Management Specialist All Other
Resume:
Taylor
ad5vm5@r.postjobfree.com
Austell, GA 30168
Authorized to work in the US for any employer
Summary
Result oriented with effective communication and presentation skills. Customer focused Team player with
high standards for quality and services. Ability to work independently as well as in-group projects. Extensive knowledge of HIPAA
Work experience
Physician/Hospital Denial Management Specialist •
Orlando Health Orlando Regional Medical Center - Orlando, FL
April 2022 to December 2022
●Navigated Epic software to bill, resubmit and note patients accounts
●Contact insurance company and requests EOB on all denied claims in work queue.
●Reconciled aged accounts with insurance company.
●Performed all other duties as assigned.
Physician/Hospital Denial Management Specialist
Northside Hospital - Atlanta, GA
August 2021 to January 2022
●Navigated Epic software to bill, resubmit and note patients accounts
●Contact insurance company and requests EOB on all denied claims in work queue.
●Reconciled aged accounts with insurance company.
●Performed all other duties as assigned.
Account Receivables Specialist
GoHealth Urgent Care/Remote - Atlanta, GA
January 2020 to September 2020
●Reconciled aged accounts with insurance company.
●Contacted insurance company and requests EOB on all denied claims in work queue.
●Navigated Epic software to bill, resubmit and note patients accounts
●Performed all other duties as assigned.
Denial Representative
Kforce - Allendale, NJ
May 2017 to January 2018
●Review all accounts in Epic and other company software to ensure true denial
●Contact insurance company to confirm false denials and resubmission.
●Send reconsideration and appeals to insurance company for denial reversals
●Conduct daily follow up on claims, reconcile financials on account and adjust according to contractual
● Full knowledge of Medicare, Medicaid and commercial insurance guideline follow up
Third Party Billing Specialist
Community Healthcare Network - Manhattan, NY
December 2009 to December 2014
●Received all insurance EOB denials electronically and paper daily
●Researched and entered all denial codes in eCw from EOB on a spreadsheet for reporting,
●In addition, tagged recurring denied ICD -10 codes for follow up and possible mass rebill
●Contacted insurance company and their manage care on open claims not paid
●Follow up and follow through on all denied claims to ensure timely re submissions on claims that can rebill and adjusted true denied claims with the appropriate adjustment code
Finance Manager
PerScholas - Bronx, NY
May 2008 to December 2009
Received and process all methods of payment from vendors
●Generated all Sales orders and Purchase Orders for shipping
●Created invoices, spreadsheets for financial report and maintained company product database
●Conducted daily and weekly reconciliation for bank deposit, performed other duties assigned
Cash Application Associate
Central Pet & Garden - Mahwah, NJ
February 2006 to March 2007
●Received all methods of payments through lock boxes and mail, then accurately apply them to customer's account
●Assist with credit collection to ensure all accounts are current according to their terms
●Set up all new customer and vendor account with specific terms and method of payments
●Maintain all customer accounts to ensure contact, shipping information and terms are current
●Issue credits for return on damage products, post all NSF checks, create spread sheets for GL logs, research and maintain all manifest and perform other duties as assigned
Logistical Specialist
US Army Reserves - Orangeburg, NY
March 1996 to December 2001
Data entry and computer operation
●Responsible for issuing military Ids and drivers license
●Responsible for issuing and maintaining weapons and gears
●Quality control of military supplies and work closely with the supply sergeant
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