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patient accounts coordinator resume example with 9+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Professional Summary

Driven business professional aiming to leverage a proven history of managing competing priorities and completing diverse business responsibilities with accuracy and efficiency demonstrated over 12 years in similar roles. Eager to fulfill an Airport Operations Officer role to bring immediate value to the City of Charlotte and Mecklenburg County.

Skills
  • Operational Efficiency
  • Process Optimization
  • Office administration
  • Customer Relations
  • Financial administration
  • Scheduling
  • Workflow planning
  • Documentation and control
Work History
Patient Accounts Coordinator, 02/2016 to Current
Spectrum Health Systems, Inc.Methuen, MA,
  • Provides customer service support for providers and patients concerning benefits policies, claims, inaccurate and incomplete information.
  • Obtains thorough understanding of benefits and plans to communicate policy information clearly and concisely to policyholders.
  • Investigates and resolves discrepancies and issues regarding ICD-9 and CPT codes on behalf of providers and patients.
  • Performs accounts payable and receivables tasks, including verifying transaction data, calculating charges and refunds, emailing invoices, resolving denied claims, submitting appeals, and identifying delinquent accounts and incomplete payments.
  • Generates financial reports, then analyzes trends and summarized account data for payer-provider representatives.
  • Resolves account discrepancies by investigating account data, documentation, then stop payment processing or make necessary adjustments.
  • Conducts vendor analysis reports and performed routine audits on aging reports.
  • Processes insurance claims and followed up with agencies concerning denials or payment delays.
  • Adheres to all applicable internal and external policies and guidelines concerning client confidentiality and HIPAA regulations.
  • Manages billing and insurance follow-up on all Medicaid claims through Encompass (Epic) Revenue Application.
  • Establishes and maintains professional relationships with healthcare providers regarding medical plans, insurance claims, and insurance benefits.
  • Checked claims for errors, corrected issues and mailed out promptly
  • Run statements each month to review outstanding balances and identify accounts in need of collection processing
Senior Claims Examiner, 01/2012 to 08/2015
Sedgwick Claims Management Services, Inc.Lexington, KY,
  • Reviewed and investigated more than 100 claims per day, including contractual provisions and authorizations, according to internal policies and procedures.
  • Performed auditing and handling specific claims and appeals, including processing claims when applicable, tracking, documenting, and reporting findings.
  • Identified discrepancies and improved departmental performance by support quality and production goals.
  • Answered high-volume of incoming customer calls regarding claims processing, documenting claims, and associated history.
  • Evaluated data to validate claims, verifying policyholder information, policy effective date, premium status, and verification of claim eligibility.
  • Investigated complex claims and determined level of resolution, advised claimant of status, and assisted with negotiating settlement and resolution of claims.
  • Identified missing data and contacted appropriate party or source to obtain needed information.
  • Verified beneficiary or claimant information, then identified payment amount amounts and requirement management approvals to process payments.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
Compliance Manager, 01/2011 to 01/2013
Arena Investors LpMiami, FL,
  • Developed and oversaw control systems to prevent operational violations of legal guidelines and policies.
  • Collaborated with key leadership to evaluate efficiency of operational controls and developing strategic action plans for improvement.
  • Generated reports and evaluated procedures to identify risks and non-conformity issues, modifying and implementing company policies to boost compliance.
  • Partnered with executive leadership, HR personnel, and other stakeholders to identify compliance issues monitored enforcement of organization standards, policies, and regulations.
  • Reviewed colleagues work and performance to identify compliance concerns and coordinated with management to improve compliance training.
  • Reviewed customer issues, company processes and all other operational areas to check compliance
Social Worker, 01/2011 to 12/2011
Lifepoint HospitalsGallatin, TN,
  • Performed direct service and support to clients, providing consultations, leadership, and educational functions for clients, and families.
  • Responsible for promoting client-centered care and supporting clients' financial needs and providing support and crisis intervention when needed.
  • Facilitated patient's continuum of care and identify, address, and resolve barriers and obstacles that interfere with patient's ongoing care plans.
  • Reduced clients admitted to institutional care by 20% over 7 month timeline to help people live as independently as possible.
  • Developed workable solutions for recurring problems for individuals and families
Education
Bachelor of Arts: Social Work, Expected in 05/1997 to Temple University - Philadelphia, PA
GPA:

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Resume Overview

School Attended

  • Temple University

Job Titles Held:

  • Patient Accounts Coordinator
  • Senior Claims Examiner
  • Compliance Manager
  • Social Worker

Degrees

  • Bachelor of Arts

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