Insurance Medical
Resume:
REGINA G. WILLIAMS
Cell: 561-***-****
Email: **********@****.***
SKILLS:
Medical Collections, Appeals, Medical Billing, CMS Tracking, Medicare and Medicaid Claim processing, Claims Follow up, Proficiency in Microsoft Office including Excel, Word and Access.
EXPERIENCE:
Envision Healthcare Company, West Palm Beach, FL Feb 2017 – Sept 2017
Amsurg/Sheridan
A/R COLLECTION SPECIALIST
● Investigate rejected claim to see why denial was issued and resubmit claim for processing.
● Review delinquent accounts and call for collection purposes.
● Code patient services and enter into computer.
● Collect, post, and manage patient account payments.
● Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.
● Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
Medix, Nashville, TN Oct 2016 – Feb 2017
Healthcare Revenue Cycle- Division
MEDICAL COLLECTION SPECIALIST
●Utilize A/R reports from SoftAid and identify accounts that are past timely payment.
●Write appeals to insurance companies to overturn denied or short paid claims.
● Make contact with insurance company, vendor and patient to learn status of payment.
●Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to insurance carrier to affect payment of claim.
●Knowledge of hospital policy and regulation as related to hospital billing and collections required by department and hospital administration.
●Research any unbilled issues to optimize the billing possibilities for the billing period.
●Maintain system for all projects, with all the appropriate documents, including expenses, consultant invoices spreadsheet and monthly payment posting in accordance with standard procedures.
●Review delinquent accounts and call for collection purposes.
ReliaBill Solutions, Delray Beach, FL Aug 15, 2015 – Sept 2016
COLLECTION SPECIALIST
●Knowledge of the collection in professional services industry.
●Research any unbilled issues to optimize the billing possibilities for the billing period.
●Maintain system for all projects, with all the appropriate documents, including expenses, consultant invoices spreadsheet and monthly payment posting in accordance with standard procedures.
●Review delinquent accounts and call for collection purposes.
●Maintain system for all projects, with all the appropriate documents, including expenses, consultant invoices spreadsheet and monthly payment posting in accordance with standard procedures.
●Verification, billing, analysis, follow-up, denial and appeal processing for accounts
●Effectively communicate with Project Managers and Principals, regarding contract documents, change orders and other contract modifications, approvals, and any additional services-related to billing.
Good written and verbal communication skills and strong organizational skills
Ability to work independently, take initiative, set priorities and see projects through to completion
Behavioral Health of the Palm Beaches, North Palm beach, FL July 07, 2014 - June 15, 2015
COLLECTION SPECIALIST
● Responsible for verifying patients’ insurance benefits and following up with insurance carriers
●Utilize A/R reports from SoftAid and identify accounts that are past timely payment.
●Write appeals to insurance companies to overturn denied or short paid claims.
● Review delinquent accounts and call for collection purposes.
●Verification, billing, analysis, follow-up, denial and appeal processing for accounts
● Follow-up and adjusted outstand accounts for claim processing.
Bethesda Health Hospital, Boynton Beach, FL May 05, 2014 - June 2014
COLLECTOR/BILLER
●Basic understanding of insurance appeals,
● Short pays, and insurance contracts,
●Knowledge of hospital policy and regulation as related to hospital billing and collections required by department and hospital administration.
●workman’s compensation laws, as well as Medicare and Medicaid laws.
●Understanding the following systems AS400, Excel, Word, Invision, HBOC, Document Imaging, 3rd Millenium, HPF, FTP, VPN, Citrix, Account Link, and Mainframe.
●Write appeals to insurance companies to overturn denied or short paid claims.
Tuft Medical Center, Boston, MA Aug 03/2012 – June 2013
MEDICAL COLLECTION SPECIALIST
●Verification, billing, analysis, follow-up, denial and appeal processing for accounts
●Utilize A/R reports from SoftAid and identify accounts that are past timely payment.
●Write appeals to insurance companies to overturn denied or short paid claims.
● Make contact with insurance company, vendor and patient to learn status of payment.
●Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to insurance carrier to affect payment of claim.
●Knowledge of hospital policy and regulation as related to hospital billing and collections required by department and hospital administration.
Children’s Hospital, Boston, MA Aug 17, 2011 – 08/01/2012
CREDIT BALANCE COORDINATOR
● Responsible for daily review, analysis and posting payments to patient accounts.
● Supports multiple projects and audits as assigned.
● Received and review all detail on remittance advices to determine proper identification, posting and reconciliation of accounts.
● Corrects insurance information on account .
● Prepares refund requests as necessary.
● Adjust any missing data elements for proper billing and work accounts via on-line work list ages trail balance reports or other report by telephone called to the payer.
Beth Israel Deaconess Medical Center, Boston, MA Aug 10, 2009 – Aug 15, 2011
THIRD PARTY COLLECTION SPECIALIST
● Investigate rejected claim to see why denial was issued.
● Review delinquent accounts and call for collection purposes.
● Code patient services and enter into computer.
● Collect, post, and manage patient account payments.
● Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.
● Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
Spectrum Health Hospital, Grand Rapids, MI June 7, 2007 – June 2, 2009
COLLECTION SPECIALIST
● Follow-up and adjusted outstand accounts for claim processing.
● Processed inpatient and outpatient claims to insurance companies.
● Knowledge of payer regulations and reimbursement.
● Rebilled account from hold reports.
The Children’s Hospital, Denver, CO Nov 9, 2001 - Dec 7, 2005
SURGERY BILLER
● Assigned diagnostic and procedural codes to inpatient and outpatient accounts.
● Batched claims and adjusted outstanding accounts for claims processing.
● Medicare and Medicaid compliance coding experience.
● Edited invoice claims and submitted referrals for authorizations.
EDUCATION:
AMERICAN INTERCONTINENTAL UNIVERSITY June 13, 2006 – June 2009
ASSOCIATE DEGREE
HEALTH INFORMATION MANAGEMENT
CONCORDE CAREER INSTITUTE Denver, CO 2002
CERTIFIED MEDICAL BILLING AND CODING SPECIALIST
REFERENCES WILL BE FURNISHED UPON REQUEST
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