Esha Carter

*** *. **** ******

Baltimore, MD ***18

443-***-****

ac5l3o@r.postjobfree.com

OBJECTION: To obtain a position within the healthcare industry; including responsibilities of problem solving, planning, developing, organizing and managing budgets and policies while using my knowledge of Medicare, Medicaid, Medicare A Replacement plans, Workman compensation and all other healthcare insurance plans.

SUMMARY:

Exceptional communication, interpersonal, written and verbal skills

Team player and building, innovative thinker and motivational leader

Able to work independently as well as in a group

Ability to perform multiple tasks while demonstrating accurately

Demonstrates dependability

Completes all expectations within specified deadlines

Ability to work in a fast-pace environment

EDUCATION: High School Diploma, Mergenthaler High School

Associates Degree: Ashworth Uniersity Health Care Administration: 2018 - Present

MILITARY: United States Naval Service, Norfolk, VA 1998-2001

WORK HISTORY:

Erickson Living Management LLC

A/R Associate 9/2015- 10/2017

Translates internal charge files to appropriate billing formats for electronic and manual claims submission to third party and private payers.

Performs follow-up and collections of accounts with outstanding balances. Adheres to department guidance on account documentation note structure and content to provide all stakeholders with actions taken and next steps for accounts receivable management

Initiates appeals, corrected claims submissions, or submits medical records in response to payer requests for information or claims denials.

Performs appropriate cash posting and adjustments for subsequent billing or account resolution

Researches unapplied cash and credit balances utilizing appropriate payment and write-off codes

Provides excellent customer service; resolves both internal and external customer issues within an appropriate time frame; shows persistence and seeks alternatives when obstacles arise.

SAVA SENIOR CARE, Owings Mill MD 4/2012-9/2015

Medicare Billing Specialist

Manages the billing of claims to ensure timely and accuracy of billing

Analyzes claims and determines appropriate adjustments

Ensures quality assurance of claims related to contracts and agreements

Analyze revenue impact to the Income Statement from adjustments

Prepares state and/or government audit reports as required including quarterly credit balance for

Medicare and Medicaid

Identifies claims/account issues

Reviews and analyzes cash collection

Supervises case management of Medicaid Pending by state by ensuring the cases are reported

correctly and timely (training)

ADVANCED PHARMACY, Columbia, MD 09/09 10/10

Pharmacy Biller – Claims Adjuster

Create billing for all payors, creating statements for facilities, reviewing statements for incorrect invoice groups, posting all created billing batches, creating private statements, sorting 30, 60, 90 day delinquent accounts.

End of month Preparation, Entering Medical Record fees, Passport fees, miscellaneous credits and third party notification prebills for current transactions and prebills after composite batches posted.

End of month composite, end of month query runs and corrections for composite batch (included but not limited to transactions to be combined, zero cost and price recalculation, invoice groups etc.) Submit composite batches for adjudication for all long term care facilities, work all rejections in composite batches, and resolve daily phone calls and facility issues.

MAXIM STAFFING SOLUTIONS, TEMP AGENCY

MEDSTAR HEALTH, CENTRALIZED BILLING DEPT., Elkridge, MD 03/08-07/09

Medical Collections Specialist

Monthly review and processing of delinquent accounts for collections and testified in collection court as needed.

Generating monthly patient statements and assisting patients as needed with account balances.

Identify and process overpayments and correspondence.

Negotiating monthly payment arrangements with patients and follow up on those accounts in default.

Assisting coworkers in the resolution of outstanding insurance and account issues as needed.

MERCY MEDICAL CENTER, Baltimore, MD 2006-2007

Patient Accounts Billing Specialist

Team Leader for the billing department of a busy medical center.

Responsible for Medicare, Blue Cross and third-party billing and follow-up.

Resolution of outstanding claims in Sexual Assaults, Division of Cancer and Disability claims; in addition to completing Physicals for Immigration claims.

Handled incoming patient billing calls and worked to resolve outstanding account issues.

Reviewed patient accounts for outside collections and sent accounts to an agency as needed.

Worked directly with management towards the realization of the goals of the facility.

Accurate charge and receipt entry for billing and collection of third party and patient balances.

Daily system updates. Electronic and paper claim submission to all insurance carriers.

Generating monthly patient statements and reviewing accounts for collections.

Assist patients in the resolution of outstanding account issues.

Training new employees on billing policies and procedures.

Maintain monthly financial spreadsheets to include fee, profit and statistical information.

Met weekly quotas of 200 claims per week, in accordance with departmental goals.

ANNAPOLIS INTERNAL MEDICINE, Annapolis, MD 2006-2006

Medical Billing Representative

Responsible for Medicare, Blue Cross and third-party billing and follow-up.

Assisting patients in understanding their healthcare coverage and benefits.

Accurate charge and receipt entry for billing and collection of third party and patient balances

Processing appeals for medical claims denied in error by various third-party carriers.

PHYSICIANS MANAGEMENT GROUP, Baltimore, MD 2005-2006

Medical Billing Representative

Follow-up and collection of outstanding patient accounts.

Daily submission of both electronic and paper medical claims.

Daily reconciliation and entry of patient and Insurance payments.

Processed insurance claim appeals denied in error by various third-party carriers.

Generating monthly patient statements and assisting patients as needed with account balances.

PROFESSIONAL EMPLOYMENT TEMP AGENCY, Baltimore, MD

JANET, JENNIFER & SUGGS, LLC 2003-2005

Administrative Assistant/Receptionist

Daily processing of high-volume new client intake forms.

Maintained electronic filing system.

Scheduling and confirmation of upcoming conference calls and meetings.

Preparation and distribution of correspondence to clientele.

Provided clientele with an updated status of their pending medical malpractice cases.

Assisted co-workers in short and long-term projects as needed.

PROFESSIONAL EMPLOYMENT TEMP AGENCY, Baltimore, MD

GREATER BALTIMORE MEDICAL CENTER 2002-2003

Medical secretary

Scheduling patient appointments and verification of patient demographics.

Daily input of patient demographic and insurance information.

Assisted in training of new front desk employees.

Filing and archiving of patient and billing records.

Preparation of patient referrals and authorization for upcoming appointments

JONES NETWORKING TEMP AGENCY

JOHNS HOPKINS 2001-2002

Patient Services Coordinator

Input patient demographic information for new patients.

Scheduling of clinical appointments; which included office visits, laboratory testing and special examinations.

Preparation of new patient charts.

Receipt and processing of patient payments made via phone and mail.

SKILLS:

Medical Billing Systems used: Passport, MYSIS, Medical Manager, Medical Mastermind, SMS, Epic, TRAC, MediTech, ImageNow, AdvantX and Framework.

Experience with CPT and ICD-9 Coding.

Microsoft Word

Excel

Vison

Emdeon

Point Click Care

SSI

REFERENCES AVAILABLE UPON REQUEST

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