Experience

Vericle- Now A Part of ClinicMind
• United States
• Medical Practices
• 1 - 100 Employee
• SWAT Analyst

  • Apr 2022 - Present


Sourcefit

• Philippines
• Outsourcing/Offshoring
• 300 - 400 Employee

• Medical claims biller

  • Mar 2021 - Mar 2022

  ● Perform as a practice expert at the department on all issues relating to billing and intake processes. ● Updating cash spreadsheets, and running collection reports. ● Checking each insurance payment for accuracy and compliance with contract discount and calling insurance companies regarding any discrepancy in payments if necessary. ● Following up on unpaid claims within standard billing cycle timeframe. ● Prepare and submit billings to insurance companies or other payers ● Serves and protects the clinical community by adhering to professional standards, hospital or clinic policies and procedures, federal, state, and local requirements and standards. ● Identifies root causes of insurance denials, sends appeals to payors, and strives to minimize lost revenue. ● ADDITIONAL SKILL: Knowledge in charge entry and payment posting position. Show less



Optum

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Claims Specialist

  • Dec 2017 - Mar 2021

  ● Responsible for working with claims, Reconciling carrier submissions, edits, and rejection reports. ● Follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO ● Respond to questions and complaints from insurance companies about the claims. ● Follow-up on late or missed payment notices ● Update and review all accounts to keep records of payments up-to-date ● Work with personal information and maintain patient confidentiality ● Review referrals and authorizations ● Follows up with insurance company on unpaid or rejected claims. Resolves issue and re-submits claims. ● Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany appeal. Show less



Teleperformance

• United States
• Outsourcing and Offshoring Consulting
• 700 & Above Employee

• Provider Service Representative

  • Apr 2016 - Dec 2017

  • Provides eligibility, benefit and claims information • Ensures that all provider inquiries are addressed accordingly. • Maintain good customer-provider relationship • Work with patient confidentiality. • Provide accurate benefit information based on the patient’s plan. • Provides eligibility, benefit and claims information • Ensures that all provider inquiries are addressed accordingly. • Maintain good customer-provider relationship • Work with patient confidentiality. • Provide accurate benefit information based on the patient’s plan.