Financial Counselor Resume Example

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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - - -
Professional Summary
To employ my knowledge and experience with the intention of securing a professional career with opportunity for challenges and career advancement, while gaining knowledge of new skills and expertise
Education and Training
Expected in 1992
Associate of Science: Business Administration & Computer Science
North Shore Community College - Lynn, MA
Business Administration & Computer Science
Skill Highlights

Microsoft Word, Excel, Outlook, Mass Medical Information System, Paragon, Claim Administrator, Medicare, Online System, NeHen Express, IDX 8,6, SSI Billing System, PaySpan, ECMS Document, Exceptional organizational / computer skills and team work ability. Willingness to take responsibility.

Professional Experience
04/2011 to Current
Financial Counselor Hospital Sisters Health System - Corporate Sheboygan, WI,
  • Review daily reports of in-house patients needing Medicaid.
  • Conduct financial assessments for public benefits including but not limited to: MassHealth Safety Net, Commonwealth Care, Commonwealth Choice, Medicare D, Prescription Advantage, Disability Review and others that assist patients in accessing health care.
  • Determination of the appropriate forms of financial assistance for the patient.
  • Assist patient and/or patient representative in insurance program application submission, approval, and enrollment processes acting as the patient representative to State agencies.
  • Complete applications for providing patients access to medical services for discharge planning in order to place patients in appropriate settings and for obtaining facility reimbursement.
  • Initiate applications to State and Federal medical insurance, with criteria for approval and courses of action designed to address patients needs (upgrade from Community Medicaid, Disability application, Standard approval, etc.).
  • Determination of whether patients/ families should seek legal counsel for financial assistance.
  • Responsible for explaining to patients/families the MassHealth look back requirements as set by the State.
  • Accurately and sensitively collect all required documentation and data in order to maintain a patient database that supports clinical and financial needs of the facility.
  • Responsible for following up on applications and supplements until the required documentation has been submitted and a final determination has been made at State offices.
  • Verify and obtain records on personal demographic and financial information via telephone or face to face interview for facility records.
  • Recommend Medig plans for patients who do not qualify for MassHealth due to higher income.
  • Inform patients and/or patient representative of what a Patient Pay Amount (PPA) is and when it's due.
  • Maintain Personal Needs Account for patients.
  • Work closely with internal and external groups such as Case Managers, Social Workers, and State workers in order to resolve patient issues including access, billing and discharge barriers.
  • Act as liaison with Business Office on payment plans.
  • Assist Business Office Supervisor and Manager with billing MassHealth claims and resolving denials.
  • Complete tasks as assigned by team leaders, supervisors and managers.
2009 to 03/2011
Blue Cross Representative Florida Cancer Specialists, P.L. Columbus, OH,
  • Patient accounts Blue Cross Representative: Refers all change correction allowance, refunds, payments transfer and other accounts correction to the appropriate sources as defined by the Department.
  • Resolve payer rejections for coding, invalid member ID, non-covered charges.
  • Validate payer edits for clean submission within the Claims Administrator application.
  • Report on monthly denials.
  • Assist with training on new Blue Cross claim edits.
01/2007 to 11/2009
Financial Counselor - Team Lead Hospital Sisters Health System - Corporate Highland, IL,
  • Daily self-pay reports of payment s and insurance updates.
  • Verify Mass Health patients approval and / or denials.
  • Monthly write off of Free Care Patients.
  • Training of new employees.
  • Report on daily patient co-payments posted to the system.
  • Maintaining Trail Balance for Medicaid accounts.
02/2005 to 03/2007
Financial Counselor Charleston Area Medical Center Ronceverte, WV,
  • Responsible for contacting Mass Health and other Insurance companies form recent updates on insurance information.
  • Registered new patients into Health Pro.
  • Update any new regulation information from Mass Health / Free Career away applications.
  • Assist patients with applying for State insurances.
02/2000 to 03/2005
Patient Accounts Supervisor Health Alliance Of Hudson Valley Port Jervis, NY,
  • Monthly claims submission reports for all insurances.
  • Functional Supervisor responsible for ten (10) team members for the Department.
  • Analysis of all claim rejections.
  • Major insurance payment analysis reports.
  • Resolve issues with outstanding account balances.
  • Maintaining Trail Balance for Medicare accounts.
  • Assist with any coding / billing issues.
08/1992 to 02/2000
Billing Supervisor Hallmark Health Visiting Nurse City, STATE,
  • Month end closing reports.
  • Implementation of new billing and hospice system.
  • Review of A/R for all third party insurances, Medicare and Medicaid Maintaining weekly work log for failed Medicaid accounts Claim denials reports Weekly MSP denials for registration Monthly Medicare cash reports.

as set, Balance, benefits, billing, Billing System, database, discharge planning, documentation, financial, forms, Functional, hospice, Insurance, legal, access, Excel, Office, Outlook, Microsoft Word, Month end closing, organizational, Assist patients, Assist patient, processes, coding, Express, Safety, SSI, Supervisor, team work, telephone, upgrade

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Resume Strength

  • Personalization
  • Target Job

Resume Overview

School Attended
  • North Shore Community College
Job Titles Held:
  • Financial Counselor
  • Blue Cross Representative
  • Financial Counselor - Team Lead
  • Financial Counselor
  • Patient Accounts Supervisor
  • Billing Supervisor
  • Associate of Science