LILLIAN S. REINDORF-ADDO 703-***-**** ©

***** ***** ***** ***** #**

Centreville, VA 20121 adjpe1@r.postjobfree.com

Objectives:

To obtain a challenging position in a healthcare organization that allows me to utilize my

Background education and my professional experience to succeed the organization

Mission and vision.

Skills Profile

Oracle: Research batch numbers and pull reports..

Xacti Med (Med Asset Revenue Solutions): pull EOB’s of different payers,

Emdeon: Pull EOB of different payers, patients information in order to post in Epic

Computer Software:

Proficiency in EPIC, Microsoft office and Outlook

.

EDUCATION

Everest College –Medical Insurance Billing and Coding

Northern Virginia Community College-Associates in Computer programming

University of Science and Technology-Bachelor of Science in Information System

Current Department:

Ambulatory/Billing Department

From 3/15/2017 to Present

As Physician Insurance Analyst 2

Duties

The position performs the following duties:

Able to perform all duties of a physician insurance analyst 1.

Responsible for the timely and accurate editing, submission, and/or

Follow up of assigned claims, while meeting the expected productivity and quality standards on a weekly basis.

Able to process claims for at least two payer types (Commercial,

Managed Care, Blue Cross.)

Assure all assigned claims meet clearinghouse and/or payer processing criteria.

Assure timely processing and transfer accounts for write off and

Adjustments.

Payer response reports and rejection reports are worked timely and

Meet Departmental Productivity and Quality Review standards.

Assure appropriate and timely documentation of all account activity.

Correspondence is handled appropriately.

Complete all EPIC billing/claim edits and insure all required reports are filed timely and accurately.

Identify opportunities for revenue cycle performance improvements to management team.

Work experience:

Valley Health

11/2012 – 3/2017 Valley Health Winchester, VA

Medical Biller

Work directly with the insurance companies, healthcare providers, and patients to get claims process paid.

Review and tracked claims, appealing unpaid, denial and pending claims

Handles collection accounts and by performing account review follow up

Managing accounts receivable reports and highlight problem account

Sort, verify in the epic and distribute.

Review and manage correspondence especially the checks, to find out whether it is HB

Payment PB Payments, or self-pay from epic.

Request payments when appropriate by send follow up letters requesting for

Explanation of benefits.

Follow up by calling and answering of inbound telephone calls.

Resolution of billing problems and inquiries by patients, physicians, attorneys,

Insurance companies by calling to find out the account accurate information

Needed.

Management of accounts with payments and reconciliation of account residing

With third party agencies.

Research information with third party payers, physician’s offices, health

Information management department and other hospital’s departments.

Payment posting for physicians (PB) and Hospital (HB), base recovery and

Electronic posting of remittance and fixing errors in epic.

Providers level adjustment (PLA’s) for Medicare, Geha and balance out

Batches and close them in oracle.

Patient refund in either HB (18 and 35) for overpayments, distribute and

Transfer payment from one account to another.

Check for accurate payments by reading explanations of benefits by insurance

And self pays if the right amounts were paid. And if not forward to the posters for

Posting on the various accounts.

Epic: posting payments of HB and PB in epic.

10/2010- 11/2012 Annandale Family Medicine Annandale, Virginia

Medical Billing/ Reimbursement Specialist

Answered multi-line telephone and took messages and computer data entry

Perform primary and secondary verification of eligibility and claims and status

Corresponded with patient and insurance companies concerning balances

Retrieved information in computer system and update to ensure payment received

Processed and tracked appeal claims and interpreting explanation of benefits (EOB)

Coordinates with physician/prescriber/pharmacy and prior authorization assistance

Explaining insurance benefits and adhering to each insurance carrier’s guideline

Documenting all activities using correct technique and medical terminolog

05/2006 – 03/2010 Anacomp Chantilly, Virginia

Data Entry and Review Analyst

Entered data electronically utilizing word processing, spreadsheet or database commands and format materials as required. Verified data routines in accordance with Company procedures

Reviewed discrepancies in receiving data, requested clarification on data and advised supervisor of issues related to data. Prepared final products for quality controlled review to be sent automatically

2003 -05 / 2006 Department of Health and Human Services Rockville, Maryland

Data Analyst for AHRQ Publication ClearingHousUtilized SQL queries and reports for Oracle database

Researched and analyzed data for computer processing and data preparation for AHRQ; created queries for data extraction into Microsoft Access/Excel spreadsheets

Communicated with healthcare professionals to maintain consistent and accurate information in Oracle database.

Manipulated data by copying, appending, deleting and editing current information in oracle database.

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