Dea Maloy

Aurora, CO *****

720-***-****

ac6rqp@r.postjobfree.com

OBJECTIVE:

Seeking a challenging and rewarding position in a company that will utilize my education, training, and experiences to its fullest potential. As well as have room for advancement in a career.

SUMMARY:

Ensure that billing for all services provided is accurate, timely and fully documented. Provide efficient cash collection through excellent reimbursement practices while ensuring compliance with relevant laws, regulations and established Company policies and compliance programs.

EXPERIENCE:

10/15-08/18 Cordant Health Solutions Denver, CO

Workers Comp Specialist/Accounts Payables and Receivables/Payment Posting

•Manage the client billing, deposits and payment postings

•Perform capitated client billing, aging and collections tasks

•Monitor test files, client promise pay and associated pricing

•Providing monthly delinquency notices

•Administer client communications, correspondence, and client files

•Adhere to departmental guidelines and protocols

•Provide support for the department and assist with special projects, as assigned

•Meet defined department goals and activity metrics

•Manage account reviews, credit balances, contractual agreements, allowances, and pricing.

•Perform payment postings, deposit reconciliations, batch reviews, and adjustments and refund processing.

•Administer manual adjustments, refunds, and reimbursements.

•Research payment discrepancies, refund requests, and account suspensions.

•Provide support for the department and assist with special projects, as assigned

•Reduced total AR from 3 million to $89K in 6 months

01/14-08/15 Hanger Orthotics and Prosthetics Denver, CO

Worker’s Compensation/Collections/Administrative Assistant

•Obtain accurate insurance information, verification and pre-authorization.

•Assisted with internal audits

•Process all billing daily, ensuring that claims are accurate, timely and fully documented.

•Follow up on all open accounts, maintaining thorough chronological financial records on each patient account.

•Coordinate communications with payers to ensure accurate billing practices, enhance reimbursement opportunities, achieve cash collections targets and reduce or maintain A/R over 120 days at and below target level.

•Provide counseling to patients advising them of their financial responsibility and obtain credit agreements for outstanding balances.

•Apply payments and adjustments to patient accounts, process deposits and maintain accurate records of all cash received in a timely manner and in accordance with Company policy.

•Maintain accurate and complete patient files, ensuring that they are in compliance with the Hanger Compliance Policies.

•Familiar with Oracle I-Supplier, ECHO health care payment systems, Navi-Net, Linkia Portal, CLMS(claims life-cycle management system)

•Ensure the privacy and security of protected health information per HIPAA requirements.

•Review clinician documentation to ensure that patient charts are complete.

•Perform other duties or special projects as assigned.

10/13-01/14 Robert Half/Office Team-Eating Recovery Center Aurora, CO

Medical Billing Specialist

•Performing the timely and accurate entry and updating of patient demographic and third-party payer information, daily charge posting, daily payment posting, and will act as administrative support to the business office team members.

•Read, interpret, and understand an explanation of benefits and an understanding of insurance benefits

•Working knowledge of patient accounting, third party payer procedures, and managed care

•Extensive Facility Billing in a hospital setting and a broad range of experience with Insurance contracts and adjustments

•Prioritize and manage multiple projects simultaneously. Follow through on issues in a timely manner

04/10-07/13 Zynex Medical, Inc. Lone tree, CO

Workman’s Comp Billing Lead

•Assist department in accomplishing the goals of the billing team through accurate billing of claims for medical products and services

•Initiation of referrals to Medicare and non-Medicare carrier, retro if available

•Increased revenue by providing billing and coding support concerning devices, accessories and supplies for patients, insurance carriers, physicians, and the patient attorneys

•Vast knowledge of compliance and billing requirements for commercial, federal, and/or private HMO, PPO, Medicare, and Workers Compensation carriers

•Maintain open accounts receivable within time limits for filing claims to insurances and dispute payment denials

•Knowledge of HCPC and ICD-9 coding

•Pull/Review Explanation of benefits for secondary claims processing and appeal procedure

•Ability to negotiate and collect payment from insurances, patients and attorneys as required

•Excellent communication skills with regards the use and benefits of the specific units, while keeping attorney, patient, and insurance adjuster of the case status and needed documents

01/05-03/06 Accounting Principles Denver, CO

Medical Records Custodian

•Retrieve records for physicians, benefits administrators, government agencies and attorneys

•Enter admission of patients for outpatient procedures

•Schedule appointments

•Collect and record co-pays and coinsurance.

•Call for insurance verification with all major and minor insurance carriers.

•Prepare daily bank deposits

•Responsible for answering multiple phone line

EDUCATION

Hinkley High School-1996-Academic Diploma

Certification in Travel, Tourism, and Hospitality

Pickens Technical College Aurora, CO, 1996

Pursued Business Management Degree 2009

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