Overprovision Specialist Resume Example

POSTING SPECIALIST

• Post all payments received into the billing system while maintaining a high level of productivity through speed and accuracy, and generate reports to ensure the accuracy of the data entered.
• Researches patient inquiry to verify correct account for applying payment.
• Sets weekly goals to maintain timely postings in accordance with productivity standards.
• Monitors reimbursement for any underpayments.
• If underpayments is made the account is forwarded to the collections department for follow up resolution.

REIMBURSEMENT SPECIALIST

• Promoted to the reimbursement department (collections) and my process to date is just beginning, my training is in progress.
• Calling and checking on claim status, working A/R and insurance carrier reports and insurance denials.
• Resubmitting improperly paid/denied claims to carriers for proper payment in a timely manner.
• Notified customers of delinquent accounts with attempt to collect outstanding amounts.
• Reviewed accounts to determine payment plan compliance.
  Located and monitored overdue accounts using billing system to begin collections process.
• Received payment and ensured proper posting to appropriate customers accounts.

• Posts customer payments by recording cash, checks and credit cards transactions.
• Resolves valid or authorized deductions by entering adjusting entries.
• Summarizes receivables by maintaining invoice accounts; coordinating monthly transfer to accounts receivable account; verifying totals; preparing report.
• Accomplishes accounting and organization mission by completing related results as needed.
• Maintains confidentiality of company information and member personal health information (PHP) in accordance with HIPPA privacy and security regulations.
• Verified patients insurance, claims coverage by coordinating with providers.
• Maintained strict patient privacy and confidential patient information, taking care to meet all HIPAA guidelines and statues for data security.
• Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
• Submitted claims to insurance companies.
• Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
• Performed insurance verification, pre-certification and pre-authorization.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Used ETM -IDX-Waystar and Zirmed to record weekly statements, including expenditures and balances.
• Reviewed received payments for accuracy and applied to intended patient accounts.
• Applied HIPAA Privacy and Security Regulations while handling patient information.
• Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
• Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
• Managed benefit contract pricing, processing, policies and procedures.
• Verified final claim submissions by comparing account charges with documentation.
• Reviewed medical records to meet insurance company requirements.
• Effectively coordinated all communications between patients, billing personnel and insurance carriers.

• Accomplishes accounting and organization mission by completing related results as needed.
• Set up new patients accountants.
• Accurately applied payments to patient accounts.
• Maintained the patient's information, reports, income reports and statistics with balancing the daily schedule.
• Data entry.
• Accounting.
• 954.