Customer Service Medical Billing

June L. Horton

*** **** ***** ****** ( New York, NY 10039 ( ( 917-***-**** ( (

********@*****.***

Medical Billing - Accounts Payable / Receivable - Contracts

Versatile, resourceful, and results-driven professional with exemplary

qualifications and experience to lead and support medical billing, AP/AR,

and contract management activities/functions. Skilled at working

effectively both independently and collaboratively as part of a team in

fast-paced and demanding environment to complete tasks and projects while

adhering to strict deadlines and quality standards. Self-motivated

individual with exceptional interpersonal skills to establish productive

working relationships with staff, management, patients, and third-parties.

Actively contribute to improved efficiency, productivity, and customer

service goals and business success.

Areas of Strength

( Billing, Coding, and Collections ( Accounts Receivable & Payable

( Training / Mentoring / Coaching

( Cross-Functional Collaborations ( Manage and Maintain Contracts

( Hospital and Healthcare Systems

( Software/Systems/Applications ( Patient/Vendor Communications (

City/State/Government Contracts

( Professional/Positive Demeanor ( Analyzing / Resolving Problems

( Budgets and Financial Oversight

Professional Experience

Client Billing Manager, Harlem United, New York, NY

2011 - 2013

Held accountable for demonstrating a high degree of communication and

problem solving skills to coordinate, prioritize, and manage the Medicaid

billing function. Directly responsible for ensuring the accuracy,

reliability, and timeliness of all billing submissions, information, and

reports generated and for confirming that transactions comply with Medicaid

billing policies and procedures as well as applicable government and

insurer regulations.

. Displayed excellent capacity to meet deadlines, build rapport with

individuals at all levels and backgrounds, and to support billing goals by

facilitating an environment that consistently achieved/exceeded

expectations.

. Managed and completed multiple duties/tasks accurately and in a timely

manner, worked effectively within a fast-paced team environment, and

adhered to all Medicaid and company billing policies and procedures.

. Maintained professional and courteous communications, demeanor, and

interactions with all individuals as well as continually identified and

provided additional assistance as needed to support efficient daily

operations.

. Effectively managed team members including performance management and

evaluation, individual training and coaching, establishment of work

goals/expectations, and handling/resolving employee matters as needed.

. Implemented practical follow-up procedures within the billing department

for all submitted, resubmitted, and unpaid claims. Participated in the

fiscal audit by organizing supporting documentation and reports.

. Confirmed accurate and timely posting and reconciliation of third-party

reimbursements to patient accounts as well as ensured client support and

comprehension on billing reports to drive necessary client follow-up.

Billing Supervisor, St. Lukes Roosevelt Hospital, New York, NY

2008 - 2010

Maintained full responsibility for utilizing well developed organizational,

analytical, and leadership abilities to efficiently manage day-to-day

billing operations including charge entry, payment posting, and insurance

updates in a fast-paced environment. Consistently applied strong

communication skills to liaise between management, staff, and physicians to

streamline processes, assist front desk staff, and identify, address, and

resolve patient issues.

. Applied well developed facilitation and coordination abilities to support

and manage all internal and external billing needs and requirements, track

deadlines and timelines, and to consistently achieve optimal results.

. Leveraged attention to detail and organization skills to thoroughly

review and correct IDX edit reports, handle refunds, adjustments, and

claim denials, and submit and follow-up on appeals for reconsideration as

needed.

. Independently investigated and resolved problems, provided internal and

external customer service, maintained accurate documentation, managed

complex billing requirements, and ensured compliance with policies.

Professional Experience (Continued)

. Provided administrative sign-off on cash, credit card, and check

deposits, evaluated credentials for new and existing providers, and

determined compliance in accordance with procedures and regulatory

requirements.

. Cultivated a reputation for professionalism, honesty, and integrity as

well as for maintaining a high level of work quality. Quickly learned and

mastered new systems and job responsibilities to produce excellent

results.

Director of Billing / Contracts Manager, Burchman Terrio Quist, LLC, New

York, NY 1999 - 2006

Directed and coordinated medical billing and customer service needs for

Federally Qualified Health Centers (FQHC) and Article 28 clients. Held

accountable for developing and implementing effective billing and contract

strategies and for identifying trends in claim patterns. Improved the

timeliness of department claims submissions resulting in a reduction of

accounts receivable delinquencies and the facilitation of payments for

future claims.

. Contributed to improved organizational efficiency and productivity

through effective team leadership, holding meetings to ensure billing

compliance, managing office workflow, and implementing process

enhancements.

. Reviewed/handled a high volume of documentation, ensured completion and

submission of monthly voucher, organized supporting documentation for

audits, and controlled monthly variance reports related to contracts.

. Prepared budgets and wrote justifications for contract renewal packages,

analyzed and monitored spending and reimbursement patterns/trends, and

regularly advised management on the status of contract spending.

. Effectively managed various processes, procedures, and functions related

to contract maintenance and renewal including submitting monthly,

quarterly, and annual reports to city, state, and government-funded

agencies.

. Maintained up-to-date billing and financial information to provide

highly reliable data quickly while using well developed interpersonal

skills to respond to a variety of internal and external requests and

inquiries.

Billing / AP Supervisor, Mount Sinai Medical Center, New York, NY

1987 - 1998

Held directly accountable for the coordination and management of all

Radiology billing and accounts payable functions. Trained, supervised, and

motivated up to 14 employees, improved productivity and workflow, and

supported a wide range of billing and AP needs. Regularly responded to and

resolved calls from vendors, patients, physicians, and insurance companies

regarding claims, complaints, discrepancies, and other issues/concerns.

. Exhibited ability to communicate clearly and effectively while utilizing

excellent coordination and facilitation skills to lead and evaluate the

status of projects and to ensure timely completion of tasks and

assignments.

. Oversaw check distribution process, reviewed and countersigned checks,

assisted with month-end accruals and fiscal year-end closing, and reviewed

invoices to ensure accurate coding and appropriate source process.

. Managed vendor inquiries and issues including reconciling vendor

accounts, reviewing statements, resolving credit holds, and ensuring that

vendor shipping, billing, and return policies were followed accordingly.

. Collaborated with collection agencies to authorize holds, write-offs, and

payment plans for patient accounts and processed check requests for

refunds, reimbursements, travel advances, and additional business needs.

. Gathered and analyzed AP data to prepare reports for management,

identified and documented quality control issues, assisted with account

review and reconciliations, and ensured adherence to AP policies and

procedures.

Education

Some College Courses -

Training and Development:

. Medical Billing and Coding, Medical Insurance, Contract Protocol

Training, Leadership/Supervisor Training, Customer Service/Office, Billing

Applications/Systems/Databases, Medicaid, Contracts, Medical Terminology

Technical / Computer: AP/AR, HCPC, EPaces, MedicsElite, MDeverywhere, URS,

Eagle, FundEZ, Medical Manager, ADS, ICD-9, CPT-4, A/P Flexware, Cash

Applications, IDX, Omnipro, Medicaid Billing, Account Reconciliation,

Exchange, Millennium, Great Plains, FHP and Stop Loss Billing, Microsoft

Office Suite

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