Pamela G. Alston

**** ******** ***** ******** ** 30071 Home: 770-***-**** Cell: 404-***-**** Email: ac3tyk@r.postjobfree.com

Billing Specialist/Revenue Cycle Analyst

Customer Service Expert MS Office Adept Written/Verbal Communicator

KEY SKILLS

Office Skills:

Telephone & Front Desk Reception Customer Service Filing Database & Records Management Reports & Spreadsheets Complaint Handling Data Entry, Revenue cycle billing

Computer Skills:

Word Excel Doc-star, Access, EDM imaging, IDX, Patient Management, Task Management, Gateway, Centricity, MS400, Payerpath, EDI, Medicare DDE, palmetto GBA, Vista/XP, Emdeon, NueMD, HeathFusion, Caneware, Optum Claim Adiministrator,eFR,Scenario,CernerCareB,MS4,Artiva,Optum360 software

HEALTHCARE PROFESSIONAL EXPERIENCE

The INTERSECT GROUP (PSA HealthCare) Account Receivable Collector 1/17-11/17

Achieves cash goal on a quarterly basic.

Understand payor specific requirement for submitting claim include CMN’s, nursing notes, invoice.

Work and collects delinquent A/R account. Prepare itemized statements

Frasier Consulting (Phoenix, AZ) Revenue Cycle Specialist 4/16 to 12/16

To identify the source of credit balance.

Take necessary action to resolve the account. Analyze payer reports for payment trends.

Apply the necessary contractual adjustment to account base on the payor EOB.

To ensure all refunds are appropriately identified and issue timely.

Nue Medical, (Lawrenceville, Ga.) Billing Support Analyst, 6/14 to 4/16

Complete and accurate charge entry through lab reconciliation procedures

Assist with the resolution of Unbilled Revenues and other billing issues

Support financial statement audits related to AR

Extensive knowledge of Third Party Payer Billing requirements and complexities

Assisting in the maintenance of billing status reports.

ApolloMD / PaymentMD (Sandy Springs, GA) Rejection Specialist, 6/10 to 4/14

Submission of 837 files, resolving edits and for CMS 1500 claims, Review EOB’s and RA’s to ensure payment are post

verifying eligibility through payer website and/or on phone, follow-up on contract with insurance rate

Communication with clearinghouse, Medicaid, Medicare, BlueCross, HMO’s, PPO’s Commercial insurance. Knowledge of UB-92 and Explanation of Benefits (EOB) interpretation

Balance and reconcile batch control totals with source documents

Summitridge Hospital (Lawrenceville, GA) Billing Specialist, 11/08 to 5/10

Transmit all claims, Medicare, Medicaid and commercial insurance.1500 and UB claim with emdeon

Audited billing report to ensure accuracy, reconciling of account for late charge, denials, missing codes, interview patients and complete all admissions and registration function

Assisted with month end audits and customer report preparation Documents all requests to system vendors for edits/changes/fixes and maintains a detailed log.

East Metro Health District (Lawrenceville, GA) Billing Analyst, 7/00 to 10/08

Help process invoices, Invoice Resolution, Balance Systems, AP Specialist Work,,Aged Invoice Review. Identifies payer specific error trends and investigates and resolves with appropriate revenue team member.

Assisted with training of new office assistants, telecommunication with patients

Analyzed and summarized file rejections and claim denials from Medicaid

Collaborated effectively with management and business office team to provide ongoing feedback regarding coding, systems, and contract/eligibility

EDUCATION

DeKalb Technical Institute/Heritage Professional Education (GA) Certificate Insurance Billing Claims & Collection

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