Insurance Medical Billing

Accounts Receivable / Medical Billing Coordination

L

ooking to join the team of a progressive company, make further use of existing talents, and gain additional work experience by mastering new challenges in a role that provides support for assorted A/R and/or medical billing processes. This quest is not just to find a job. It is to further an established career that makes full use of best practices and established protocol to refine existing systems and make them more robust.

Third Party Billing Resolutions Cash Applications / Charge Entry Service Data Entry

Billing Profile Maintenance Journal / General Ledger Billing Document Management

Patient Billing Administration Billing Recovery Billing Dispute Resolution

Insurance Referral Service Coordination Settlement Negotiation Report Processing

Bookkeeping Process Management Third Party Relationship Management

Qualifications Summary / Core Competencies

15+ years of direct experience administering Accounts Receivable, Medical Billing functionalities

Capably investigates and resolves issues related to billing accounts and Medicare compliance

Leader of highly functioning work teams

Proficiently provides seamless support for miscellaneous ancillary duties as they relate to medical billing and/or accounts receivable resolution processes

Utilizes relationship building expertise to amicably resolve billing issues with third-party payers

Stays abreast of Medicare standards and Governmental regulations

Well organized, results driven accounting professional, experienced with processing refunds, insurance claim denials, with posting insurance payments, and with managing aging reports.

Computer Proficiencies

CRM Software

EMD's

Oracle Imaging & Processing

Customer Information Systems

MS Word / Excel / PowerPoint

QuickBooks

Professional Experience

BILLING COORDINATOR

Dr. Gabriella Bonomo, M.D. – Jupiter, Florida

October 2015 to Date

Reviews schedules and advises staff of what amounts to collect each day. Updates patient accounts with current insurance information and expiring or terminated policies. Obtains Insurance eligibility and verifies benefits for deductibles, co-pays and/or coinsurance amounts to be collected at the time of service.

Verifies eligibility for patients recently admitted/discharged from the hospital prior to follow up appointments and scans hospital demographics into patient chart.

Assists with A/R follow ups for outstanding claims by calling insurance companies on denied claims and balances pre pay reports against daily credit card summaries. Completes bank deposit slips for insurance checks received and prepares for deposit. Determines patient’s accounts entitled to receive refunds, and issues checks for overpayment. Processes daily invoices for accurate coding, modifier usage and other pertinent information to ensure “clean claim” submission. Transmits claims via Gateway and various other programs.

Additional Contributions / Achievements

Coordinate referrals with insurance companies for patients that require services by specialist providers.

Consistently processed credit card payments provided by insurance companies and patient account payment information with skill and precision.

ACCOUNTS RECEIVABLE REP

Liberator Medical Supply – Stuart, Florida

2014 – 2015

Responsible for ensuring the accuracy of all pertinent data fields on claims to ensure timely and maximum reimbursement. Reviewed each file for accurate and completed doctor, diagnosis, insurance, and patient demographics; ensured items dispensed matched and did not exceed the quantity prescribed. Utilized available tools to review file history and ensure the order accuracy and completed appropriate billing software screens to ensure the revenue was recognized. Completed end of month reports and other duties as assigned.

Additional Contributions / Achievements

Follow up with insurance companies to determine the status of medical claims.

Address issues that may prevent the timely payment of claims such as billing errors and denial of claims and where appropriate, resubmit claims to insurance carriers.

Complete appeals; resolve denials and correct billing errors when analyzing AR.

Answer and follow up on inbound and outbound calls.

Processed payments provided by patients utilizing various company systems.

Contributes to team effort by accomplishing related results as needed.

ACCOUNT SPECIALIST

Liberty Medical Supply – Port Saint Lucie, Florida

2006 – 2012

Handled daily A/R processes; supervised A/R reps; oversaw timely and accurate processing of claim denials, aging reports, invoices and payment transactions in accordance with corporate, accounting and Medicare standards.

Addressed escalated issues regarding accounts receivables; ensured accurate and compliant A/R procedures and records in accordance with company policies and government regulations. Reviewed customer activity to determine document requirements for validation using various software and determined the next steps in the resolution process. Processed aging reports, service tickets, denials, and collection reports in a timely manner. Updated the document status using detailed written notes and service ticket creation/closure processes. Updated relevant data as needed using the appropriate systems.

Additional Contributions / Achievements

Devised methods to increase cost-efficiency and revenue generation

Expertly applied the Cash Application process and subsequent effects of credit/debit transactions

Cross checked open A/R and invoices to resolve a previous history of thousands of dollars in overpayments and denials for supplies.

Corrected unbilled claims and reduced the dollar amount of unbilled revenue.

Improved corporate cash flow and assisted with facilitating the company’s return to profitability.

Education

Legal Secretary/Computer Operations

Atterbury Job Corps – Edinburg, Indiana

1999

High School Diploma – Basic Education

Riverside University High School – Milwaukee, Wisconsin

1997

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