neurosurgery co billing collection specialist resume example with 19+ years of experience
I am an experienced Customer Service Representative with over 20 years of full time professional experience seeking expanded opportunities, where my past and present experience may be effectively utilized.Customer Service Representative with management experience and exceptional people skills. Versed in telephone and computer attributes. Desires a challenging role as a customer service representative.
PC word processor, multi-line phone and ACD system, CPU, copier, fax machine, calculator, all hospital information applications (scheduling, registration, etc). Microsoft (Access, Excel, Outlook, Power Point) Medical Terminology. Understanding of medical billing and experience using the following billing system IDX,EPIC,MEDITECH,Keane. |
Under the direction of a PUM,perform accurate and timely billing and collection processes: perform charge entry,claims processing,A/R management,payment posting, refund processing and other billing functions.
Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. Keep abreast of third party payer specific coding guidelines.
Verify registration information in several systems (IDX,EPIC,MEDITECH,KEANE) applying knowledge of medical insurance coverage to enter and edit registration if necessary.
Entering charges into IDX billing system in a timely and accurate manner. Recognize and determine proper charge entry sequences to produce accurate and complete claims.Recognize limited diagnoses for each procedure. Post time of service and lockbox payments. Review various edit list and take appropriate action to correct incomplete claims.
Handle correspondence and patient inquiries. Use various applications and reports to identify and work unpaid claims for collection/appeal.
Research and process refunds according to department policies.
Perform several different duties as required.
- Under the direction of a Customer Service Supervisor, I am responsible for handling incoming calls, written correspondence, from patients, third parties, Clinical Departments of JHU and other internal and external of Johns Hopkins Medicine.
- Resolve simple and complex patient account issues with the following and understanding JHU policies and procedures.
- Coordinate and Identify delinquent accounts with Self Pay Collection Unit, working with responsible parties to arrange payment plans.
- Communicate with patients, physicians, third parties, and other departments to resolve accounts through bills, correspondence, phone calls and database entries.
- Print and mail claims forms and statement when needed.
- Responsible for a daily credit card report to identify key issues and take appropriate follow-up action to resolve account issues and ensure revenue accuracy before handing to our Payment Posting Unit.
- Coordinates complex, linked appointment scheduling for single designated department.
- Coordinates website request from all areas of the United States and other countries.
- Assists patients and physicians requesting services within JHMI.
- Maintains patient demographic and referral databases.
- Provide patient with information on physicians, directions to affiliate and clinical locations and educational materials.
- Knowledge of hospital and physicians protocols, making all necessary revisions for the White Marsh Orthopedic department as well has Hand-Off revisions.
- Knowledge of medical insurance plans, including, but not limited to managed care plans.
- Placed and received telephone calls from beneficiaries addressing concerns about their health coverage.
- Made outbound calls to beneficiaries to remind them of their quarterly/annual payments using data via PGBA and DOES) a Department of Defense Database).
- Assisted with the workloads to ensure compliance with Tricare requirements.
- Daily inventory tracking of all incoming Enrollment applications.
- Developed procedures and application to increase performance.
- Had access to the Enrollment Manager's Microsoft Outlook.
- Communicated with MTF's, OLA and TMA as necessary.
- Processed 500+ enrollment applications weekly.
Skill Path Seminars
THE ESSENTIALS OF COMMUNICATING WITH DIPLOMACY & PROFESSIONALISM.
ACD, Billing System, Calculator, CPU, Emdeon Credit Card System, Onbase, Aviality, NPI registry, Copiers, Fax machine, Forms,Medical Terminology, Access, Excel, Microsoft Outlook, Word,Power Point, Nursing Policies, Doctors Protocols, Scheduling system, Avaya phones, website.
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Resume Overview
School Attended
- Edmondson Senior High
Job Titles Held:
- Neurosurgery CO Billing & Collection Specialist
- Customer Service Representative II
- Core Services Specialist II-/Protocol Specialist
- Customer Service Representative I
Degrees
- PTC Career Institution Baltimore, MD Nursing Assistant Certification Internship: Pimilico Manor Nursing Home
- Diploma
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