Customer Service Credit Balance

TESIA HARBOUR

**** ***** *** **. 346-***-****

ad5c3n@r.postjobfree.com

I am a friendly, loyal, and clearly dedicated individual who has an ambition to succeed in an environment where my experience and skills are coupled with my degree of motivation. I am seeking a position where I can use my education and training while giving my best to an employer.

EXPERIENCE

SEPTEMBER 2013-CURRENT

COLLECTION SPECIALIST, VILLAGE HEALTHCARE

Obtaining pre-authorization for scheduled surgeries and inpatient stays

The insurance collection process includes initial payment, payment validation whether over or under paid, appeal/overturn denied claims, and credit balance resolution. Responsible for key performance indicators, including days in AR, AR greater than 90 days, cash collections compared to goal, denial recovery rate, avoidable write-offs, and days in credit balance.

Review medical documentation to insure proper submission of claims with proper diagnosis and CPT/HCPCS codes.

AUGUST 2018-2023

REIMBURSEMENT SPECIALIST LEAD, AMD GLOBAL

Resubmitting clean or corrected both CMS 1500 and UB04 claims based on the

processing of the claims or any correspondence needing additional information.

Work closely with the business owner and director to identify any trends and formulate a plan of action.

Create spreadsheets to analyze aging reports and remittance for a better understanding of money being collected.

Able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a stressful environment with constant work-related interruptions. Professionalism and courtesy when communicating with patients and other external contacts, primarily by telephone, displaying an attitude of proven, committed customer service as well.

JANUARY 2017-AUGUST 2018

INSURANCE FOLLOW-UP REPRESENTATIVE, ACCLARA

Under the supervision of the Business Office Supervisor ensures the efficient operations and effective reimbursement of third-party account receivables by researching accounts, re filing or appealing claims, submitting additional medical documentation, and tracking account status by monitoring and analyzing assigned unresolved third-party accounts.

I conducted all duties in accordance with industry federal and state billing and

contractual obligations and in compliance with department policies and procedures. I demonstrate dependability and an ability to work independently.

EDUCATION

JANUARY 2014

MEDICAL BILLING, TEXAS SCHOOL OF BUSINESS

2000-2004

DIPLOMA, KLEIN FOREST HIGH SCHOOL

SKILLS

Hospital in and out of network collections

Knowledge of medical and insurance terminology

Problem solving

Customer Service

Experience in preparing appeals for denied and underpaid claims

Resubmittal, payments, and adjustments

Management

Filing/Data Entry

Pre-Authorization for services

ACTIVITIES

Love to volunteer and feed the homeless and give back to my community while putting a smile on others face.

KEY SKILLS

ICD-9 AND ICD-10 Coding

CPT/HCPCS Coding

Recovery and Appeals

Microsoft Office

40+ WPM

EPIC, MEDHOST, COLLABORATE, STRATIQ, WAYSTAR, ECW, TRUBRIDE, and EVIDENT

Contact this candidate