Experience

GATEWAY FOUNDATION, INC.

• United States
• Mental Health Care
• 1 - 100 Employee

• AR Representative

  • Sep 2021 - Present

  Review and investigate discrepancies such as denied claims, missing or short payments, or past due accounts. Complete re-billing for all rejected or claims that needed to be corrected by updating the REV or procedure codes, or add the proper modifier and submit the claims to the proper payer. Review EOB and EOR for the payment received form the insurance companies and verify that the charges are posted correctly and funds are moved to the patient's responsibility according to the fee schedule and EOB. Submit Appeals along with medical records and any proof showing the service were approved for payment and we were advised that the service was a part of the patient policy as well as the reason why we are requesting to provide this service. Show less



Mercy Hospital

• Medical Biller

  • Jun 2020 - May 2021

  Entered charges for professional billing of claims for work that was performed by a physician or other healthcare professionals. Compile, sort, verify, and correct client data. Entered data and charges through the careful review of resources provided by the physician. Researched denied claims by identifying the root causes of insurance denials. Submitted corrected claims and appeals to be reprocessed for all commercial payers. Entered charges for professional billing of claims for work that was performed by a physician or other healthcare professionals. Compile, sort, verify, and correct client data. Entered data and charges through the careful review of resources provided by the physician. Researched denied claims by identifying the root causes of insurance denials. Submitted corrected claims and appeals to be reprocessed for all commercial payers.



US Tech Solution Temp Agency/North Western Hospital,

• Chicago, Illinois, United States

• Financial Assessor

  • Nov 2019 - Jun 2020

  Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation. Made sure that quality standards were met in timely resolution of all claim edits. Made outbound calls to insurance companies to ensure claims met medical necessity for reprocessing. Made sure the appropriate responsible party was billed in the correct order. Worked timely follow-up and collection of third party payer receivables. Worked denials and appeals to overturn denials for payment resolution. Follow-upped with third party payers regarding outstanding accounts receivables. Show less