Tomeka Hall

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**** ** ** ***** *******, Fl. ***51 - (C) - 954-***-****

acebmn@r.postjobfree.com

CAREER OVERVIEW

An experienced Patient Account Representative with experience in performing a variety of duties requiring a

range of skills and knowledge of Medical Support Service. Possess a strong work ethic and personal commitment to

customer service excellence. Detail-oriented, resourceful discretion problem resolution capability.

Ability to complete tasks in a time manner; while working in a dynamic and fast paced environment.

Computer Technology Knowledge:

• MS Word, Letters, Fax machine, Scanner, DDE, Emdeon, Smart System, Navi Net, Ace System

• Excel, Internet, MediTech System, Trizetto, VI Webb, Star, Care Manager, Share Point, PBAR

Professional Experience:

February 2014 to Present Broward Health/Ideal Personnel Service Davie, FL

Claims Processor

Research and resolve discrepancies on CMS1500 forms into Trizetto system.

Process 8-10 batches print and process, Claims Inventory Listing report daily.

Verify and Update patient’s information process into Enrollee maintenance files.

SMS and Enter codes and verifies data for claim processing.

June 2013 to January 2014 Sheridan Health Corp. /Ideal Personnel Service Sunrise, FL

Patient Registration Representative

Create and update demographic and encounters 80-150 daily.

Update and make corrections to patient’s demographics, patients insurance.

Process and make adjustments; and reconciling accounts.

Post all payments received into the billing system while maintain productivity.

Verify Pull Explanation of benefits and remittance Advice, Complete and process verification forms.

Enter procedure Codes into system electronically.

March 2011 to April 2013 Conifer Health Solution Boca Raton, FL

Support Service Representative/Payment Posting/AR Collections Representative

Verify update and enter patient’s demographics into system on daily basis; Copy, Scan, Sort

and Email, patients insurance updated information.

Research and resolve discrepancies and disputes, Post payments and adjust credits for denied claims .

Verify and Pull Explanations of Benefits remittance daily, Verify Third Party insurance thru portal.

Conducts appropriate account activity on final billed claims by contacting government agencies,

third party payors, and patients/guarantors via phone, e-mail, or online.

Requests additional information from Patients, Medical Records, and others upon request from payors.

Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or

corrected bills as needed.

Recognizes potential delays with payors such as corrective actions and responds avoid A/R aging.

Escalates payment delays/ problem aged account timely to Supervisor .

Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors.

Responsible for maintaining inventory on desks with no backlog.

November 2005 to June 2010 Terra Group

Administrative Assistant Miami, FL

Assisted in all areas of administrative work including data entry, receptionist duties, and

Organize files, research and development.

Managed daily office operations Filing, Faxing, Scanning, and E-mail maintain accurate records,

for all business supplies.

Education: 1994 Miami Edison Senior High School High School Diploma Miami, FL

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