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Medical Customer Service

Location:
Houston, TX
Salary:
negotiable
Posted:
November 24, 2015

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Resume:

Cynthia Antoine

832-***-****

acsk5b@r.postjobfree.com

Experience:

HSW Financial Recovery LLC 12/2009 - 08/31/2015

Account Manager/Accounts Receivable/High Dollar Collector

Primary Function- Follow Up and Resolve Commercial accounts (20k and above) as it appears in the CUBS queue/ Hi Dollar Collections /Follow up on equipment finance and recovery.

Providing via phone, fax, and email appropriate submission of documents relative to resolving commercial accounts. Making up to 65 outbound phone calls per day to debtors and attorneys in compliance with the provisions of the FDCPA and FCRA. Maintain internal performance standards in order to meet or exceed the monthly goal objectives of a personal and departmental budget. Negotiate and settle commercial accounts in adherence with the HSW guidelines. Create and maintain Payment Plan accounts.

HCA Houston Shared Services 10/2004-12/1/2009

Patient Account Representative\ High Dollar Collector

Primary Function - Follow up on Commercial Insurance claims as it appears in Artiva queue via

various web links, phone, faxback. Ensure processing of medical claims with 30/60/90 day age .

Maintained quota of 125 outbound phone calls per day to both insurance companies and patients.

Providing via phone or fax appropriate submission of any data

needed to process claims for consideration or reconsideration of reimbursement.

(Tx and La Medical Facilities)

Ensure both In Network and Out of network claims are processed

and appropriate reimbursement is obtained as well as contractual

discounts are applied and Patient balances are billed to the patient

Responsible for verification, preparation,, and follow up of claims

eligible for reimbursement under the Veterans Millennium Act.

Responsible for follow up on accounts greater than 10k

Competent in both the Legacy and Artiva Collections System/Software

Wilson D. Lynch M.D. 10/2000 -03/2003

Office Manager

Initially hired as a billing clerk promoted to Office Manager within 90 days

*Accurately and efficiently billed all Primary, Secondary and Tertiary, medical claims Both EFT and paper.

*Processed all Hospital Admissions, Pre-certifications and Pre-authorizations

*Accurately processed all Medicare, Medicaid, HMO, PPO, Workers Comp, and Patient statements

*Processed all mail keeping with policy of same day denials to be appealed or forwarded for reprocessing

*Maintained all provider contracts, keeping with currency of licensing and any business correspondence

*Collections and Appeals

*Handled over 40 inbound and outbound calls daily

Doctors Hospital 01/2000- 10/2000

Collections Specialist (Patient Account Representative)

*Responsibilities included running bi- weekly reports on all commercial insurance and Workers Comp accounts with 30/60/90 day balances. Worked these accounts as they would appear in the Kearns(computer data system) queue until they were zero balances

*Handled over 40 inbound and outbound calls daily

GoldStar EMS 02/1999- 01/2000

Billing specialist/ Data Entry/ Old Money Committee Member / Quality Assurance

Initially hired as a data entry and billing clerk. Within 6 months promoted to Quality Assurance run sheet coder, and Old Money Committee member (Legacy Collections)

*Accurately coded and entered up to 100 ambulance claims per day

*Worked and appealed over 70 aged claims\accounts per day, both paper and electronic

*Collections

American Medical Response 05/1995-12/1998

Dispatcher/Medical Billing Specialist/ Customer Service Representative/Collector

Initially hired as a dispatcher. Transferred to Billing department within 6 months. After one year of filling and appealing all Medicaid and Lone Star claims was promoted to Senior Billing Specialist, worked on the team which was responsible for all the data entry. Worked closely with Clinical Department to assure run sheets were acceptable for coding and medical necessity was documented as keeping with Medicare/Medicaid guidelines. Promoted to the team responsible for ECF (working rejection reports)

Patient Balance Collector

Ambulance Providers 02/1990-12/1992

Dispatcher/Medical Billing Specialist/ Accounts Receivable

Dispatcher /Front Desk /Billing /Collections for the VA contract

Certifications

National Academy of Emergency Medical Dispatch Port Arthur, TX -1995

Certified Emergency Medical Dispatcher

American Medical Response Port Arthur, TX -1995

CPR-Pre arrival Instruction \Medical Terminology

American Medical Response Port Arthur, TX - 1997



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