Customer Service Manager
Resume:
Ebony White
La Vergne, TN 37086
********@*****.***
Objective: To explore strategic opportunities within an organization and
secure a position leveraging strong customer service and relationship
building skills, which may involve internal auditing to improve business
processes.
Qualifications:
o Training Experience
o Revenue Cycle Principles/Patient Accounting
o Invoice Analysis
o Proficient in Excel (Pivot Tables & V-Lookup)
o EMR
o 10+ years Medical Billing Experience
Education 2008-present University of Phoenix, Health Information
Management
Experience
2012-Current Medicare/Medicaid Assistance Specialist, PASI
Assist medical facilities, in various states, with insurance follow up, by
working placed accounts to resolution expediently, research claim denials
and any other special projects to reduce account receivables by using
Medicare and Medicaid provider manuals to resolve claim issues. Analyze
adjustments, late charges, recoupments, and non- covered charges, interpret
contract matrixes, identify trends by presenting information and responding
to questions from managers, clients, customers, along with supplying daily
documentation regarding productivity to management.
2011- 2012 Billing Compliance Analyst/ Billing Supervisor, Oppenheimer
Urologic Reference Lab
Audit billing records to ensure accurate data has been submitted to various
insurance carriers within the pre-established contract guidelines. Identify
and resolve process deficiencies, by providing recommendations to the
Operations Manager and assisting with the development of processes and
internal guidelines. Identify training needs, create process manuals and
training material to present in a classroom setting. Implement productivity
metrics for to help reduce that AR days and increase cash. Work claim
denials received from insurance correspondence and clearinghouses, post
payments, including patient coinsurances and deductibles, submit appeals,
and resubmit corrected claims for payment.
2011-2011 Traveling Contract Reimbursement Specialist, Xtend Healthcare
(Contract)
Review payer contracts to become familiar with the established terms and
provisions, maintain system tables for rates, healthcare-related codes
(e.g. CPT, DRG, ICD-9, etc), and fee schedules. Resolve underpayments by
establishing methodologies to model contract provisions. Identify issues
and implement corrections to ensure that reimbursement is according to the
contract guidelines. Reconcile billing data in the patient accounting
system, identify and research variances and recurring billing errors.
2008- 2011 Lead Reimbursement Specialist, Perot Systems/Dell Services
Investigated claim data and reviewed contracts to gain thorough
understanding of payment methodologies. Identified accuracy of payments by
calculating reimbursement based on contract terms, through use of various
reports and supporting documentation. Contact insurance companies to obtain
information, resolve underpayment discrepancies, and arrange for payment or
adjustment processing on behalf of client; Presented trending issues,
status reports, and other findings to manager. Trained and audited the
performance of account representatives to improve accuracy and productivity
to ensure workplace compliance.
2006-2008 Practice Reimbursement Analyst, HCA Physician Services (Contract)
Monitored accounts to ensure that charges were reported accurately, and in
compliance with contracts and insurance guidelines for prompt
reimbursement. Identified trending issues that resulted in a delay of
payment, and performed billing corrections as needed, while working in
collaboration with other departments. Researched and prepared appeals for
all underpayments or denied claims, along with maintained monthly invoice
analysis on all reconciled accounts. Developed strategies to minimize bad
debt and improve cash flow.
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