoenix

Skills

Accounts To, Billing, Claims, Clarify, Collection, Collections, Credit, Excel, Excellent Organizational Skills, Medical Records, Microsoft Office, Ms Office, Organizational Skills, Outlook, Powerpoint, Problem Solving, Progress, Project Manager, Quality Assurance, Solutions, Word, Writing Skills, Clients, Basis, Coaching, Documenting, Team Lead, Access, Epic, Lawson, Sms

Resume Overview

School Attended

University of North Texas
University of Phoenix

Job Titles Held:

Account Resolution Specialist
Collections Coordinator II
Assistant Program Director
Single Point of Contact Representative/Team Lead

Degrees

B.A. : Psychology 2013

Account Resolution Specialist Resume Example

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