Objective: I am seeking an opportunity wherein my vast knowledge and skills in the business

aspect of the medical industry as well as my excellent customer service experience are fully

utilized to further the goals of the organization in where world class patient care is the norm.

Experience

2007 – Current Piedmont Medical Care Corporation, Atlanta, GA

As a Piedmont Medical Care Corporation employee, I have had increasing

responsibilities throughout my tenure. My work experience is as follows:

Hospitalists Revenue Cycle Representative – 2011

Responsibilities include but are not limited to: Maintaining AR follow- up of 50+ Hospitalist

Physicians; Follow-up on all commercial and government claims including Medicare, Medicaid

as well as Government HMO; Timely and efficient resolution of unpaid accounts for 4 hospitals;

Maintaining quality and productivity standards set for the Specialty Department; Reviewing and

modifying initial filing claims; Reviewing and correcting payor specific denied claims assigned

in queue; Identifying and reviewing billing trends department manager; Reconciling patient

accounts via adjustments; Charge entry, training, supervising and maintaining quality and

support for other team associates; Transition to new Epic system since August 2012.

Significant Job Achievements: Obtained and secured substantial one million dollar plus

payment for the Hospitalist program for the first time in the programs history.

2008-2011 Transplant AR Follow-up Specialists

Solely responsible for the A/R of 13 multi-organ Transplant Surgeons and Specialty physicians;

Reviewed coding denials for appeals with Surgeons to attain medical record specific coding;

Reexamined and resolved high dollar denials to ensure increase of monthly revenue; Assisted in

other aspects of AR such as payment posting, bad debt, charge entry, customer service, write

offs, eligibility, surgical benefits, online and phone verifications; Monthly review of A/R and

RVU’s.

2007-2008 Patient Financial Services Collector

Determined medical assistance needs; Set-up payment arrangements with customers; Assisted

patients in identifying available insurance benefits and other assistance; Updated patient account

records to identify actions taken on account; Worked with patients and guarantors to secure

payment on outstanding balances; Reconciled patient accounts via adjustments; Responsible for

conducting sensitive financial interviews with patients and/or their representative; Advising

patients of financial obligations to the institution; Initiating referrals to a hospital social worker

and/or the appropriate public assistance agency: Assisted patients with interpretation of rules,

regulations and policies governing programs such as Medicaid income requirements; Obtained

appropriate signatures on a variety of forms.

2012 – Current North Side Hospital, Atlanta, GA (Part-time)

Financial Counselor Emergency Department

Assisting patients in understanding of insurance, Medicare, Medicaid and the various other

forms of healthcare coverage; Help patients and/or responsible party coordinate financial

obligations; Involved with patients throughout their hospitalization to assist them in

understanding the financial picture and to develop solutions to meet financial responsibilities

when necessary; Secure and collect payment at point of service.

2006 – 2007 Emory University, Decatur, GA

Financial Authorization Specialist

Duties included but were not limited to: Financial clearance for patient appointments;

Reconciling patient accounts; Demographic data entry.

2005 – 2006 Staten Island Hospital - Staten Island, NY

Medical Biller

Responsibilities included: Inpatient commercial and government claim follow-up; Insurance

and patient collections; High dollar insurance appeals; Monthly patient account

reconciliations. Heavy patient and insurance company contact.

2001 -2003 Mt Sinai Hospital – New York, NY

Financial Specialist

Responsible for: Outpatient claim follow-up, collections; Insurance appeals; Monthly account

reconciliation; Insurance and patient account adjustments; Surgical coding and billing; 3rd

Party payment posting: Patient demographic entry. Knowledge of ICD 9/CPT, contact with

insurance companies to ensure accurate and timely payments. Patient demographic entry.

Third party payment posting.

1999-2001 Seaport Orthopedics – New York, NY

Assistant Billing Manager

Responsible for: Surgical billing and coding; Charge entry; Payment posting; Account

reconciliations; Serving as liaison between staff and management; Patient financial collection;

Outpatient claim follow-up; Monthly trial balances; Arranging and implementing patient

payment plans; Quality control.

1997 – 1999 Bridge Island Associates - Staten Island, NY

Assistant Billing Manager

Duties included but not limited to: Billing and coding for Emergency Department, Obstetrics

and Gynecology, Anesthesia, Primary Care Physicians, and Pain Management: Charge entry;

Payment posting; Claims adjudication; A/R Follow-up and appeals; Quality Control;

Monthly review of staff accounts; Serving as liaison between staff and management.

Education

Medical Assistant Diploma (Certification)

Mandell of Allied Health

New York, NY 10036

Capella University

Online Campus

Anticipated Graduation date: 01/2015

Software Expertise:

Microsoft Office 2007 & 2010, GroupWise, Nextgen: EPM & EHR, EPIC, Navicure,

Navinet, Star HBOC, Teleresults, Sunrise Quest/SCM, Filebound, Meditech, Clinical

Browser, Ingenix Encoder Pro, Medix, Citrix, Internet, Data Entry 10key, 60 wpm typing,

PCN, SMS, Medical Manager 8.0-9.0, Express Bill, Availity, Financial Tool Estimator, Image

Now Indexing.

Regulatory Experience

NCQA, JCAHO, OSHA, HIPAA, CAQH, Fair Debt and Credit Act

Professional Environment

Multi-Organ Transplant, Orthopedics, OB/GYN, Endocrinology, Intensivist, Nephrology,

Hepatology, Internal Medicine, Dermatology, Podiatry, General Surgery, Hospitalist, Workers

Compensation.

Contact this candidate