Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Professional Summary
Driven and Passionate Health Care Service professional with 12 years hands-on experience in fast-paced Medical Billing and Customers Service environment. Accountable and responsible with a strong focus on client, insurance and patients accounts needs.
Skill Highlights
Professional IntegrityÂ
Team Player
Self-DirectedÂ
Strong Communication
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 Detailed-oriented
Strong analytical skills
Strong Research Skills
Strong Interpersonal skills
Professional Experience
09/2016 to CurrentCustomer ServiceFirstservice Residential | Silver Spring, MD,
Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax. Placed Orthotic orders for Doctor's office and Nursing Facilities daily
Verified that information in the computer system was up-to-date and accurate.
Created, organized, updated and maintained over 200 patient charts weekly.
Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax.
Communicate with Doctor's office and Nursing Facilities Daily regarding coding of patient charts
Communicate with Sales Reps daily regarding patient orders
Verify patient insurance eligibility and benefits for multiple payors
Request Insurance Authorization for patient orders
Enter new patient demographics in system software
Verified Doctor Credentials for all orders
Created new facility locations in system
Created daily reports of Sales Reps orders for follow-up
Communicated daily with Sales Reps regarding issues/concerns regarding patient orders received
Created Certificates of Medical Necessity for patients and faxed to doctor's office and nursing facility for signatures
Created Assignment of Benefit letters for patients and mailed out
Handled In and Out bound calls
Posted insurance and patient payments in system as requested
Verified and tracked patient orders via UPSÂ for daily reportingÂ
Handled replacement and exchanges orders as needed
Managed Insurance websites used
09/2011 to 08/2016Accounts Receivable Rep / Team SupportSika Corporation | Chino, CA,
New Hire On Boarding, orientation of staff providing Company compliance policy education and training courses.
Ensured all New Hires Compliance documents are signed.
Communicated with HR/IT Support Team on behalf of New Hired Employee regarding compliance requirement issues/concerns
Processed and distributed all credit card payments for patients & insurance.
Monitored reports for patient and insurance credit card payments to improve performance
Maintained credit card Inventory Spread sheets monthly for multiple clients to support company compliance policy.
Established and maintained positive relationships with government payers, clients, office staff and multiple health care providers.
Maintained Excel spread sheet for multiple Client website portal access logs for insurance payers and electronic data interchange.
Managed over 200 websites ensuring smooth cash flow allowing over 5 million dollars of in-coming revenue monthly.
Provided update to Management Team with websites concerns and/or issues for clients and office staff.
Prepared and update Office Policy and Procedure Manual for Management Office Team.
Provided Support to office and client staff regarding website access.
Provided Quick Reference Guides and/or Helpful Hints user guides
Trained office staff to use website portals to improve quality of work production.
Timely follow-up and communication with insurance payers for claims appeals, corrections and re-adjudication of denied claims.
Responsible for reducing AR for 120 days> to less than 15%
Identified, corrected any billing and coding issues for conflict resolution.
Provided Customer Service Team Staff support with patient calls and account resolution.
Worked Patient Collection Report, reviewing patient accounts to determine accounts to be sent to collection.
Reviewed Patient Account Credits balances for payment reallocation to reflect true patient account balance.
Support Customer Service Team with Spanish Speaking calls. Â
09/2009 to 09/2011System Software Trainer/SupportMcKesson | City, STATE,
Worked with IT Support Team members regarding test and upgrade requirements
Researched and update of ANSI carrier codes for system software
Maintained and distributed updated system analysis to all Management Team weekly.
Identified and Report potential problems for system software with resolution to Management Team Weekly.
Maintained Multiple Client website access logs for insurance and electronic data interchange
Provided Team Leaders with carrier news/changes for current and/or future events.
Performed 50 Employee Audits monthly to ensure accuracy of greater than 86% and compliance of company and client policies.
Reported Employee Audit results to Management Team, while focusing on failing audits of less than 86%.
2007 to 09/2009Accounts Receivable & Customer Service SupervisorMcKesson | City, STATE,
Managed multi state client site in central business office.
Monitored Clients A/R cash receipts to ensure 25% weekly income.
Monitored all cash discrepancies for corrections weekly.
Monitored Client refund and over payment for both Insurance and Patient accounts weekly.
Reviewed patient account for client authorized small balance write offs monthly.
Monitored Clients A/R aging weekly.
Reviewed employee daily/weekly production and report discrepancies to Management Team.
Created employee work plans based on existing aging focusing on timely filing limits & payer amounts outstanding.
Analysis and correct all errors related to Pre-bill & WebMD billing reports; report all trends to Manager and Clients for efficient resolution process.
Monitor Denial Module and Collections Module to ensure resolution of patient accounts daily.
Monitor Collections Agency Reports.
Perform daily/monthly closes for multiple client sites.
Monitor Payroll, Approve overtime/make up time for all employees assigned as well as resolving all employee discrepancies.
11/2003 to 2007Team LeaderMcKesson | City, STATE,
Conducted audits of A/R, call center collection staff Maintain the internal processes that will allow the company to meet and exceed the needs of the client.
Assisted in determining action plan when audits do not meet standards of the company.
Communicated with management team to provide feedback on quality of work, status of training programs, and the implementation/maintenance of new/current processes.
Provided one-on-one training to individuals or provide training in group environment.
Worked in conjunction with corporate training team to deliver training on any software upgrades and/or changes, Implementation of effective billing and follow up procedures.
Reviewed collection, denial module and corrective action module for update.
Reported clients with trending of current denial rejections.
Maintained EDI folders and ensure timely follow up and return to the appropriate departments.
Reviewed refunds and credit balances.
Communicated with clients on software errors and billing procedures.
Analysis system errors and ensure correct process is being used by employee and for timely billing and filing of insurance claims.
Researched on government rules for billing on procedures, diagnosis and report to management and clients.
Assisted cash posters with posting errors and ensure employees have clear explanation of insurance explanation of benefits to ensure better processes for insurance billing and posting.
Assist on posting of insurance and patient payments for multiple clients.
Assist collection representative with patient calls and letters.
Assist on special projects requested by Manager.
Perform other duties requested by supervisor and manager.
Skills
Microsoft Office 2013 - Microsoft Excel 2015 - Outlook 365 - eSolutions - ADP-ezLabor Manager - AR Express Billing System - Healthcare software system - NextGen EPX - Electronic Payment Exchange Chase Credit Card Software - Avality Emdeon-Claims tracker /Payment Manager - Medical Manager - Website System Support - A/R & Patient cash posting skills - Staffing management and development ability - Creative Problem Solving - Personal and professional integrity - Relationship and team building - Spread Sheet - Customer Service - Critical thinking - Multi-Task Management - Sound judgment and decision making skills - Time Management - Written and Telephone Communication Skills - Hard Worker - Team Player- Self-Directed - Detailed-oriented - Strong analytical skills - Strong Research Skills - Strong Interpersonal skills
Education and Training
Expected in 1997GED | , Philadelphia, PAGPA:
Expected in 1998Graduate Diploma | Computerized Business & AccountingDPT Business School, Philadelphia, PAGPA:
Interests
Create Fund Raisers to raise money and collections of items for multiple different organizations and an Active member of community Church
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Resume Overview
School Attended
DPT Business School
Job Titles Held:
Customer Service
Accounts Receivable Rep / Team Support
System Software Trainer/Support
Accounts Receivable & Customer Service Supervisor