WINIFRED HINTON
**** ********* **. ***** ******, OH 44121
acc2hp@r.postjobfree.com
Objective: To obtain a challenging position which enables me to utilize my skills in quality claims processing and follow up billing.
Work Experiences:
02/2014 - 02/27/14 Litigation Management, Mayfield Heights, OH-Contract
Records Acquisition Follow Up Rep: Third party record collations.
09/2010 - 10/2013 CHE Trinity Health, Livonia, MI
Patient Financial Rep: Responsible for collection, posting and managing accounts payment. Responsible for submitting claims and following up with insurance combines. Prepares and submits clean claims primary and secondary to various insurance companies with electronically or paper. Managed care HMO accounts AR Follow up Specialist
09/2009 - 08/2010 Accretive Health, Warren, MI
Patient Financial Rep: Responsible for collection, posting and managing accounts payment. Responsible for submitting claims and following up with insurance companies. Prepares and submits clean claims primary and secondary to various insurance companies with electronically or paper. DC Medicaid accounts AR Follow up Specialist
08/2007 - 02/2009 Molina Healthcare Inc, Troy, MI
Claims Recovery Specialist Rep; Analyze reports and other information to identify overpayments and pursue reimbursement. This includes analysis of potential duplicate claims, claims paid to terminated or deceased members, and/or claims paid fully or partial in error. Provider backup to refund and return efforts in Finance department. Responsible adjusting incorrect paid claims, COB recovery, posting refunds, reprocessing claims.
11/2006 - 08/2007 Molina Healthcare, Troy, MI
Call Resolution Rep: Assisting providers in resolving claims issues. Examines and process claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within policies. Determines steps necessary for adjudication. Call center
05/2005 - 11/2006 Detroit Medical Center, Detroit, MI
Patient Financial Rep: Responsible for collection, posting and managing accounts payment. Responsible for submitting claims and following up with insurance companies. Prepares and submits clean claims primary and secondary to various insurance companies with electronically or paper. Managed care HMO accounts AR Follow up Specialist
08/2000 - 01/2005 Omnicare Health Plan, Detroit, MI
Provider Inquiry Specialist: Responsible for collection, posting and managing accounts payment. Responsible for submitting claims and following up with insurance companies. Prepares and submits clean claims to various insurance companies with electronically or paper.
12/1998 - 08/2000 Omnicare Health Plan, Detroit, Mi Claims Processor: Examines and process UB04 and 1500 professional paper claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within polices. Determines steps for adjudication.
01/1998 - 12/1998 Great Lakes Health Plan, Southfield, MI
Medical Claims Processor: Examines and process paper UB04 claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within polices. Determines steps for adjudication.
09/1994 - 12/1997 Cape Medical, Detroit, MI
Lead Claims Processor: Examines and process paper UB04 and 1500 professional claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within polices. Determines steps for adjudication. Claim auditor, training.
05/1990 - 08/1994 Summit Medical Center, Detroit, MI
Medical Assistant: Assist OB/GYN physician with patients, lab procedures, sterilization
procedures, front office duties
Education:
1990 - 1991 Michigan Paraprofessional Training Institute, Oak Park, MI
Medical Assistant: diploma received
1981 - 1982 Schoolcraft College, Livonia, MI
Child Care Development and Nurse Assistant: Certificate received
09/1974 - 06/1978 Southwestern High School, Detroit, MI
09/1978 - 01/1979 William Booth School, Detroit, MI
Diploma received
Other skills: Computer literate, CRT, SDM, Lotus, Microsoft Word, Excel, Outlook, QXNT, CMS, Diamond, Web Denis, Champs, Kronos, Medifax, Facets, Emdeon, Health quest, McKesson, IDX
References: Available upon request