Medical Billing Customer Service

Wendy Fonseca

**************@*****.*** ** Alice Drive Concord NH 978-***-****

Objective

Secure a responsible career opportunity to fully utilize my training and skills, while making a significant contribution to the success of the company

Education

Granite State College – Concord NH.

Experience

Billing Advantage 58 Concord Street, N. Reading 01864

Supervisor 6/18 – present

Managed a staff of 5 in the billing and receivable department

Reported directly to the Operations Manager

Coached, developed and motived billing team

Supervised and created reports for claims proofing, cash posting and claim tracking

Installed protocols to ensure all charges are captured and billed appropriately

Reviewed and consulted monthly reports with providers to suggest improvements on outstanding A/R

Resolved providers concerns and questions to ensure an ongoing successful business relationship

Responsible for maintaining the providers contracts and fee schedule in the electronic billing system

Checked insurance eligibility and obtained authorizations as well as ensuring completion of superbills

Managed all billing, collections, charge entry and claim follow up for various providers for all locations

Trained employees on organizational policies and procedures, billing software

Responsible for all providers and practices that require special account receivable clean-up

Submitted behavioral health and Neuropsych claims to insurance companies for several practicing healthcare providers over the united states

Oversaw and ran necessary reports to ensure that all statuses were worked in a timely manner and helped in any capacity necessary

Quickly identified and resolved billing, coding and insurance discrepancies

Ran, processed and ensured accuracy of patient statements on a bi-monthly basis

All aspects of billing, including charge entry, transmission, correction and resubmission as required, posting payments including patient/mail/ERA

Organized and evaluated office procedures to ensure an effective and efficient workflow

Kareo software

Northeast Clinical Services 1 Southside Road, Danvers 01923

Team Leader 6/15 – 6/18

Managed a staff of 4 in the accounts receivable department

Reported directly to the CEO and CFO

Provided excellent customer service internally and externally using oral and written communication

Created a positive team-focused working environment

Facilitated meetings with case managers and billing staff regarding changes in benefit coverage guidelines

Assisting in training and education of billing staff

Managed home healthcare authorizations for all commercial, Medicaid and workers compensation claims

Uploaded corrected claims and authorization request on POSC and all commercial website

Maintained reporting system for tracking and auditing of PA’s for Medicaid

Prepared patient balances and mailed monthly invoices

Checked new patient eligibility and maintaining recurring patient eligibility

Prepared monthly financial reports processing the aged accounts and took appropriate action to ensure claims are processed correctly

Completed special billing projects as required by the CFO

Rejection reports

Reviewed clinical notes to ensure accuracy for authorization request

Ran daily reports to ensure all scheduled skilled, PDN visits have been authorized for service

Accurately applied insurance payments to patients accounts

Displayed strong organizational and problem solving skills, utilizes time efficiently

Kantime and Healthwyse software

Partners Healthcare at Home 152 Conant St #3, Beverly Ma 01915

Senior Managed Care Assistant 5/11-6/15

Reported directly to Managed Care Director

Managed home healthcare authorizations for all commercial, Medicaid and Medicare

Uploaded authorizations on insurance portals

Follow up on outstanding prior authorizations request and denials

Work closely with the Case Managers for clinical support – reviewed clinical notes for accuracy for authorization request

Appeals and authorization request reconsiderations within the timely manner

Posted payments to patients accounts and verified medical insurance

Kept accurate records of all activity and conversations for each patient profile

Maintained the highest levels of accuracy and patient confidentiality

Performed all other duties as directed by the Managed Care Director

Centrix, Cerner and Epic software

Skills

Experienced of more than 20 in the medical billing field

Positive attitude

Leadership – Management skills

Team work

Time Management

Willingness to learn

Problem solving

Communication

Resilience

Ability to work under pressure

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