Experience

Currance

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Insurance Verification Specialist

  • Jan 2023 - Present

  January 2023 to Present • Utilize EPIC to run nightly admission reports and FC Census to establish workflow of all out of state and Hawaii homeland patient accounts pending verification insurance/authorization verification • Contact insurances to obtain, claims/appeals information, eligibility/ coverage guidelines and submit for prior authorization along with providing notification of admission for all hospital services within 48 hours of admit • Troubleshoot all insurances responses and registration entries to resolve errors and ensure accuracy of patient/ guarantor account summary and coverage Show less



Aston Carter

• Staffing and Recruiting
• 700 & Above Employee

• Insurance Verification Specialist

  • Jan 2022 - Dec 2022

  Performed benefits verification, prior authorization request and coding review for specialty drugs. Contacted insurance companies to ensure correct in network reimbursement. Processed all incoming documentation in order to maintain accurate records for all patient demographics. Faxed all benefit verification forms to the treating site to ensure accurate patient responsibility. Performed benefits verification, prior authorization request and coding review for specialty drugs. Contacted insurance companies to ensure correct in network reimbursement. Processed all incoming documentation in order to maintain accurate records for all patient demographics. Faxed all benefit verification forms to the treating site to ensure accurate patient responsibility.



HMS

• Argentina
• Telecommunications

• Medical claims auditor

  • Jul 2021 - Dec 2021

  HMS- Pricecenz temp agency Call carriers to ensure Medicaid reclamation claims are received and entered under government tax is for processing. Insurance and authorization verification analysis for all accounts. Updating patient and payer demo daily for quality assurance. Rebilling claims not on file to correct mailing address. Submitting appeals for Cob request and denied newborn claims. Closing previously paid accounts after verifying all payment information. HMS- Pricecenz temp agency Call carriers to ensure Medicaid reclamation claims are received and entered under government tax is for processing. Insurance and authorization verification analysis for all accounts. Updating patient and payer demo daily for quality assurance. Rebilling claims not on file to correct mailing address. Submitting appeals for Cob request and denied newborn claims. Closing previously paid accounts after verifying all payment information.



Medix™

• United States
• Staffing and Recruiting
• 700 & Above Employee

• Medical Revenue Cycle Analyst

  • Jan 2021 - Jun 2021

  UT Southwestern Medical Center Performed AR follow up, billing analysis, insurance/authorization verification, appeals and account auditing, identified trends and billing errors in order to boost revenue. Fresenius Medical- Medix temp agency April 2021-July 2021 Medical Revenue Cycle Analyst Ran A/R reports daily from Athena to review outstanding balances. Worked with payers to verify Medicare coverage and submit claims for payment. Submitted appeals for incorrect denials for revenue coding. Adjusted claims for the auditing reasons in the system. Followed up on unposted payments by researching check information and cashed status to reconcile all accounts. Billed non covered claims to self pay while providing customer service for patients regarding summary of benefits and payment arrangements for patient responsibility. Show less



North Texas Therapy & Home Care

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Billing Coordinator

  • Jan 2020 - Dec 2020

  • Performs insurance and authorization verification for pediatric therapy services. • Responsible for creating all invoices and processing payments to manage self-pay accounts. • Analyzes A/R daily to request reimbursement, submit adjustments and identify aging. • Posts all manual/electronic checks and request eob’s to reconcile open balances. • Researches rejections, denials and bills all assigned insurances on a weekly a basis. • Drafts all appeals/disputes to resolve all overpayment and underpayment issues. Show less



Axxess

• Media Production

• Revenue Cycle Specialist

  • Jul 2019 - Dec 2019

  • Contacted insurance companies to reprocess OON claims as INN to ensure account are paid at the highest benefit level. • Verified gaps, waivers and authorizations to rebill claims within a timely manner • Collected payments from patients for deductible, coinsurance and copay balances • Identified aging AR as uncollectable to submit write offs and confirm payor updates • Confirmed all submitted appeals and reconsideration request to dispute open balances • Corrected coding errors by researching LCD compliance rules and NCCI edits to provide quality assurance of all accounts • Entered all EDI and ERA enrollments for billing agencies Show less



Aveanna Healthcare

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Cycle Specialist

  • Jan 2017 - Jun 2019

  • Analyzed denial reports, billing rejections, $0 pays and payor contracts to ensure compliant billing of medical accounts. • Submitted formal appeals in order to dispute/request reimbursement. • Traveled to oversee transition of full revenue cycle processes and procedures. • Identified coding, credentialing and charge entry errors to decrease aging of outstanding AR • Utilized clearinghouses to upload, bill and crosswalk codes for autism services. • Transferred and billed all secondary claims • Researched unposted payments, posting errors, debits/credits, recoupments to resolve all accounts. • Worked with patients to set up payment plans, process credit card payments and obtain insurance information. Show less



Seconds and Surplus Building Materials

• Wholesale Building Materials
• 1 - 100 Employee

• Jr. Buyer

  • Jan 2015 - Dec 2016

  • Provided pricing and inventory analysis before placing all stock, special and internet orders for each location to ensure quality control. • Assisted AP/AR department with invoice/pricing discrepancies, journal entries, credit memos and accounting reports. • Assisted installation department with new construction and interior design billing. • Provided pricing and inventory analysis before placing all stock, special and internet orders for each location to ensure quality control. • Assisted AP/AR department with invoice/pricing discrepancies, journal entries, credit memos and accounting reports. • Assisted installation department with new construction and interior design billing.



Auto nation CBO

• United States
• Information Technology & Services
• 1 - 100 Employee

• Loan Analyst

  • Jan 2014 - Dec 2014

  • Balanced company credit line by entering journal entries into ADP for all dealership accounts. • Contacted account managers and financial analyst to process charge backs, reverse transactions, update payment information and process corrections. • Generated audit reports to calculate, verify and document all vehicle information. • Balanced company credit line by entering journal entries into ADP for all dealership accounts. • Contacted account managers and financial analyst to process charge backs, reverse transactions, update payment information and process corrections. • Generated audit reports to calculate, verify and document all vehicle information.



Provista

• Croatia
• Advertising Services
• 1 - 100 Employee

• Item master analyst

  • Jan 2013 - Dec 2013

  • Maintained accurate pricing and descriptions for all surgical/hospital equipment invoices. • Produced follow up reports including negotiated pricing factor, medical equipment usage and sales for all vendors. • Scrubbed and billed over 400 medical items per day via internal billing systems. • Maintained accurate pricing and descriptions for all surgical/hospital equipment invoices. • Produced follow up reports including negotiated pricing factor, medical equipment usage and sales for all vendors. • Scrubbed and billed over 400 medical items per day via internal billing systems.