Xavier Love, Sr.

**** **** **** ******, *******, Florida 33025, 954-***-****

ac0you@r.postjobfree.com

OBEJECTIVES

To seek a high-level position utilizing my twenty years of experience in healthcare business operations for high growth companies and creating top line profitability.

EXPERIENCE

Collection Specialist January 21, 2016 to May 05, 2016

CCS – South Florida, LLC Oakland Park, FL

Review and work from A/R aging report thru Microsoft Excel on daily bases.

Make necessary telephone calls for follow up to contracted or non-contract (Commercial), and government insurance payers for claim status.

Review denied claims and notify facilities of findings and report for possible appeals.

Contact patients for any information that’s needed to update data base and expedite claim for payment.

Collection Administrator II October 27, 2014 to Aug. 26, 2015

Mednax Pediatrix Associates Sunrise, FL

Make necessary telephone, electronic or written contact with payers to check claim status and reimbursement.

Consistent follow-up on outstanding accounts by working collection reports and correspondence.

a. Not Worked Report – Summarizes outstanding accounts not worked within department’s guidelines.

b. Denial Report – Identifies specific denials posted from EOB’s received.

c. Queue Summary Report – Identifies the accounts that are schedule to be worked for any given day.

d. Review and work all daily correspondence received from patients and payers.

Appeal denied claims via mail or internet when necessary, obtain Medical Records from associate/clinics and send

to payer, collector must also review diagnosis and procedure codes with coding unit and submit problem packs or

appeals to payers to ensure confirmation of receipt of claims.

Perform a variety of other collection duties such as working on special projects determined by Manger and meet

deadline dates and times on assigned projects.

Collection Specialist May 27, 2014 to October 20, 2014

American Ambulance, Inc. Miami, FL

Communicate with patients where accounts are in a private pay status.

Obtain and verify Insurance benefits information, if applicable.

Initiate payment of patient accounts, determine the reason for unpaid balances; negotiate payment commitments.

Review follow up work on no payment remittance advises and Ability to read & understand Explanation of Benefits.

Establish and maintain accurate and systematic records.

Make appropriate write-off requests according to Business Office Policy.

Monitor and manage accounts receivable within scope of responsibility.

Courteously answer and respond to questions and telephone calls from patients.

Perform other work related tasks as assigned.

Patient Financial Rep. II/Medicare Billing Team-Lead Jan. /2001 to Apr.8, 2014

Memorial Healthcare Systems Miramar, FL

Responsible for review and analyzing Medicare accounts before billing electronically.

Correct all billing errors and issues before sending to government payers.

Work and follow up on billed accounts after 45 days thru reports.

Develops and coordinates communication with Medicare and RAC Contractor (Maximus) regarding chart audits RAC requests, audit results, appeals and overpayment/underpayment amounts.

Responsible for tracking audits requested by RAC Contractor to ensure documentation is sent out timely, tracking responses, appeals, overpayments and underpayments and financial impact on organization.

Responsible for incoming mail from CMS/Medicare Redetermination, Maximus/Reconsideration, and Attorney Law Judge (ALJ). All appeal documents are scanned and uploaded to Hospital systems.

Billing part B (ancillary) services for claims that did not meet inpatient criteria or medical necessity after appeals have denied.

Medicare Analyst/Billing Supervisor Jan. /1989 to Oct. /2000

Mount Sinai Medical Center Miami Beach, FL

Oversees daily activities of billing staff to insure the proper accounting steps are taken for the updating of claims and the reconciliation of customer's accounts.

Develops instructions, guidelines, and procedures to perform billing functions.

Prepares monthly aging reports and refers delinquent accounts to collections department.

Interacts with managers and clients regarding billing activities.

Review and analyzing Medicare accounts that (RTP) for billing errors.

Work and follow up on billed accounts after 45 days and aging reports that list accounts 120 days or greater.

Education

Miami Edison Senior High Miami, FL

Diploma Aug. /1973 to Jun. /1977

Chowan College Murfreesboro, NC

Jun. / 1977 to May 1979

Skills/Qualifications: Medicare/Medicaid Billing Follow up, Claims Adjustment, Systems: Direct Data Entry (DDE),Epic, Artiva, Image Cast, SSI, Documentation Skills, Data Entry Skills, Analyzing Information, Problem Solving, Verbal Communication, Customer Focus, CMS Regulations, General Math Skills, GMPS (PDX), Computers and internet, including Microsoft Office and computer software.

References:

Dana Alvin

Federal Correction Officer

786-***-****

ac0you@r.postjobfree.com

Wayne Branton

City of Boca

954-***-****

ac0you@r.postjobfree.com

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