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.