Insurance Manager

Maria Crosby Email:********************@*****.*** Phone: 214-***-****

Address:

P.O. BOX 700232

Dallas, Texas 75370

Objective:

To bring a proactive attitude to your company. Allowing common sense

approaches to real problems faced daily that may affect the end

result, and that is growth, profit and success. To allow training and

great perception to be my guide.

Experience

Texas Hematology & Oncology Center P.A./Medical Edge Healthcare Group

Dallas, TX. 2008-Current

Account Representative and Insurance Verification

Maintain the Weekly Radiology Log and updating it, (This is for the

registration and release of orders from the ordering physician(s).

Print and date the orders from the fax system by e-mailing those

orders that disseminate from physicians who are working internal as

well as external, whom may have orders that need processing.

Registering those orders in the weekly log.

Taking the orders to be coded properly.

Contacting the insurance carriers to verify the radiology benefits.

Contacting the various physician offices for more information as to

the patient insurance information.

Obtaining the authorization number as needed to process the orders

disseminating from the physician(s).

Contacting the patient(s) and collecting the deductibles, also

balances and/or created financial agreement previously agreed to by

the patient.

Helping to schedule the Spanish speaking patients, then releasing the

recommendations prior to the test (CT, MRI, PET SCAN, BONE SCAN, MUGA

and BONE DENSITY).

Resurgens Orthopaedics

Roswell, GA. 2007-2008

Patient Account Representative

Conducted all billing and collection issues for 2 Physicians, this

includes patient balances, resolving face to face patient questions

and complaints, conduct phone calls to obtain patient payments,

insurance verification and follow-up, corrected claims from denied

EOB’s, correcting and refiling claims from rejection reports, mailing

Workers Comp and auto claims with attachments, filing secondary claims

to secondary carriers, handled all Spanish speaking patients, posting

of surgical procedures and payments.

Comprehensive Orthopaedic Group. Cumming, GA.

2007-2007

Billing and Collection Supervisor.

Supervised a group of 4 billing representatives for 4 physicians.

Conducting charge posting, payment posting, insurance verification and

follow-up,

correcting rejected claims from the clearing house, corrected claims

from denied EOB’s.

Also from EOMB’s filed claims to second insurance carriers.

Filed claims to Workers Comp and Auto Insurance with attachments.

Prepared financial reports for physicians and the Practice Manager.

Monthly and daily reconciliation. In charge of Pre-settlement contracts.

Helped to train the front desk staff.

Resolving various billing issues by trouble shooting with technical

support team with Misys Tiger and Misys EMR.

Conducting back-up to computers at end of day.

North Georgia Physician Services Roswell, GA.

2002-2006

Medical Claims Supervisor & Dental Assistant & Front Office.

Assisting with account questions and inquires from patients regarding

their account balances.

Filing insurance claims to each carrier. Posting payments and charges

to accounts on Softdent dental software by Kodak.

Creating new charts, filing and updating patient information in their

medical charts.

Answering phones and scheduling new patient visits for consultations

and existing patients for a follow-up.

Preparing rooms and patients for comprehensive exams, as a medical and

dental history, instruments and X-ray.

Assisting Dentist with surgical procedures including Bone Grafts,

Tissue Grafts, Implants in Mandible and Maxilla and PRP. Also assist

in preparations and seating of Crowns and Bridges and Extractions.

Performing ZOOM, Alginate Impression, and fabricating Trays to allow

patients to perform home bleach.

Cleaning and sterilizations of instruments. Along with preparing

patient rooms for visits and procedure.

Also handling all Spanish patient calls.

PRS, Inc

Roswell, GA

2000-2002

Orthopaedic Follow-up

Conducted Insurance Follow-up.

EMR, Pre-settlements, Posting Charges, Posting Payments

Implemented training course for new recruits speeding profitability.

Corrected Misys Tiger Rejections Report.

Misys Support Staff.

Education

1990-1994 Santa Luisa High School

Bogota, Colombia

v1 Basic Education

1997-2000 Central University

Bogota, Colombia

v2 Business Administrator

Skills

Softdent Dental Software,Medical Manager 5.0 thru 10.0, Cycare 2000, Centricity,

Misys Tiger,Tiger P.M. & EMR, IDX, Touchwork, and Ecommerce.

X-Rays: Panorex and FMS. EKG

Certified CPR

Notary Public, State of Georgia

Computers, fax, printers, Internet, Excel, Power Point, Word and more.

My Hobby is Reading

Offer me a good book.

Contact this candidate