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Patient Account Rep III Resume Example

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PATIENT ACCOUNT REP III
Summary

Seeking for a claim specialist position that will effectively maximize 7 years experience in meeting the demands of a fast-paces work environment. Strong organizational and bilingual communication skills, the ability to effectively multitask and demonstrated success in building positive relationships at all level.

Skills
Oral bilingual communication skills, Epic, IDX System (GE Centricity), Clinical Database, AS/400, Emdeon, Noridian, Cerner Millenniums, STAR System, MediTech, Citrix, CareMedics, Medical law and Ethics, Medical and Dental terminology, billing and collections, insurance coding, Microsoft Word, Excel, Power Point, Access, Computerizing billing, typing (45 wpm).
Experience
April 2015 to Current
Company NamePatient Account Rep III
  • Conducts such activities as account investigation, follow-up and collections on unusual and complex accounts.
  • Consistent follow up on insurance such as Medicare, Medicare advantage, Workers Compensation, Tricare, & Kaiser.
  • Serves as lead worker and trainer for junior level staff.
  • Performs AR follow up on rejected claims.
  • Performs consistent follow up on open invoices by insurance class utilizing PCS or ATB.
  • Resolves BAR edits within department guidelines.
  • Resolves TES edits within department guidelines.
  • Resolves E-commerce edits within department guidelines Resolves accounts on the No Activity Report Resolves accounts on the AES reports.
  • Researches and resolves insurance denials through written appeal, telephone call, web based adjudication system, charge correction or write off request.
  • Charge correct billing and coding data elements in GE/IDX.
  • Enters charges accurately and timely, ensures charges are balanced and reconciled within department guidelines.
January 2014 to April 2015
Company NamePatient Account Rep III
  • Performs consistent follow up on insurances such as Medicare, Medicaid, & BCBS payers.
  • Reviews unpaid accounts to determine status and take appropriate action to ensure payment.
  • Contacts payers via phone, website or correspondence, regarding denials and reimbursement for unpaid accounts.
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  • Review monthly accounts assigned, enter detailed account notes to document activity and action taken.
  • Review and process remittance recommendation and correspondence.
  • Analyze partial payment denials and report recurring denials resulting in slow payments.
  • Utilize uniform collection follow-up procedure based upon payer specific requirements.
  • Ensure claims is in compliance of CPT, HCPCS and ICD9  coding regulations and guidelines as necessary for payment.
  • Answering all customer service billing enquiries promptly and courteously and with quick resolution when possible.
September 2008 to January 2014
Company NamePatient Account Rep III
  • Performs consistent follow up on open invoices from Medicare & HMO plans.
  • AR follows up on rejected claims from Medicare & HMO resolves E-commerce edits within department guidelines & accounts on the EAS reports.
  • Reviewing correspondence/rejections for the pathology billing division, such as charge entry, basic coding, to ensure all charges are screened accurately and entered into the TES billing system, collects from the third party payers based on entries, which appear in accounts receivable reports.
  • Addresses incorrect payments and denials respond to requests in a timely manner.
  • Obtaining the requisitions from the lab and making sure it matches the date with correct billing report.
  • Receives incoming telephone inquiries and other duties as assigned.
May 2008 to September 2008
Company NameMedical Office Assistant
  • Perform work such as but no limited to answering of phone calls, making appt.
  • and confirming Pt's appt.
  • reproduction of forms, preparation of documents for new and old patients, arrangement of referrals and filling out forms to appropriate specialists, verifying Ins.
  • Coverage, Collect payments and co-payments, file management including updating pt charts, Assist the Dr.
  • in all phases of pt care specifically, collect & prepare laboratory specimens, dispose contaminated supplies, preparation & administration of vaccines, inventory of vaccination or any other supplies and perform other administrative duties.
Education and Training
Current
Baltimore Community College

05/05/08
Medix School
City, State
Medical Office Administration
05/07
Chesapeake High School
City, State
High School Diploma
Work History
Company Name
Company Name
Languages
Spanish and English.
Skills
accounts receivable, Administrative Skills, administrative duties, AR, AS/400, basic, billing, billing system, charts, Citrix, communication skills, Oral, CPT, customer service, Database, E-commerce, English, filling, file management, forms, insurance, inventory, law, notes, MediTech, Access, Excel, Power Point, Microsoft Word, Office Administration, pathology, coding, quick, Spanish, telephone, phone, trainer, typing (45 wpm, vaccines, website, written
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Resume Overview

School Attended

  • Baltimore Community College
  • Medix School
  • Chesapeake High School

Job Titles Held:

  • Patient Account Rep III
  • Medical Office Assistant

Degrees


  • Medical Office Administration
    High School Diploma

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