billing collections supervisor resume example with 16+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
Home: (555) 432-1000
Cell:
resumesample@example.com
:
Summary
Reliable Collections Specialist adept at operating. History of meeting high productivity, quality and performance standards.
20+years in the Medical field, 15 in billing and collections with strong written and verbal communication skills, detail oriented, professional appearance and demeanor.
Proficient in insurance knowledge, Medicare, Medicaid, Commercial policies, Auto and Workers Comp. Including verification and authorizations.
Translate diagnosis to ICD-10, CPT codes, modifiers and medical terminology.
Strong work ethic with all in attitude, I strive to grow and meet demands.
Skills
Critical Thinking
Problem Solving
Customer Service Skills
Team Player
Adaptability
Dependable
Leadership Skills
Time Management
People Skills
Experience
Billing Collections Supervisor, 09/2014 to Current The Rotary Foundation – Detroit, MI,
Mentored collection team on successful tactics to increase workflow and productivity for 7 physicians and 2 ARNP's. and over 10 facilities, inpatient, outpatient and office.
Oversee verification processes of all hospital face sheets for correct insurance eligibility to ensure insurance order.
Oversee the insurance and authorization specialist and assist with any issues or questions and ensure authorization are on file for each upcoming appointment one month in advance. Assure all work comp visits have a signed authorization on file.
Incoming/outgoing patient calls regarding billing questions and taking payment information and working with patients providing payment plans.
Provides billing ledgers to law firms and completes necessary information they require upon request.
Work all denied EOB's and electronic ERA's in a timely manner for resolution and appeal processes for all commercial, Medicare, Medicaid, Work Comp, Auto and Managed care plans.
Prepare and scrub all claims to ensure proper codes and modifiers are in place prior to submitting claims. Correct any errors for Primary, Secondary and Tertiary claims.
Post all office charges for visits and procedures, adhere to billing guidelines per payer and append modifiers where needed. Send corrected claims paper and electronically with required information.
Pull and review all patient statements, ten day letters and collection accounts. Write off accounts to collections.
Utilize payer sites for appeals, claim status and uploading needed documentation for claims processing.
Pull and work all AR reports every 30 days, rework past appeals and claims sent for reprocessing and validate current status
Outgoing calls to all insurance on denied claims for reprocessing
Send out patient letters for denials that require COB updates and other denial issues that must be handled by member.
Utilize hospital websites to research authorizations, demographics and pulling records for insurance review.
Delegate work loads per demand
Work with provider reps to resolve contractual issues when payer has denied and unable to resolve by calling the provider line.
Note all patient accounts with steps taken for issues being worked.
Self pay accounts worked monthly for reverification of Medicaid or other insurance that may have became active to bill.
Ensure payments and adjustments are entered properly.
Approve time off for department and arrange coverage for position.
Update and correct invalid ICD-10/HCPC codes used causing errors on claims.
Ensure claims are coded properly for telehealth and using correct modifiers.
Fill out necessary paperwork for transplant claims required for submission.
Worked in office and remote from home as needed on overtime for work flow and deadlines.
Commercial/Medicare Collections, 05/2012 to 08/2014 Elara Caring – Stockbridge, GA,
Responsible for 8 Wound Care , Infusion Therapy and Infectious Disease Physicians.
Report numbers to Director for quarterly meetings. Report issues with insurance denials, billing issues or office issues etc., that may have an effect on A/R numbers.
Identify and correct any errors with billing or insurance that was not caught during scrubbing process, rebill corrected claims and appeal if necessary.
Call on insurance denials and take necessary steps to have claim reprocessed for payment.
log all calls in patient accounts, take phone calls from insurance companies and patients.
copy and scan all correspondence, denials, appeals into system.
Work denial lists to resolve before they hit A/R
Run summary aging reports, every account must be worked every 30 days.
Apply unapplied money to necessary accounts, work refunds for patients and insurance.
Work closely with biller to address and resolve any issues causing denials.
Make necessary adjustments to accounts that are not correct, or were applied by cashier when payment was posted.
Review and Work credits on accounts.
Billing and Collections Specialist, 06/2005 to 05/2012 Expert Claims Consultants – City, STATE,
Data entry and billing charges for office, hospital visit's and procedures (inpatient, outpatient, nursing home, infusion therapy, wound care and hyperbaric. ( Internal Medicine, Pediatrics, Gastroenterology, Infectious Disease and Wound Care, Ambulance billing and Primary Care)
Identify and correct issues that could delay claims or result in a denial, ensuring all required information is in place prior to claims submission.
Assist patients with billing inquiries, account details, payment plans. Assisted patients in resolving account disputes in a respectful and courteous manner.
Post insurance and patient payments in a timely manner to keep A/R current.
Investigate refund requests made by insurance companies to validate reason for request and dispute if necessary.
Work and interpret various insurance EOB's in a timely manner.
Work open A/R for resolution to denials, provide additional documentation when requested.
Appeal claims with needed information for processing.
Submitted claims electronically and printed paper claims (Primary,Secondary, Tertiary)
Maintain all returned mail updated demographics.
Reverified insurance as needed with online websites and calls made when unable to retrieve info on line.
Worked in office and remote, traveled to different provider offices to pick up billing. Covered billing shifts at other offices as needed.
Education and Training
High School Diploma: , Expected in 06/1991 to Land O' Lakes High School Adult Education - Land O' Lakes, FL GPA:
Associate of Science: , Expected in 1998 to Florida Metropolitan University/Tampa College - Tampa, GPA:
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