Experience

PLATINUM SURGERY CENTER

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

• Billing Specialist

  • May 2018 - Present

  • Ensure all claims are submitted with a goal of zero errors • Verify completeness and accuracy of all claims prior to submission • Timely follow up on insurance claim denials, exceptions or exclusions • Meet deadlines • Reading and interpreting insurance explanation of benefits • Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days • Make necessary arrangement for medical records requests, completion of additional information request, etc. as requested by insurance companies • Respond to inquiries from insurance companies, patients and providers • Regularly meet with account manager to discuss and resolve reimbursement issues or billing obstacles • Perform additional duties as requested by supervisory or management team Show less



UnitedHealth Group

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

• Customer Service Representative

  • Jul 2017 - Jan 2020

  Answer a high volume of monitored calls, an average of 70 calls per day per representative. • Resolve and document customer service inquires on the first call. Inquires may include but are not limited to billing questions, payment plans, payments, patient pricing, re - billing insurance companies, processing adjustments, refunds, bill transfers, mail returns, appealing and filing claims and any action needed to resolve issues. • Maintain tracking log of all escalated patient correspondence, providing status updates to leadership as needed. • Offer the patient the opportunity to take the customer service survey at the end of the call. • Research, troubleshoot and/or partner with others to resolve complex issues and customer complaints. • Evaluate and respond to all aspects of written or received correspondence. • Ask for patient payments and process credit card payments if necessary Show less



Valley Baptist Health System

• Hospitals and Health Care
• 400 - 500 Employee

• Credentialing Specialist

  • Oct 2014 - Jul 2016

  Office Coordinator:• Schedules, organize and maintain minutes for medical staff committees, provide support• Serve as liaison to the medical staff member • Keep track of meeting attendance• Comply and keep track of monthly receipt of monies and deposit of medical staff services funds• Compose/edit any correspondence or special report • Assist the director with other duties as assigned • Organize, prepare and distribute monthly medical staff service meeting • Provide secretarial support at medical staff meetings as required• Utilize resources efficiently and effectively and demonstrate responsibility• Demonstrate good judgment and elevate situations appropriatelyCredentialing Specialist: • Maintain current physician roster• Maintain and ensure that all necessary documents are current and on file• Ensure data entry of all physician information is done on a timely manner • Respond timely to all healthcare verification correspondence and physician referral service inquires• Utilize resources efficiently and effectively • Demonstrate responsibility trough appropriate use of ordering/conservation of supplies• Participate in performance improvement activities as requested• Exhibit good judgment, reasoning and decision-making skills• Maintain confidentiality at all times and follows all procedures relating to privacy and security of information.• Display and promote communication and teamwork amongst the medical staff • Identify problem areas of initial and/or reappointment application process • Prepare written summary, demonstrates good judgment and elevates situation appropriately• Comply with all Tenet and VBHS customer service and mandatory compliance standards. Show less

• Office Coordinator

  • Oct 2014 - Jul 2016



Hospital Physician Partners

• Hospitals and Health Care
• 700 & Above Employee

• Chart Recovery Expert

  • Jul 2013 - Oct 2014

  • Responsible for ensuring that all information required to effectively billed • Complete patient records, Demographic information, Insurance information • Work closely with physicians and mid-level providers to review documentation • Obtain and copy all missing information and send to billing company • Assistant on daily batches sent and total missing records recovered. • Ensure close working relationship and high level of communication with supervisor • Responsible for reviewing charts for completion of documentation Show less



Commercial Metals Company

• United States
• Mining
• 700 & Above Employee

• Sales Administrative Assistant

  • Mar 2012 - Apr 2013

  • Created business documents • Spreadsheets based on research • Responsible for answering customer questions and directing phone calls • Provide administrative support to the members • Prepare expense reports, tracking sales progress, coordinate the submission of proposals. • Created business documents • Spreadsheets based on research • Responsible for answering customer questions and directing phone calls • Provide administrative support to the members • Prepare expense reports, tracking sales progress, coordinate the submission of proposals.



CIGNA HEALTHSPRING

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

• Administrative Assistant

  • Nov 2009 - Nov 2011

  • Maintained the office and ordered supplies for an office of ~30 people.• Responsible for coordinating meetings and agenda for corporate travel needs• Collected and prepared information for projects, meetings and seminars• Interacted with internal and/or external customers to provide information• Help resolve minor problems along with providing solutions for complex issues• Managed physicians’ requests of the HealthPlan• Contracted Physicians to maintain an adequate network• Presented monthly financial data at both the corporate level and physician in network• Provided training for office staff on contracts, policies, and procedures• Managed the contracting process, root cause analysis and resolution of problems • Managing monthly provider visits and calendar of events• Participating in monthly financial review with senior management. Show less

• Provider Relations Specialist

  • Nov 2009 - Nov 2011