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Customer Service Medical Billing

Location:
Las Vegas, NV
Posted:
February 15, 2014

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Resume:

Resume:

MaryEllen O'Donnell

**** ******** *** #**** *** Vegas 89102

702-***-****

***Relocated to Las Vegas Nevada due to spouse employment transfer ***

Patient Account Representative / Denial Analyst / Financial Advisor

08/2013 Present Job Agency (Alls Well)

07/2002 – 07/ 2013 Crouse Hospital Syracuse, New York

Patient Account Rep. / Financial Advisor/ Medicare Specialist/ Substance Abuse Specialist

Job Functions:

Full Charge of all Medicare & Medicaid claims (Inpatient & Outpatient) Correction of Medicare Hic#s, checking for

active coverage, collection letters, customer service with patients. Open Workers Comp files, ESRD dates,

Disabled files, communicating with Medicare Reps. updating the Common Working Files (CWF) for patients.

Adjusting claims/ working them to a zero balance. Spreadsheet of all denials for follow up. Medicare Credit

balance report. Working all Medicare denials and payments. Appeals/ Grievances. Working monthly trends

spreadsheets. Requesting Medical Records. Back up for all commercial insurances, No Fault / Workers Comp.

Also covered for the ER Dept. Prompt Care Dept. and the admitting Dept.

Met with all new clients and obtained proper benefit and eligibility information, set up Medicaid appointments.

Called for copay information, set clients up on sliding fees if need be. Obtained authorization if applicable.

Collections of all clients for their copays and/or their sliding fees required at the time of their visit. Spreadsheet of

all collections. Balancing collections on a daily basis; whether it be cash, check or Credit card payments. Balancing

of daily cash boards. Attended meetings on a weekly basis for the financial end of collections, and Medicaid status

of the clients.

08/2000 06/2002 Health South Sports P.T. Medicare Billing Specialist

10/1992 07/2000 CNY BLUE CROSS BLUE SHIELD CPT Specialist

04/1985 10/1992 Empire BLUE CROSS BLUE SHILED Medicare Specialist

10/1982 03/1985 AT&T Call Center Customer Service / Call Center

EDUCATION:

08/2000 BOCES Vocational Introduction into computers / Excel / Word / Power Point

06/1983 West Genesee High School Science/Math Business & Typing

06/1983 Onondaga BOCES Vocational Medical terminology, Data Entry / Computers

10/1992 CNY BCBS – CPT Specialist / Review analysis

07/2004 Crouse Hospital – Intro. Into Computers, Power point Advanced Excel. Medicare seminars.

CPR Training. HIPPA rules and regulations. Patients’ rights and confidentiality class.

Customer Service communication class. Diversity of patients and family members’ overview class.

SKILLS / CERTIFICATIONS:

Efficient Customer Service. Admitting, Discharge, Collections, CPR Certified, Insurance verifications,

Authorizations, Timely filing, Medical Billing, Medicare Remittances, ICD9 Coding, Accounting, Computer

Knowledge (Excel, Spreadsheets, Outlook, Lotus) SMS, Ivans, McKesson, DDE, EMR, Star. Medicare DRG's,

LTR Days, SNF days, Hospice, Medicare Payments/ Denials, Medicare RAC, RTP T File via Omnipro, Common

Working Files, Medicare Credit balance report, Adjustments, Call Center, Coordination of Benefits, Patient

Accounting, Credit balances, Appeals & Grievances. Problem solving skills, independent starter. Attention to detail.

Collecting of monies / balancing the daily logs. Medicaid rules and regulations.

REFERENCES: Cari McLaughlin (Supervisor) Carol Briggs (Day Care Provider)

315-***-**** 315-***-****

“Lets all work together with positive attitudes and Open minds”

Updated 12/01/2013



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