Customer Service System
Resume:
ROCHELLE COLON
Palm Coast, FL *2164
MOBILE 201-***-****
EMAIL- **********@*****.***
SKILLS
Excellent account review and management skills for major and private insurance carriers including: HMO/PPO, Blue Cross/ Blue Shield Medicare and New jersey Medicaid, inpatient and outpatient claims, contractual adjustment and follow up experience, manual adjustments as it relates to insurance reviews and investigation, workers comp and No Fault.
Proficient in Windows XP, Excel, Microsoft Word, Power Point, High Mark (Medicare system), iExtend( Cerner system), RCMS (internal account management system), Passport( eligibility check system), Starr & I Series, med Access (electronic claims payer), Accupost (EOB management system), Epremis (electronic billing system for facilities) and DRG experience IMBS (innovative medical billing system ), Entake and Eforms.
EMPLOYMENT
2/2012 – 2/2016 Rotech Healthcare Inc. Orlando,Fl
Billing and Collections Specialist VA ( Veterans Affair Division)
Process rejection and denials to determine if the claim needs to be re-filed or submitted for an appeal with the payer.
Review patient information in IMBS to determine why the claim is unpaid and if adjustments are valid.
Analyze and work amounts on over/under reports as well as AR aging reports.
Process Hospice/nursing home delivery tickets.
Communicate and interact with all BCC department as well as location staff and all VA Payers.
Document all collections activity in IMBS patient collection notes and on collections daily work sheet and send completed sheet to collections supervisor.
11/2011 -2/2012 Healthcare Support Staffing Winter Park, FL
Quality Assurance Specialist
Billing for Rotech Healthcare Inc. VA (Veterans Affair Division).
Verifying the accuracy of the information in IMBS system compared to information on the required delivery tickets.
Maintain patient profile.
Communicate any form errors to corresponding supervisor for corrections.
Managing corrected documents in Eforms system.
Added follow up date and notes for accounts with missing documentation.
Rejected invalid tickets back to location for correct information.
Maintain VA documentation received date in IMBS.
07/2011-09/2011 CSI TECH Maitland, FL
iExtend Cerner Activation Support Trainer
Completed extensive training on Cerner application management system for registration and scheduling system (iExtend).
Assisted in the training of all Florida Hospital Physicians medical group Staff on using Registration/scheduling system.
System testing on assuring that all providers, NPI and tax ID numbers are accurate in the system before Go-Live.
Responsible for the conversion of appointments from former system use to new system for physician assigned.
Provided one on one attention to staff members when needed in navigating through the system during Go-live for Cerner.
02/2007- 06/2011 Apollo Health Street Clifton, NJ
Medical Billing Process Associate
Maintained patient coverage verification, confirmed of receipt for submitted claims, processing denials with correction for payment settlements and data entry.
Responsible for billing outpatient, inpatient and EMS services on UB04’s claim form for Jersey City
Medical Center, Christ Hospital and East Orange General Hospital.
Registration for Ambulance, helicopter services for UMDNJ (University for Medicine and Dentistry of New jersey)
03/2004-03/2006 Newark Airport Medical Offices Newark, NJ
Patient Service Representative
Established new client relationships while providing excellent customer service for patients injured and covered under workers compensation.
Prepared patient registration and coverage verification, worked with utilization management team to obtain pre certifications and authorizations for provided services such as occupational therapy, MRI’s and CT scans.
Billing physician claims on HCFA 1500’s, confirmation of receipt for submitting claims, initiating
negotiations for payment settlements
EDUCATION
06/2001 Union Hill High School Union City, NJ
High School Diploma
LANGUAGES
Bilingual: Spanish/English
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