Customer Service Claims Processing Collections
*3rd Party Billing Medical Coding Reconciliations
*Claim Follow up Credentialing/ Appeals MCR/MCD/HSN
*Problem Solving Coverage Verification I am a detailed oriented professional bringing forth 12 years of financial and medical administrative experience. I've successfully implemented effective strategies to meet strict deadlines with consistency and accuracy. My objective is to obtain an administrative position within finance where I can apply my skills and excel in the medical field.
Accurate coding of diagnoses and procedures, using ICD-9, CPT and HCPCS codes.
Working knowledge of medical terminology, claims processing and medical office procedures
Patient Account Coordinator January 2014 to CurrentBoston Children's Hospital － Boston, MA
Ensure all required demographic, insurance, referral/authorization, clinical, data is collected, verified, and communicated appropriately Coordinate activities with specific physician offices, service sites and ancillary departments Prepare and submits accurate insurance claims to payer within proper time frame Work payer scrubber and denial reports in an effective and timely manner.
Ensure prompt resolution of outstanding insurance claims Identifies trends, denials, and issues impacting account resolution and refer as appropriate Maintain a good understanding of third party payer contracts Participate in process improvements Provide positive and effective customer service that supports departmental and hospital operations.
Patient Account Specialist January 2013 to January 2014Cambridge Health Alliance － Medford, MA
Audit and reviewed patient accounts to ensure billing accuracy Completed correspondence from insurance carrier or patient for prompt reimbursement Determined accounts ready for outsource placement or other adjustments and/or discounts Assisted Patients with billing issues and resolved delinquent balances Processed refunds, charge corrections and charge offs Ensured all required demographics, insurances, referral/authorizations, clinical, data was collected, verified, and communicated appropriately Coordinated activities with specific physician offices, and ancillary departments Prepared and submit accurate insurance claims to payer Effectively worked denial reports and rectified errors for claim resubmission Ensured prompt resolution of outstanding insurance claims Assisted patients and family members with coverage limitations and financial liability Monitored account receivables and initiated collections call/follow-up.
Special Events/ Marketing Coordinator January 2011 to CurrentBoston Elite Event － Boston, MA
Plan, organizes, coordinates, promotes, and facilitates special events Schedule and maintains communication with speakers, vendors, and participants Assists in preparing a variety of publications, materials, and programs for events Schedule meetings coordinates participation in charitable contributions Acts as prime source for promotion of activities and special events; initiates, coordinates Participate in all efforts to publicize promotion of activities, services, and events.
Business Specialist January 2007 to January 2013Brigham & Women's Hospital － Boston, MA
Interacted and coped effectively with diverse populations in stressful situations resulting from trauma to illness Oriented and Educated patients and their families in triage process Provided assistance between nursing administration and other ancillary physicians Received and distributed messages and documents to appropriate staff Compiled and record medical charts, reports, and correspondence Transcribed doctor's orders and administered all medical records for care plans Coordinated requests for medical reports photo imaging and demographics to be transferred to and from medical facilities Assisted families and friends to locate and connect with the patients Arranged ambulatory transportation for patients to other facilities Generated ED census reports, audited medical charts, verify MD dictation for notes and reports Initiated medical codes in dangerous situations or patient crisis.
Education and Training
2007Salter School － Cambridge, MA
High School Diploma : 1995Fenway Middle － Charlestown, MA