CINDY M SPEARS

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

Beaverton, Or 97007

832-***-**** or 503-***-****

EMPLOYMENT OBJECTIVE

To obtain a position with a company that will provide an opportunity for

professional Growth and Development.

WORK HISTORY:

ENFINA HEALTHCARE SOLUTIONS

211 Highland Cross Suite 275

HOUSTON, TX 77073

281-***-****/Belinda Ratcliff

REIMBURSEMENT SPECIALIST

NOV 2004 - FEB 2010

Worked in office for group of Internal Medicine and ER

Physicians performing the duties of a billing office; working with Practice

Manager computer system; responsible for printing paper claims daily,

checking for errors like provider numbers; admit and discharge dates;

coding errors; insurance claims address and secondary claims to mail out

with primary eob's. Worked the web rejection reports, checking for

electronic claim errors to correct and refile. Did follow-up with insurance

eob denials by calling the insurance companies and filing appeals or

redeterminations on claims denied for no authorization and out of network,

etc and pull medical chart documentation as necessary. Worked the (CMS)

claims management reports which was the aged account receivables. Follow-up

with the unpaid claims to resolve any issues to get them paid including

submitting provider credentials when necessary. I answered phone calls

from the patients and insurance representatives regarding the patient

accounts. Also responsible for gathering the code blue t-sheets from the ER

physicians from the hospitals. I would review them and make sure the t-

sheets were completed and signed by the doctors before scanned for the

coding department. Did special projects which consisted of physically

going to the hospitals and retrieving our physician t-sheets for charges to

submit to patient or insurance. I would process the emergency Medicaid

forms requiring verification of physicians and signatures for possible

Medicaid eligibility applicants.

GULLO FORD MERCURY

925 I-45 North

CONROE, TX 77301

936-***-****/Mark Stevens

RECEPTIONIST

NOV 2003 - MARCH 2005

Part Time Evening Position: answering a 10+ line switchboard for sales

and service of an automobile dealership; responsible for logging in

license plates and mailing license tags

to customers. Greeted customers

SADLER CLINIC

2912 West Davis

CONROE, TX 77304

936-760-

7900/Vicky Day

PAYMENT POSTER/REIMBURSEMENT SPECIALIST AUG 2002 - MARCH

2004

Worked in business office posting daily cash from insurance eob's and

patient payments. Also posted medicaid payments and adjustments from the

electronic remittance reports.

Processed and posted the eob denials and recoupments using the Medical

Manager System. Moved to Insurance follow up clerk, working the Cigna

insurance accounts; working accts w/ unpaid balances, calling the insurance

company to find out why claims were not paid; found numerous problems w/

their system and some with ours; worked the eob denials, aged reports and

also helped out with other insurance accounts and special projects.

PC INC BILLING SRVC

4001 Dale St

ANCHORAGE, AK 99508

907-***-****/Kay Bias

PAYMENT POSTER/MEDICAID INSURANCE BILLING OCT 2001 - JUNE

2002

Worked in Radiology Department posting insurance and patient payments.

Moved to Medicaid after 1 month; posting medicaid remittance advices;

processed refunds, adjustments worked denials. Also processed all Medicaid

secondary claims on Keymaster (program for medicaid - transmitted thru

internet) Answered incoming calls for insurance and patient inquires on

balances and input insurance information.

HAWTHORN PHYS SRVC

10820 Sunset Office Dr

ST LOUIS, MO 63127

800-***-**** / 314-***-****/Linda Statton

PYMNT POSTER/ INS BILLER / REFUND SPECIALIST SEPT 2000 -

JUNE 2001

Worked in E.R. Dept posting insurance and patient payments to patient

accounts. New to working with insurance EOB's; learned provider discounts,

allowed amounts, write offs and adjustments. Found numerous problems with

computer system. Reported all problems to supervisor to work with and

solve. Due to my eye for detail and thoroughness, was promoted to Follow-

Up/Claims processor after just 5 weeks. Handled patient accounts; answered

patient and insurance billing questions; made corrections to insurance

claims; worked medicaid and insurance denials; processed accounts for

collections and cleaned up accounts. Found many clients physician provider

numbers were expired and helped work a project regarding this issue. After

3 months was promoted to a new position in the Specialty Dept as a Refund

Specialist. Developed refund guidelines and procedures for employees to go

by, along with revising the refund request form. Processed all refund

requests for all departments, researching refund requests for authenticity;

prepared statements, invoices and checks; then posted to patient accounts.

Developed manual log for refunds not in the computer and kept records of

money on acct from clients for refunding.

ANCH NEIGHBORHOOD HEALTH CLINIC

903 W Northern Lights Blvd St 218

ANCHORAGE, AK 99503

907-***-**** / 907-***-****/Rhonda Pidge

ACCOUNTING/BILLING SPECIALIST

SEPT 1999 - JUNE 2000

Worked in Administration; balanced daily cash from 4 clinics & reconciled

bank deposits; responsible for opening and sorting mail for daily deposits

and account payables. Reconciled medicaid, medicare, medical insurance and

patient payments for deposits. Handled patient accounts; filing for accts

payable, payroll and daily patient encounters. Posted daily payments to

patient accts and answered patient and insurance billing questions. Also

responsible for balancing days for entire department for end of month.

Promoted to Billing Specialist; responsible for posting daily hospital

charges for 18 Physicians. Worked with and created spreadsheets for

physician work schedules and perinatal; input diagnosis and procedure codes

for hospital visits. Also processed Work Comp and Motor Vehicle claims.

CAL WORTHINGTON FORD

950 Gambell

ANCHORAGE, AK 99501

907-***-**** / 907-***-****/Deanna Slack

SRVC CASHIER/SRVC WARR CLERK JULY

1994 - SEPT 1999

Direct contact with customers; Prepared billing, invoicing and cashiering

of service repair orders. Daily cash contracts for customer receipts for

new and used vehicle deals and car payments. Prepared rental loaner

contract; handled damaged transportation claims on new vehicle arrivals.

Calculated mechanic flag sheets and time cards for payroll; prepared

redlines for new and used vehicles; Handled audit packages and cleaned

schedules for month end; Invoiced internal repair orders and misc billing.

Service/Warranty Clerk: secretarial duties for service department Handled

daily appointment scheduling; developed follow-up procedure for Special

Ordered Parts to contact customers; when necessary would help out service

advisors with write-up of customers in service drive. Warranty Dept.

handled daily registers of rejects and paid warranty repairs; input of ESP

(Extended Service Program) contracts and trained on Ford system to code

warranty repairs. Crossed trained in business office and filled in when

necessary, such as: preparing daily bank deposits, DMV for new and used

vehicle title and transfers and then courier driver to make runs to DMV

offices, FMCC and banks.

WORK REFERENCES:

Dana Messinger / Reimbursement Specialist / Enfina Healthcare Solutions 281-

784-1500 ext 233

Kristi Banos / Reimbursement Specialist / Enfina Healthcare Solutions 281-

784-1500 ext 228

Kelly Hightower / Refund Specialist / Enfina Healthcare Solutions 281-784-

1500 ext 249

Gloria Turley / Office Clerk / Enfina Healthcare Solutions 281-***-****

ext 259

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