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senior patient access representative resume example with 14+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

Results driven Medical Biller with over 20 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation.

Skills
  • Administrative and Office Support
  • Registration and Scheduling
  • Database Search and Data Entry Skills
  • Evaluating Quality of Care
  • Organized and Detail-Oriented
  • Helpful and Service-Oriented
  • Appointment Scheduling
  • Financial Procedures Adherence
Experience
08/2018 to Current Senior Patient Access Representative Eastern Connecticut Health Network | Watertown, CT,
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Verified demographics and insurance information to register patients in computer system.
  • Organized and maintained records by updating and obtaining both personal and financial information from patients.
  • Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information.
  • Communicated financial obligations to patients and collected fees at time of service.
  • Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
  • Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
  • Optimized provider time and treatment room utilization with appropriate appointment scheduling.
  • Verified patients' insurance and payment methods during admissions or check-in processes.
  • Collaborated with clinical and administrative staff to meet patient needs.
  • Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
  • Received patient inquiries or complaints and directed to appropriate medical staff members.
07/2012 to 08/2018 Medical Reimbursement Specialist Select Medical Corporation | Atlantic City, NJ,
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Corrected, completed and processed claims for payer codes.
  • Processed refund requests and reconciled deposit and patient collections.
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Managed all payments processing, invoicing and collections tasks.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Processed invoice payments and recorded information in account database.
  • Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Checked claims coding for accuracy with ICD-10 standards.
03/2010 to 07/2017 Patient Billing Representative 1960 Family Practice | City, STATE,
  • Coordinated communications between patients, billing personnel and insurance carriers.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Input details into accounts and tracked payments.
  • Handled billing, waivers and claims for private and commercial clients.
  • Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
  • Organized information for past-due accounts and transferred to collection agency.
  • Answered customer questions to maintain high satisfaction levels.
  • Managed all payments processing, invoicing and collections tasks.
  • Collected, posted and managed patient account payments.
09/2008 to 02/2010 REIMBURSEMENT OPERATIONS SPECIALIST UT Physicians | City, STATE,
  • Posted charges, payments and adjustments.
  • Confirmed patient demographics, collected copays and verified insurance.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Meticulously tracked and resolved underpayments.
  • Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
  • Prepared and submitted claims to insurance companies electronically and manually.
  • Determined customer eligibility for benefit programs and services.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Completed appeals and filed and submitted claims.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Verified proper coding, sequencing of diagnoses and procedures.
Education and Training
Expected in 11/1997 to to GED | HISD, Houston, TX, GPA:
Languages
Spanish:
Native/ Bilingual
Negotiated:

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Resume Overview

School Attended

  • HISD

Job Titles Held:

  • Senior Patient Access Representative
  • Medical Reimbursement Specialist
  • Patient Billing Representative
  • REIMBURSEMENT OPERATIONS SPECIALIST

Degrees

  • GED

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