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Medicare and Medicaid Collector Specialist Resume Example

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MEDICARE AND MEDICAID COLLECTOR SPECIALIST
Professional Summary
I am a very experienced Collector with a strong background in billing and collections experience. I have a long history in handling patient eligibility, coordination of benefits research, and obtaining authorizations.  My extensive knowledge with claims collections for commercial insurance, Medicare and Medicaid policies, ensures I have the vast ability to handle all aspects of insurance issues. I am seeking a new and challenging position in a medical office setting. 
Skills
  • Billing and collection procedures expert
  • Hospital inpatient and outpatient records
  • HCPCS Coding Guidelines
  • Familiar with commercial and private insurance carriers
  • Excellent problem solver
  • Resourceful and reliable worker
  • Excellent verbal communication
  • Insurance and collections procedures
  • Understands insurance benefits
  • Composed and professional demeanor
  • Research and data analysis
  • Office management professional
  • Close attention to detail
  • Adept multi-tasker
  • Office support (phones, faxing, filing)
Work History
Medicare and Medicaid Collector Specialist, 09/2012 to Current
 Integrated Health Management Services – 4400 E. Broadway Blvd, Tucson AZ 85711
  • Confidently and adeptly handled claim denials and/or appeals.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Updated patient financial information to guarantee accuracy.
  • Identified and resolved patient billing and payment issues.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Verified patients' eligibility and claims status with insurance agencies.
Patient Account Representative, 01/2007 to 12/2011
 Fresenius Medical Care – 4560 S. Coach Drive Suite 100, Tucson AZ 85714
    I was responsible for handling a large commercial insurance Blue cross of California for my Dialysis patients receiving dialysis 2-3 times per week. I personally had a patient list that I had to verify eligibility monthly and investigate any coordination of benefits issues related to ESRD. The weekly billing of claims would include attention to detail and the correct coding of HCPC and diagnosis codes being used. There was monthly collection revenue goals to meet or exceed, which I consistently was able to meet. Monthly facility balancing reports were performed. I frequently had to contact the Facilities and speak with nurses with coding issues as well. 
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Verified patients' eligibility and claims status with insurance agencies.
  • Diligently filed and followed up on third party claims.
  • Determined prior authorizations for medication and outpatient procedures.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Accurately posted and sent out all medical claims.
  • Submitted electronic/paper claims documentation for timely filing.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely evaluated and verified benefits and eligibility.
  • Responded to correspondence from insurance companies.
  • Posted and adjusted payments from insurance companies.
  • Identified and resolved patient billing and payment issues.
  • Maintained and updated collections tracking spreadsheet to help organize payment information.
  • Confidently and adeptly handled claim denials and/or appeals.
  • Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.
  • Updated patient financial information to guarantee accuracy.
Collector , 06/1993 to 02/2014
 Business Revenue Systems – 5015 Speedway Drive, Fort Wayne, IN 46825
 Handled the collections of hospital bills for third parties. Had to call debtors to set up payment plans for debts owed. Had to investigate and perform skip tracing to locate parties that were unable to locate. The clerical duties also included involved mail sorting, answering of phones, ordering and stocking of office supplies. There was cash balancing and daily deposits to prepare for bank deposits. 
Education
Dental Certification: Dental Assisting, 2003
 Carrington College - 3550 N. Oracle Rd, Tucson AZ 85705
Undetermined: General studies, IPFW - 2101 E. Coliseum Blvd. Fort Wayne, IN 46835
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Resume Overview

Companies Worked For:

  • Integrated Health Management Services
  • Fresenius Medical Care
  • Business Revenue Systems

School Attended

  • Carrington College
  • IPFW

Job Titles Held:

  • Medicare and Medicaid Collector Specialist
  • Patient Account Representative
  • Collector

Degrees

  • Dental Certification : Dental Assisting , 2003
    Undetermined : General studies ,

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