Insurance Manager
Resume:
Dominique Boyd
Chicago, IL ****0
***********@*****.***
Education
Richard J Daley(Chicago, IL) - Associate in Science 05/2006
Loyola University (Chicago, IL)- 2 years Pre-Med 2014
Experience
Billing Coordinator 06/2018-current
Help At Home (Chicago, IL)
Bill Home Base Community Services(electrically and paper).
Learn and master contract billing requirements details.
Meet billing deadlines according Medicaid/State regulation.
Upload billing file to KYMMIS for reimbursement.
Monitor clearinghouse for rejections.
Follow A/R denials and supplement claims and resubmit corrections .
Review prior authorization to ensure proper servicing to clients.
Assist Cash Posting with remittance issues.
Train new employees on billing and handling A/R.
Assist Manager with interview processes.
Delegate task via spreadsheets to ensure A/R is under 180 days
Develop and maintain working relation with branch office and Case Managers.
Billing/Insurance Follow-Up (Lead) 08/2017-06/2018
Rev MD (Lombard, IL)
I Oversee 10+ Reps. in a department of 140 reps.
I perform weekly Audits to ensure Quality and Assurance
I delegate daily tasks via Excel Spreadsheet and report methods
I monitor clearinghouses such as: True-Bridge, Availity and internal billing system for rejections and/or RTP claims.
I perform charge entry, billing, editing and follow up in multiple systems to ensure proper reimbursement for all insurance carries.
I analysis ATB, Ad Hoc reports, EP summaries for system or billing trends.
I perform weekly training classes to ensure quality is maintained and company protocol is upheld.
I attend weekly Lead meetings to report all problems with resolution to upper management and to ensure company policies are being maintained.
I also perform Cash Posting from ERA(s) and 835(s) reports of Insurance, Client and Patient payments.
Financial Assessor/07/2016-03/2017
Advance Resources-Northwestern Medicine (Chicago, IL)
●I reviewed and updated Epic system with new insurance, claim edits, and EOBs, information
●I reviewed payers fee schedule ensure proper payment reimbursement was made.
●Submitted paper and electronic billing in a timely manner to payers such as: Medicaid and Medicare, BCBS, Cigna, ABH and MCO plans.
●I reviewed EMR for billing and appeal purposes
●Train new employees on Work-ques for No authorization or/and per-certification denials and locating trends.
●I reviewed payers’ web-portal or IVR to obtain claim or benefit information.
●I posted Medicare contractual adjustments in the Epic system
●I attended bi-weekly training meetings to keep updated on new procedures and trends.
Full Cycle Biller (November-2013-March 2016)
Magna Health System (Bedford Park, IL)
●I Billed full revenue cycle for Physicians, Facility and Anesthesia for all payers.
●I reviewed pre- coded Op-reports and enter CPT and ICD-9 codes for billing.
●I reviewed payers’ contracts and billed accordingly.
●I submitted I department claims electronically.
●I worked closely with office Physicians and Clinical Nurses, in reviewing medical records in order to obtain information relevant to patient issues or/and billing trends.
●I followed up on insurance A/R reports
●I verified patient’s eligibility and benefits prior to services.
●Generated EOM audits to ensure monthly goals were met.
Medical Collector/Biller (Aug.-2009 – November-2013)
Miramed Revenue Group (Lombard, IL)
●3rd party debt collector on past due medical balances for clients such as: Resurrection, Advocates, Northwestern Memorial Hospital and Faculty, Provena and Elmhurst
●Received 150-200 Inbound/Outbound calls from patients, insurance and attorney’s offices on delinquent accounts
●Pulled Credit Reports in effects to collect on outstanding patient accounts
●Reviewed EOBs for accurate adjustments and billing to patients
●I performed skip trace on patients to obtain new demographic information.
●I Assisted Kaiser Permanente Patients w/ account resolution
●Collected on hospital and physician billing ensuring payment plans were current.
●Updated Epic system with new insurance, patient information and all other related information necessary for re-billing
●Trained new employees on maneuver through epic and call handling.
Telephone Service Rep. (April-2006 – May-2009)
Teleperformance USA (Oakbrook, IL)
●Received inbound calls from Citibank customer inquiring about open credit card account
●Resolved financial problems for customer with outstanding balances
●persuaded customers from canceling their protection plan on their Citibank CC
●Received 100% monitoring on Quality and Assurance monthly
●Transferred all other questions or/and dispute to escalation department
Skills
I have worked the following billing systems: DataFlex, AuthentiCare, EVV, KYMMIS. Epic, McKesson, Med Mate, SIS, Cubs, DDE, Xifin, Evident and Cerner. Also Microsoft with all functions and Citrix.
I am proficiency with EMR, Avality, Navinet, Connex, HFS and NEBO and many others.
I have strong knowledge with UB, 1500, HCPCS, ICD 9/10 and CPT codes and Revenue codes
Knowledge with Ad Hoc, ATB, EOM consolidation reports and able to multitask.
Strong attention to details, excellent communication skills and able to type 35-40 wpm.
References
Danielle Berta- Human Resource Director(Rev MD)- 630-***-****
Demont Wahid- Consult for NM Professional- 678-***-****
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