Experience

Women'sCare

• United States
• 1 - 100 Employee

• Team Lead Collections and Customer Services

  • Aug 2020 - Present

  Responsible for reviewing CPT, HCPCS, and ICD-10 codes for claim prior to getting billed and also reviewing claims after denied. I ensure appropriate procedures and modifiers are apply, identify if codes are bundled. Review CCI edits, PTP and Mue’s when needed. I am in charge of resolving issues that Patients' Account Representatives cannot resolve on their own. Responsible for reviewing CPT, HCPCS, and ICD-10 codes for claim prior to getting billed and also reviewing claims after denied. I ensure appropriate procedures and modifiers are apply, identify if codes are bundled. Review CCI edits, PTP and Mue’s when needed. I am in charge of resolving issues that Patients' Account Representatives cannot resolve on their own.



Womenscare FL

• United States
• Hospitals and Health Care

• Insurance Account Representative

  • Feb 2018 - Aug 2020

  I am responsible for reviewing CPT, HCPCS, and ICD-10 codes for claim prior to getting billed and also reviewing claims after denied. I ensure appropriate procedures and modifiers are apply, identify if codes are bundled. Review CCI edits, PTP and Mue’s when needed. I understand Medicare guidelines as well as federal and state low regulations in medical reimbursement to ensure proper billing.Perform general clerical tasks required to ensure proper business organization, maintaining the confidentiality of all patients information according to federal, state and local requirements. Perform other duties and functions such as adjustments and money movements, insurance verification, verify eligibility



Surgery Partners

• United States

• Financial Account Representative

  • Mar 2015 - Feb 2018

  Financial Account Representative I was responsible for the following tasks: medical collector, insurance correspondence: supporting medical documentation, appealing denial, rejection and/or low reimbursement of claims, reconciliation of billing and payroll reports; medical billing process, coding, insurance regulation and rules by policy and procedure; verifying patient benefit coverage for in-network and out-of-network procedures and provide financial responsibility amount to patients on their out-of-pocket cost; electronic and paper claim submission; insurance follow up; general clerical tasks that were required to maintain an organized and functional business office; maintaining the confidentiality of all patients information according to federal, state and local requirements.



BayCare Health System

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

• Financial Insurance Representative

  • Mar 2011 - Feb 2015

  Financial Account RepresentativeI was responsible for the following tasks: billing data entry, reconciliation of billing and payroll reports; medical billing process, coding, insurance regulation and rules by policy and procedure; verifying patient benefit coverage for in-network and out-of-network procedures and provide financial responsibility amount to patients on their out-of-pocket cost; electronic and paper claim submission; insurance follow up; appealing denial, rejection and/or low reimbursement of claims; general clerical tasks that were required to maintain an organized and functional business office; maintaining the confidentiality of all patients information according to federal, state and local requirements.