Experience

• 

  Redeem Health Care Medical Systems

  • Baltimore, Maryland Area

  • Billing Manager/Executive Assistant

    • Apr 2018 - Present
    • Baltimore, Maryland Area

    Reviews the medical record to assure specificity of diagnoses and procedures for code assignment that is compliant and provides data and optimal reimbursement for hospital and/or professional charges.Researches and provides education to providers and staff regarding coding and compliance issues utilizing regulatory and medical informational resources.Abstracts information from medical records following established methods and procedures.Identifies problem documents and works with submitting departments to correct errors.Performs coding, abstracting, and documentation audits.Responds to other departments who use coded information, verifies codes and charges assigned by other departments for accuracy. May enter charge information when appropriate.Collaborates with clinical staff, documentation specialists, and physicians to assure accurate documentation to enhance hospital case mix index for data capture and reimbursement.Work with president of the company to increase revenue,ensure all claims are cleanapply for all NPI and medical assistance numbers, maintain accounts receivable and close all open batches timely, ensure each patient is up to date on all authorizations, maintain credentialing with insurance companiesLiaise with superior to make decisions for operational activities and set strategic goalsPlan and monitor the day-to-day running of business to ensure smooth progressSupervise staff from different departments and provide constructive feedbackEvaluate regularly the efficiency of business procedures according to organizational objectives and apply improvementsOversee customer support processes and organize them to enhance customer satisfactionReview financial information and adjust operational budgets to promote profitabilityRevise and/or formulate policies and promote their implementationManage relationships/agreements with external partners/vendorsEvaluate overall performance by gathering, analyzing and interpreting data and metrics

• 

  Total Health Care, Inc.

  • Baltimore, Maryland Area

  • Patient Access Specialist

    • Jun 2015 - Apr 2018
    • Baltimore, Maryland Area

    Collect patients and other responsible party information completely and accurately.Perform pre-registration/registration processes, verify insurance coverage Confirm payer requirement for authorization and follow payer processes /obtain authorizations and notifications Accurately and completely document all information into the EMR and other related systems to ensure maximum reimbursement.Assist patients with completion of the Intake/Consent forms and OMS Obtain all necessary signatures and documentation required by the patients’ insurance plan. Determine the appropriate financial class and/or account type and correctly assign primary and secondary insurance billing status when two insurance plans require coordination of benefits.Enter insurance, demographic and other related information into EMR.Verify patients’ insurance coverage guidelines and principles as well as insurance companies and/or third party’s guidelines. Scan front and back of patients’ insurance cards and other identification and enter into EMR accordingly Collect payments, co-payments as well as deductibles and post receipts accordingly. Determine eligibility of patients for 30-day, 6-month sliding fee scale and maintain file/records on 6-month sliding fee scale patients.Complete daily self-pay log for self-pay patients and obtain appropriate sign-off at the clinic level Track Department of Social Services vouchers and other third party/community payer documentation as well as medical form and submit to Revenue Cycle Manager for billing. Answer phones Provide quality customer service to internal and external customers. Reconcile receipts and prepare point of service collections for bank deposits Create claims within 1 business day for encounters completed by providers Resolve Athena holds related too front end billing edits within 2 business days in accordance with THC’s procedure, standards Follow established downtime proceduresAdhere to company procedures for keeping of cash secure

• 

  ManAlive

  • Executive Administrative Assistant

    • Mar 2013 - Jun 2015

    •Act as Billing/ MCO billing manager when current manger is out• Excellent time management skills, schedule timelines and ensure all deadlines are met• Manage the flow of information between all parties involved• Manage expectations with vendors, clients and internal staff• Fluency in PC platform, MS Office and Meditech, Med iSOFT and HIPPA specific database software• Proficient skills in use of discretion when handling all confidential matters and documentation• Schedule and prioritize highly sensitive issues, problem resolution, maintain high level of confidentiality• Manage incoming/outgoing mail, faxes, filing, shredding management and stock replenishment for office supplies• Screen calls and handle inquiries and support multi-line telephone at front desk when needed•Pull and make available all requested charts.•Sign out and track all charts leaving the file room/ developed a system using color coded out.• Fax out treatment plan placing original in counselors mailbox / copy is filed in the billing file.•Receive and process fax request for past and concurrent treatment record•Receive faxes and deliver to the correct mailbox.•Fill in for receptionist position as necessary and adhere to all receptionist duties as outlined in job description •Authorizations .Review the OMT billing file for changes/corrections. Set up billing files for newly insured patients and new admissions.Remittances/Mail - EOB’s and checks received in the mail are emailed to MedHelp for charge posting into Protomed .Verify benefits of com. ins. patients. Call the ins. plan of newly insured or requests for Intake.MedHelp Liaison – communicate regarding billing and insured patients, information in the Tracker or demographic information in Methasoft. Protomed – Update as needed. Perform EVS checks’-Medicaid- set up new e-Medicaid login assignments.Keep a log of reasonable accommodations every Friday send email notification and maintain a log, Keep track of Fee assessments for Clinical Director

• 

  MedStar Visiting Nurse Association (VNA)

  • Medical record receptionist

    • Jan 2013 - Mar 2013

    Manage the scheduling for the patient home health visitsCreate and prepare files for Clinical staff to ensure that patient info is provided to Nurses and Therapists Screen calls, address inquiries and managed the switchboardLiaison between patients and Clinical staff for any scheduling issues or changes for an agreeable resolution Scheduled conference rooms for health fair events, training, executive meetings for the VP of Operations and sister facility’s Organize patient files prior to passing off to Medical Records

• 

  Johns hopkins Bayview

  • Health Information assistant

    • Sep 2010 - Nov 2012

    • Under limited supervision, responsible for performing a variety of complex clerical and administrative duties for Medical Records.• Responsibilities includes the following: verifying records are received; follow up on missing records; preps documents, scans documents, indexes records to patient and form name, maintains scanner and equipment.• effectively serve the general public, physicians, internal, and external customers

• 

  JCPenney

  • Customer service Team Leader

    • Sep 2006 - Nov 2011

    • Provided excellent customer service, and cultivates customer goodwill to ensure repeat business. • Performed the required cashiering duties to complete the sale. • Handled returns and adjustments within the limits empowered in a positive manner that will build customer loyalty. • Assisted in training new hires and other associates. • Maintained SET-Sell core standards assisted with stock replenishment and stocked counts as necessary.