Manager Insurance
Resume:
Linda Kemp
Email: abqdhv@r.postjobfree.com
Address: **** * ***** **
City: Compton
State: CA
Zip: 90222
Country: USA
Phone: 310-***-****
Skill Level: Management
Salary Range: $60,000
Primary Skills/Experience:
See Resume
Educational Background:
See Resume
Job History / Details:
Linda Kemp
2634 E 129th St
Compton, Ca. 90222
abqdhv@r.postjobfree.com
OBJECTIVE:
Looking to obtain a management position in a results-oriented company that seeks an ambitious and career conscious person, where acquired skills, experience and education will be utilized toward continued growth and advancement. Knowledgeable in computer software SMS AS400, ACE, HBOC, Meditech, P-Bar, CPSI, CUBS, MED ASSETS Contracts, DDE, DSG and E-premis billing systems, Mircosoft Word/Excel and Windows. Contract literate, CPT, ICD-9 and HCPCS coding structure.
EDUCATION:
Bryman School, Long Beach CA - Graduated October 1979
Dominguez High School, Compton CA - Graduated June 1978
Churches Chicken Management School, Lynwood CA- Graduated May 1978
EXPERIENCE:
California Service Bureau Insurance Manager/AHMC
10/4/2010 to present
Duties include managing 1 administrative assistant,13 collectors on accounts over 60 days under 3k and accounts over 365 days for 6 facilities, meeting with Director and President monthly, interact with supervisors at AHMC for any request needed for corrected claims or assigning accounts for a higher level of care, hiring and firing of collectors, running collector reports through CU Emulate, distributing and assign collector work queue, employee evaluations, disciplinary action, reviewing collector productivity, handle patient complaints, negotiate the highest rate of pay possible with insurance and lawyers, one on one training for employee improvement, assist in any questions regarding accounts, prepare documentation on trends with insurance, follow up on hard to collect account, appeals and identify accounts for denial management process, submit adjustments, submit request for corrected claims, assist Self-Pay Manager daily with accounts and irate patients, oversee eligibility and billing for self-pay accounts where insurance is provided.
AHMC HEALTHCARE Collection Supervisor
08/27/06 to 10/1/2010
04/04/10 Collection Supervisor
Duties include over see 8 insurance collectors, 2 capitation collectors and 3 self-pay collectors for 6 facilities on accounts over 60 days, meeting with management on a daily basis, validate payroll thru e-time, hiring and firing of collectors, distributing and assign collector work queue, attend monthly AR meeting, meet with capitation payor monthly or claim and payment issues, employee evaluations, reviewing collector productivity, handle patient complaints, negotiate the highest rate of pay possible with insurance and lawyers, one on one training for employee improvement, assist in any questions regarding accounts, prepare documentation on trends with insurance, follow up on hard to collect account, appeals and identify accounts for denial management process, key adjustments, work 180 day reports and review and key well baby adjustments bi-weekly.
09/2008 to 04/04/2010 Lead Collector
Duties included assist supervisor on reports for management, DPS, cover in the absence of supervisor (6 months), train new employees, one on one training for employee improvement, work 90 day reports, review and key well baby adjustments, follow up on my assigned collector work queue on Worker`s Compensation, HMO, PPO, Medical Manage care and Commercial resubmit claims and appeals as needed. Review accounts for correct contract reimbursement, negotiate the highest rate of pay possible with insurance/lawyers and patients, identify underpaid accounts and submit 1st & 2nd appeals, respond to incoming correspondence, review and key adjustments, request medical records for retro authorizations, work aging reports, identify accounts not coded for billing and resolve to get them billed, send patient letters for patient responsibility and set-up payment plan.
08/27/06 to 09/2008 Collector
Duties included train employees, working aging accounts, identify correct payor and ensure that claim was received, identify accounts for clinical appeals process, identify contractual underpayments for appeal process, work high dollar accounts, identify contractual adjustments not done and submit to management for keying, phone follow up on my collector work queue on Worker`s Compensation, HMO, PPO, Medi-cal Managecare and Commercial insurances, work any projects given by supervisor or management.
HMS/Cymetrix (Saint Johns Health Center) Patient Account Rep
02/13/05 to 08/25/06
Duties include training of new employees, assist in any questions regarding accounts and assist with phone calls as needed. Workers Comp, HMO, PPO and Commercial Ins collections phone follow-up, view remittance advice in I-Suite, figure and submit adjustments, retrieve medical records from e-web for insurance and retro authorization appeals, initiate NIA retro authorizations, 1st and 2nd level appeals on underpaid and denied accounts, work daily pay list and I-Suite work lists, identify accounts not coded for billing and resolve to get them billed, receive patient and insurance phones calls, assist walk in patients on accounts, take credit card payments and set-up payment plans.
Temps Unlimited
8/16/04 to 02/10/05
(HMS/ST JOHNS HOSPITAL MED CTR & PARKVIEW COMM HOSP MED CTR)
Duties included phone follow-up HMO`s, PPO`s, Commercial and Worker Comp
claims, Figure and enter adjustments according to contracts, rebills, 1st & 2nd level
appeals on underpayments, denials, MR and retro authorizations
.
ELASTAR Community Hospital Supervisor Collections
Los Angeles CA
01/94 to 08/13/04
Duties included overseer of 3 collectors, phone follow-up on Workman`s Comp, HMO`s, PPO`s and Commercial Ins on high dollar accounts. Figure and enter adjustments according to contracts, rebills, 1st & 2nd level appeals on underpayments, denials, MR and retro authorizations. Set up payment plan on cash accounts. Approve patient and insurance refunds.
Purry`s Guest Home Caregiver
Los Angeles CA
11/99-present
Chart on Consumers` behavior on a daily basis, type up semi-annual reports, go to the doctors with Consumers, pull clothes, help consumers with daily hygiene and dressings, clean house, cook and take on outings.
Hospital Employees Labor Pool Temporary Help
11/89-01/91
Went out to different hospitals to help where needed in collections and billing.
Cedar Sinai, Monterey Park, ELA Doctors and Medisac
Bellflower Doctors Hospital Biller/Collector
Bellflower,CA
09/88-11/89
Supervised two collectors, two billers and a file clerk, reported to office manager on any AR accounts over 90 days, work cash accounts and accounts over $10,000, set up payments for patients, contract write-offs and liaison between hospital and outside collection agency.
South Bay Hospital Biller
Torrance,CA
09/86-08/88
Duties included billing for Medi-Cal and follow-up, billing Blue Cross and Medicare through DDE, and back up billing for Private Insurance, Worker`s Compensation, PPO`s and HMO`s.
Remcor and LSG Agency Biller/Collector
Bellflower, CA
10/86-09/88
Worked at Bellflower Doctors Hospital as needed for collections and billing.
Business Services Agency Typist/Biller
Los Angeles CA
01/86-09/86
Temporary position where my duties were to type Blue Cross inpatient billing.
Pulmonary Disease Institute Biller/Collector
07//85-01/86
Duties included insurance billing and collecting, took vital signs, took chest x-rays, Phlebotomist, EKG technician, gave injections, recorded patient complaints, and called in prescriptions.
Duane K McKinley, MD, Inc Office Manager
Compton CA
10/79-10/83
Helped doctor set up practice, ordered supplies, scheduled appointments, scheduled tests, ordered medication for office, AR on Peg Board System, performed all Insurance billing and follow up. All back office duties performed.
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