Customer Service Insurance

**** ******* *****

Dallas, Texas ***** 469-***-**** Cell

Jo Ann Gonzalez

Objective To obtain a position that will allow me to utilize

my skills and be able to advance within the

company.

Experience 032004-04/2011 Odyssey Health

Care Dallas, Texas

Cash Application Coordinator

. Posted Commercial, Medicaid and Medicare

electronic/bank deposits to patients accounts on a

daily basis

. Reconciled all cash posting to deposits on a

weekly and monthly basis

. Track interest /withholding and recoups from

intermediaries on a daily basis

. Trained New Employees

. Assisted other Departments with inquires

regarding cash posting and or/adjustments

. Performed any special projects assigned by

Supervisor

. Downloaded Medicaid and Medicare electronic

payments

. Processed all accounts receivable adjustment

and write offs

. Researched and corrected patients accounts

balances due to errors in cash posting

. Balanced to the General Ledger posting at the

end of each month, met deadlines in a timely manner

Reimbursement Specialist II

. Verified eligibility, analyze patients

accounts to assure that appropriate insurance was

billed

. Accurately monitor patient / client billing

data and billed Medicaid claims accordingly in a

timely manner

. Assured that certification and held reports

match with pre-bill data and accounts are

appropriately held or submitted to monthly packets

. Conducted all business activities in a

professional and ethical manner, contacting sites

and other parties regarding accounts that have high

balances. Returned phones calls or emails in a

timely manner

. Reviewed accounts receivable to assure that

all balances are either billable or non-billable

submitted adjustments accordingly to zero out

accounts needing rate adjustments or room & board

adjustments.

01/2003-12/2003 Health

Management Dallas, Texas

Team Leader

. Supervised and coordinated activities for

workers engaged in recovering payments

. Interviewed, hired and trained employees,

appraised performances, rewarded and discipline

employees, addressing complaints and resolving

problems

. Reviewed correspondence from insurance

carriers that included claims submitted in error,

corrected data and forwarded to cooperate office

for appropriate resolution

. Investigated all HIPPA compliance issues and

verified accuracy of accounts

. Determined work procedures, work schedules

and expedited workflow

Claims Recovery Specialist III

. Third Party Collections for over 22 States

. Reviewed claims that Medicaid paid in error

. Verified coverage for dates of services in

collections

. Appeal claims when primary coverage verified,

requested medical records as needed for claims

submitted in 2000-present

. Received inbound calls from insurance

carriers requesting additional information

. Received inbound calls from insured disputing

claims that Medicaid submitted to primary insurance

no longer active

12/2001-01/2003 Collections Company of

American Dallas, Texas

Medical Collector/Biller

. Processed insurance information received from

Debtors in collections

. Contacted Attorneys, insurance carriers,

Medicaid, Medicare, Workman's Comp regarding

claims, benefits and filing deadlines

. Contacted providers to obtained HCFA's and

itemized statements to rebill claims

. Worked daily reports from collectors and

incoming correspondence from debtors

01/2000-09/2001 Dallas Nephrology Associates

(DNA) Dallas, Texas

Patients Account Representative II

. Worked AR report for monthly collections

. Worked from explanation of benefits (EOB's)

from Medicaid, Medicare and Commercial carriers

. Posted denials, processed write offs, refunds

and appeals in a timely manner

. Entered adjustments, and commercial

contractual

. Monitored accuracy and reviewed accounts with

outstanding balances, insured balances correct

before mailing monthly statements

. Maintained high degree of professionalism

with patients

. Verified medical coverage Medicare, Medicaid

and Commercial Carriers

Education 09/2003 Medical Coding Course

11/2001 The Dallas County Medical Society

Conference

04/2001 Insurance Claims, Billing & Collections

Certificate

08/1986 Mansfield Business School/Diploma in Word

Processing

12/1985 Certificate of High School Equivalency

(GED)

Data Entry

Cash Posting (Medicaid, Medicare and Commercial)

Adjustments Posting

Lock Box/Electronic deposits

Bilingual (English/Spanish)

Customer Service Oriented

Team Player

Verification Eligibility (Medicaid, Medicare and

Commercial)

Contact this candidate