Experience

Comfort Care Home Health

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Intake

  • Apr 2015 - Present

  Intake administrator Intake administrator



Continuum rx

• Reimbursement Specialist

  • 2012 - Jun 2014

  In charge of patient admission process for home infusion pharmacy located in multiple states. Communicates with hospital liaison for new referrals and readmissions. Review medical documentation for valid information regarding billing and ICD 9 coding. Verifies insurance coverage, both online and over the phone. Explains coverage and cost to patients and families. Input all aspects of patient information into CPR plus. Acquires insurance authorizations as needed. Communicates with multiple pharmacist to insure top quality service for patients.



Golden Living

• Intake Administrator

  • 2005 - 2012

  In charge of ten nursing homes in multiple states. Reviewed all admission and readmission documents for completeness, compliance, and reasonableness of information, including MSP screening form and Medicare denial notice. Compiled and maintained admission/financial files. Contacted admission coordinator or agent to obtain missing information and confirm payment source. Provided post-admission guidance to residents/agents about third-party coverage/eligibility and/or general billing procedures. Established resident master file for all new admissions. Updated ICD-9 Codes in AR System.Awarded quarterly bonus for reducing bad debt.Consistently exceeded goals.

• Medicaid Biller

  • 2002 - 2005

  Posted all Medicaid payments to AR System and aging report. Prepared and submitted all Medicaid billing, turn-around documents and claims adjustments, including Medicare/Medicaid crossover co-insurance claims. Identified payment discrepancies and unpaid claims; took appropriate action to resolve balances. Prepared AR adjustments and corrections as needed. Requested LTC9 or LTC4 from facility to get medical approval for Medicaid.

• Business Office Manager

  • 1996 - Jan 2002

  Private, Medicare, Medicaid, Hospice, Hmo, and Medicare secondary insurance billing for a 132-bed nursing facility. Posted cash to AR System and aging report. Reconciled census. Prepared AR adjustments and corrections. Identified and initiated collection action on delinquent private balances. Researched and responded to all billing inquiries and disputes. Provided excellent customer service to families and staff.Received yearly service excellence awards.

• Account Payable

  • 1991 - 1996

  Managed Accounts Payable and Ancillary Input. Stocked central supply. Prepared bank deposits and took deposits to the bank. Posted payments to the aging report.