Customer Service Insurance

Tamera Boyd, CPC

SUMMARY OF QUALIFICATIONS:

• Career oriented professional with over 10 years of experience in Medical Billing, Insurance, Coding, Customer

Service and Collections

• Well versed in Emergency/Urgent Care, Orthopedics, General Surgery, Cardiology, Family Medicine, Pediatrics,

and OBGYN

• Skilled in Billing and Coding compliance

• Highly familiar with ICD-9 and CPT coding

• Excellent communication and written skills

EDUCATION:

Southern University, Bachelors of Computer Science, Baton Rouge, LA-1993

Dunbar Senior High, High School Diploma, Fort Worth, TX-1989

LICENSURES AND CERTIFICATIONS:

CPC-AAPC-2010

Emergency/Urgent Care Billing and Collections

Collections Coordinator

Billing and Coding Specialist

Worker’s Compensation Specialist

Medical Assistant

A/R Recovery Specialist

Hospital, ER, UC Billing and Coding

PROFESSIONAL EXPERIENCE:

E-Care Emergency Center, NRH, TX

Billing/Collections Coordinator &Patient Relations Specialist

February 2010-Janurary 2014

• Focus on patient account follow-up and collection, insurance follow, posting, and collections for 10 physician’s

specialties ranging from, Orthopedics, General Surgery, Cardiology, Family Medicine, Pediatrics, OBGYN with a

satisfaction rate of 91% with my lowest audit score of 87%

• Coding and Compliance

• EMC, EMR, UC Auditing, Billing, Coding

• Serves as the primary point of contact for multiple physicians located throughout DFW, Houston, and El Paso

• Correlated revenue retention and growth and business development

• Secure, build, and sustain physician’s expectations by managing the relationship between the insurance payers and

the servicing our patients care and needs

• Handle all patient requests, responding to insurance reimbursement level issues and questions

• Monitor and pursue collectable receivables due from the Patient, and communicating with the Insurance carrier to

continually understand their business model, goals, and challenges

• Responsible for having continuing knowledge of the scope and responsibilities of each servicing unit and maintain

daily relationships within those units being patient, doctors, and carriers to secure the overall success and growth

of A/R through reports, projects, and analysis

• Collect outstanding receivables from all major, private, commercial, and government plans including creating the

necessary reports, providing backup documentation, identify potential exposure and set up reserves accordingly

• Follow up until full reimbursement received, and ensure the funds are applied correctly,fee schedule review and

analysis

• Collections, Appeals, Audits for all commercial, government, third party, and W/C claims

Alpha Omega Financial Services, Dallas, TX

Billing & Patient Relations Specialist

March 2004-Feburary 2010

Contact: Tamera L. Boyd Email: ***********@*****.*** Cell: 817-***-****

• Focus on patient account follow-up and collection, insurance follow, posting, and collections for 10 physician’s

specialties ranging from, Orthopedics, General Surgery, Cardiology, Family Medicine, Pediatrics, OBGYN with a

satisfaction rate of 91% with my lowest audit score of 87%

• Coding and Compliance

• EMC and EMR Auditing

• Serves as the primary point of contact for multiple physicians located throughout DFW, Houston, and El Paso

• Correlated revenue retention and growth and business development

• Secure, build, and sustain physician’s expectations by managing the relationship between the insurance payers and

the servicing our patients care and needs

• Handle all patient requests, responding to insurance reimbursement level issues and questions

• Monitor and pursue collectable receivables due from the Patient, and communicating with the Insurance carrier to

continually understand their business model, goals, and challenges

• Responsible for having continuing knowledge of the scope and responsibilities of each servicing unit and maintain

daily relationships within those units being patient, doctors, and carriers to secure the overall success and growth

of A/R through reports, projects, and analysis

• Collect outstanding receivables from all major, private, commercial, and government plans including creating the

necessary reports, providing backup documentation, identify potential exposure and set up reserves accordingly

• Follow up until full reimbursement received, and ensure the funds are applied correctly,fee schedule review and

analysis

Impel Management, North Richland Hills, TX

Team Lead- Back End Collections

February 2001 to March 2004

• Coding and Compliance

• EMC and EMR auditing

• Contract Negotiation, Fee Schedule Analysis and Auditing

• Mange and supervise teams that consist of 15 to 20 collection reps.

• Reduced delinquent account by negotiating different repayment plans

• Accurately update all account that have been under an investigation

• A/R, Posting, and Collection

• Credentialing

Saxon Medical Services, Ft Worth, TX

Collection/Account Specialist

June 1994-December 2003

• Collected daily on delinquent accounts and system updates of activity for accounts along with A/R reports and

analysis

• Handled all inbound and outbound collections, insurance carriers, and patient calls

• Collected the outstanding debt, if unable to collect the full debt, reviewed the physician contracts and fee schedule

to assure accuracy of payments for patients reviewed financial situation for an alternative payment plan

• Used multiple software’s NextGen, Data General, Stolis, Medical Manager, Medisoft, and MD Versys other tools

to review the physician’s managed care packages, EMR charting and review for diagnosis and other documents to

make the best decision for the physician and the carriers to record the result of the payment or under payment

until resolved through all means necessary to do so include appealing

• Used Excel and other tools to assist with the loss severity calculations and in drafting the details of the workout

options recommended as applicable and ratio on reimbursement

• Sent prepared documentation for our new physicians to sign for credentialing, notarize and return so option given

could be concluded and finalized

• Maintained a work queue for a target date and goals

• Identified potential problems and timely communicated them to management

• Supervised teams of approximately 10 - 15 persons

Tamera Boyd, CPC

• Utilized computer software to document calls, analyze patient problems and seek resolution

• Utilized all available tools and technology to influence behavior with established procedures

• Worked in a goal orientated environment to meet production indicators with minimal supervision

• Answered incoming calls, collected fee schedules financial information, and analyzed the best possible option for

decrease in denial ratio

• Worked within Medicare and AMA guidelines, direct contact with the physicians, insurance representatives,

collection agents and other medical representatives to obtain the best option for plan retention

• Inserted patient information into various systems for approval and completion of cases

• Receive inbound calls from patient and carriers that have A/R from 1 month to 1 years past due

• Services ranged from various Insurance Companies providing exemplary customer service

Contact: Tamera L. Boyd Email: ***********@*****.*** Cell: 817-***-****

Contact this candidate