Insurance Management
Resume:
Connie Smith
San Bernardino, California 92404
ablcac@r.postjobfree.com
SUMMARY
An excellent problem solver and detail-oriented business professional
with extensive experience in Pharmaceutical Operations, Customer
Relations, and collections. Takes on increasing challenges with
proven results that exceed management's expectations consistently.
EXPERIENCE
TLC Staffing
St. Bernardine Medical Center
San Bernardino, CA
Collector
2010-2010
Held responsibility for resolution of collections issues associated with
insurance claims submitted on UB-04, appeals, resubmission of claims and
adjustment's for all commercial insurance carrier's and Managed Care Medi-
Cal. Assisted in training of new temps. Assisted with all incoming mail by
opening and distributing to correct employee for Patient Financial
Services.
Office Works
Casa Colina Hospital and Rehab Center
Pomona, California
Collector
2009-2009
Held responsibility for resolution of collections issues associated with
insurance claims submitted on UB-04 & CMS-1500, appeal's, resubmission of
claims and adjustment's for all insurance carrier's, including Medicare,
Medi-Cal, and worker's compensation for Team's; Neuro Psych, LTC, I/P
Hospital Services & Residential, Outpatient Therapy. Adult Day Health,
Sleep Center, Ortho Therapy, Audiology, Radiology, Adolescent Therapy,
Autism and Infant-CRT based and In Home. Held responsibility for
collections associated with patient billing, payment plans and charity
applications.
CVS Caremark Redlands, California
Collection Representative I 2005 - 2009
Held responsibility for researching resolution of complex collections
issues, situations, and problems associated with payers and contracts on
daily basis. Reviewed contractual agreements to understand billing and
collection requirements and identify issues that may negatively impact
reimbursement. Worked closely with management, sales, variety of
professionals, finance, and regional collections areas to resolve
identified issues and collect outstanding balances. Responsible for all
collection activity to ensure timely and accurate reimbursement for
assigned accounts. Successful completion of this assignment required
ability to effectively prioritize large number of invoices to ensure
completion of all billing and follow ups within guidelines established by
management, rebilling of claims, initial claims not on file with payer, and
completion of appeals and re-determination requests as required. Presented
completion of reporting to management detailing all collection efforts,
account statuses, and potential account issues.
Loma Linda University Health Care Loma Linda, California
Financial Counselor / Ops Support / Collector 1995 - 2005
Responsible for resolution of collections associated with insurance claims
and adjustment for various insurance carriers, including Medicare, Medi-
Cal, workers compensation, HMO, PPO, and IPAs. Worked large projects for
management diversely, in all areas of office, to provide back up wherever
needed. Covered open positions, posted payments, and handled incoming
patient phone calls. Researched and resolved payment discrepancies based
on contractual agreements.
Team Lead 1998 - 2002
Directed team of 20-25 employees in assisting with various duties, e.g.,
authorizing adjustments, handling patient phone calls, and training new and
existing employees. Also held responsibility for fertility and pre-
employment accounts. Assisted in interviews for potential new hires.
Primary duties involved assisting supervisor whenever needed in various
duties, overseeing team of employees, training new employees, authorizing
adjustments, handling patient phone calls, and tracking infertility
accounts and pre-employment accounts.
ADDITIONAL EXPERIENCE
Watson Medical Lab, San Bernardino, California, Collector, 1989 -
1996. Held responsibility for all private insurance claims for
collections, bank deposits and bank runs, and entering test results.
EDUCATION
American Academy of Professional Coders
Certified 05/23/2010
Summit Educational Services, San Bernardino, California
Certificate in Excel and Word, 1994
SKILLS
Microsoft Excel, Word, and Outlook
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