ROSE M. SARIKAYA

**** ******* **** ****

Frisco, Texas 75033

214-***-****

E-mail: acfltt@r.postjobfree.com

* *********:

SUNY- Alfred College of Technology Associate in Applied Science, AOS

Alfred, NY

May 1996

EMPLOYMENT HISTORY:

Insight Global

Frisco, TX

Temporary - Accounts Receivable Representative

July 1, 2013

to June 1, 2014

Conifer Health Solutions - Ambulance billing

Rural Metro Corporation - Responsibilities consists of contacting insurance

companies regarding outstanding claims. Appeal claims with all necessary

information (medical records, itemized statements, EOB's) requested by the

insurance companies to process claims. Identifying and documenting

insurance denial trends and issues as they arise.

Maintain a system to ensure timely follow-up is completed for each

outstanding claim.

Working closely with all outside agencies contracted with the patient,

assisting them with account resolution.

Performs accounts receivable reimbursement analysis and denial management

activities for assigned payors using monthly aged account and A/R reports.

Maintain status reports consisting of outstanding accounts assigned.

Documenting report according to patient accounting department policies and

procedures.

Pediatrix Medical Group, Inc

Richardson, TX

Collections Administrator II - Cardiology

May 2012 to

December 2012

Responsibilities includes - Telephone contact with commercial and

government payors for resolution to claims not paid or claims not paid

according to plan benefits. Submit written appeal for denied claims

according to contract along with medical records, and all requested

documents. Identify billing and collection practices that are inconsistent

with contractual agreements and government regulations.

Follow-up on unpaid/unresolved account balances, including claims rejected

electronically, EOB denial and working A/R aging reports as directed.

Reviews and researches insurance correspondence and make necessary

corrections to ensure claims payment.

Assists with credit balance resolution, review EOB's for proper

reimbursement.

Prepare adjustment and write-off request as necessary.

Resolve electronic claim rejections and complete re-bill request as

necessary to facilitate timely filing and proper claims payment.

Researching problems with out of network collections and appeal denied

claims with necessary documentation.

Med3000, Inc

Plano, TX

1 Accounts Receivable Specialist - Primary Care

January 2009 to May 2012

Health Texas Provider Network - Follow-up and review patient accounts for

discrepancies, conducts direct telephone communication with third party

payors according to policy and procedures until there is no balance or the

account is turn over for collection. Submit written appeal for denied

claims according to contract along with medical records, and all requested

documents. Provide verbal and written instructions to the practice

representatives on issues involving daily claim processes.

Follow-up on unpaid/unresolved account balances, regular contacts with

government and commercial payors for resolution to claims.

Perform claim appeals as require, resolves and documents patient issues and

communicates more complex issues to department manager.

Resolve electronic claim rejections, review EOB in an efficient and timely

manner and act on appropriate denials.

GE Healthcare

Plano, TX

Accounts Receivable Representative

January

2008 to January 2009

Health Texas Provider Network - Duties consist of follow-up on commercial

and governmental payors. Reviewing insurance payments to verify that the

insurance companies are paying according to the fee schedules, process

insurance tracers, and requests patient and insurance company refunds.

Submit written appeal on denied claims along with medical records,

providing all requested documentation.

Follow-up with insurance payors regarding balance due.

Posts payments and adjustments in accordance with EOB and patient checks.

Worked with supervisor on special projects to obtain reimbursement from

insurance companies.

Business Professional Staffing

Dallas,

TX

Temporary - Administrative Assistant

March

2006 to January 2008

Dallas Independent School District - Responsibilities consists of utilizing

Microsoft Office. Using Oracle Application to assist with invoicing,

requisitions, purchase orders and payroll. Compose correspondence; memos,

graphs, tables and reports for Athletic Directors, and answering extremely

busy telephones.

Interface with vendors/officials regarding payments of their services

rendered for athletic events.

Work in a fast-paced and demanding environment, managing multiple

priorities simultaneously. Provide excellent customer service; support

Management of vendor and athletic official.

1199 National Benefit and Pension Funds/SEIU

New York, NY

System Coordinator -Telnet

September 1998 to January

2004

Create automated solutions for repetitive processes, updating of files

using application software, and provide assistance to staff with

hardware/software operational issues.

Update the member's hours worked into Telnet Application to ensure

continuation of medical benefits.

Provide system maintenance including bimonthly reboots to increase

efficiency, monthly full system dumps, nightly file saves, and

configuration of new CPU's with network software.

Coordinate scheduling, testing and training of all Telnet enhancements and

data conversions.

Manage multiple projects with IS Management regarding System Clean-up and

Special projects.

Process incoming and outgoing eligibility bank reconciliation tapes.

Generate batch scheduled and specially requested reports for all

departments.

SKILLS:

Everest College

Dallas, TX

Medical Insurance Billing & Coding

February 2006

to September 2006

Knowledge of ICD-9, CPT, Evaluation/Management, HCPCS, and Revenue codes.

Experience in payment posting, billing and insurance reimbursement

procedures, including comprehension of EOB.

Claims processing - CMS 1500/UB-92 forms, Medicare/Medicaid and HIPPA rules

and regulations.

Knowledgeable in AS400, Onbase, Nextgen, Vision, Plus Medic, Allscripts and

Microsoft Office, XP Professional, Typing, Customer Service.

Medicare, Medicaid, and commercial payors.

Good organizational, verbal and writing skills, problem-solving, and

attention to detail.

Contact this candidate