Insurance Medical
Resume:
Margo Evon Manns
Covina, CA 91723
Profile: I am highly motivated results –oriented, dependable professional as a Senior Patient Accounts Receivable Representative and Customer Services skills with Hospital and Professional Medical Billing and Collections skills. Excellent written and verbal communication skills with an eye for detail. Extremely productive in a high volume, high stress environment. Specializing in following up on Accounts Receivable over 90 to 120 days and older and High Dollars accounts over $10,000. A Self starter with a can do attitude, I work well independently and as part of team.
Experience: Government Billing and Following up on Medicare, Med-iCal accounts both by manual and electronic billing and knowledge of Medical Terminology. I billed and collected on Commercial Billing accounts resolving problem accounts by doing Appeals Letter on accounts that where not paid on correctly or not paid on at all. I did Workers Compensation Billing and Follows up. I prepare and process Patients and Insurance Refunds and work on accounts that had credits balance to determine if the balance was a true credit balance. I also verified Insurance coverage on Insured and patient when calling Insurance companies.
Employment History:
Temp Unlimited Staffing- Beverly Hospital, Montebello, CA, 04/17/13 – 11/01/13,
Managed Care Representative my duties where Billing and Following Up on Managed Care Medi-Cal Accounts thru the Med Tech Computer System software and Billing Managed Care Accounts both Inpatient and Outpatient Claims thru DSG (Data System Group). I also did 1st Level Appeals and 2nd Level Appeals when needed for processing claims for payment, and Account Adjustments and Refunds to Insurance Company and Patient Refunds, I check Patient Eligibility through Medi-Cal Website and Anthem BC website. I work Correspondence Daily that came thru the Mail that needed additional information like Medical Records, Retro Authorization and Eligibility issues.
Kforce Financial Staffing – Kaiser Permanente, Pasadena, CA 04/25/11 - 01/25/13,
Billing in the Clinical Documentation & Audit Operations department that enter in data on Self Funded Consented accounts, Self Funding Regional accounts then the final steps is to closed the accounts. I work on posting diagnosis and CPT codes on Allied Health accounts after the Auditor have coded the accounts thru KPHC Resolute system.
Office Team Healthcare – Orthopedic Hospital Medical Center, 03/08/11 – 04/10/11
Patient Accounts Representative billing Med-iCal Manage Care HMO’s and Commercial Insurance accounts thru AS400 software and billing and correcting correspondence through Emdeon claims billing and follow up system. I also corrected claims in Athena Health professional electronic billing system.
ROI-ARC Group – Timonium, Maryland, 05/03/10 – 11/2010
Accounts Receivable Representative that worked at Pacific Health Corporation in Bellflower, CA as a outside contractor company who cleans up and resolve all types of accounts that where denied for payment such as Managed Care Med-iCal accounts and Med-iCal accounts and Commercial group Insurance accounts over 90 days that where assigned to ARC Group by billing and following up on these accounts in a timely manner through Paragon for accounts information and notes and Claim Administrators billing hardcopy and electronic claims.
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Office Works Staffing – AHMC Healthcare, Alhambra, CA 03/02/10 – 04/23/10
I did Medicare follow up on Palmetto GBA remote system on Inpatient Medicare and Outpatient Medicare accounts through CWF, MSP and COB determination. I did follow up activity and I was able to look at accounts to determine if claims should be billed as a 121 Bill Medicare Part B and Med-iCal primary.
Office Team Healthcare – Bienvenidos Children’s Center, 01/06/10 -01/28/10
Billing Family Pacts accounts to CA Med-iCal through Advance MD billing system.
Healthcare Resource Group – Kaiser Permanente- Pasadena, CA 08/13/07 – 07/27/09
Insurance Billing Specialist – Edited and did weekly reports in EPremis and KPHC on Commercial Insurance, Workers Compensation Insurance and Third Party Payers through Premise electronic billing and KPHC Epic Resolute PB and HB patient data from DHMO accounts. I also did Commercial Insurance Collections for Inpatient and Outpatient accounts for out of network provider. I also prepare and mail out Subpoena and Liens for the Special Recovery Unit.
ASAP Staffing- Tri City Medical Center, Long Beach, CA, 08/2006 – 10//2006
Med-iCal Collector that did following up on Med-iCal and Cal optima accounts.
Careers Strategies- Tenet Healthcare, Alhambra, CA, 12/2005- 03/2006
Insurance Billing I billed and rebilled Commercial Group Insurance through Premise software.
Insurance Overload System- Tenet Healthcare, Orange, CA 9/2004 – 10/2005- Customer Service Representative –Answered inbound call in support of customer needs. Work in call center environment and also did Insurance follow up.
Pomona Valley Hospital Medical Center, Pomona, CA – 05/2002 -09/2004, Contracts Billing Collector- I did Commercial Group Insurance following up on Manage Care accounts such as doing Appeals on Group Insurance accounts for underpayment and missing insurance information such as diagnosis and procedure codes billed. I also resolve Credit Balance to be refunded to Insurance companies or patients accounts that where billed incorrectly. I work on Anthem Blue Cross accounts and United Healthcare accounts contracts my doing a Microsoft Excel Worksheet showing the expected reimbursement to be paid.
On Assignment Healthcare- Pomona Valley Hospital Medical Center, Pomona, CA- 12/2001 – 05/2002 as a Contracts Billing Collector
Insurance Overload System – Tustin Community Hospital, 08/2001 -10/2001
Billed and follow up on Med-iCal accounts such as Inpatients and Outpatients accounts through CIF, RTD’S and Med-iCal Appeals.
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Pediatrics Medical Group, Orange, CA- 06/2000 -07/2001 Med-iCal & Medicaid Collector –I follow up on Med-iCal accounts, Cal optima accounts and CCS accounts that where denied by Cal optima HMO Med-iCal and CCS.
Western Medical Center, Santa Ana, CA -12/1999 – 05/2000 Med-iCal & Cal optima Billing – Billed Med-iCal and HMO Med-iCal, Caloptima accounts and follow up on denied claims. I also billed Medicare/Med-iCal crossover claims through MDX software.
Insurance Overload System- Magellan Medical Group – Orange, CA 02/1999 – 12/10/1999 – Collector my duties where collecting on Pediatric Commercial accounts.
On Assignment Healthcare Financial Staffing, Costa Mesa, CA 08/15/1998 – 12/30/1998- Medicare/Med-iCal Billing and follow up.
Downey Regional Medical Center, Downey, CA 10/1997 – 08/1997- I billed Med-iCal Inpatient accounts through BC Med-iCal.
Pacific Health Corporation, Anaheim, CA 07/1985 – 08/1997 as a Patient Accounts Representative – I was responsible for Billing and Following up on Medicare/Med-iCal facility claims and Commercial Insurance Billing. Electronic Billing system use for Medicare Billing and Medicare follow up was through Mutual of Omaha electronic billing system. I also billed Med-iCal through MDX and Bill and follow up on Workers Compensation accounts.
Computer Skills: Microsoft Office including Excel, Word and PowerPoint, Microsoft Windows XP Professional. Microsoft Outlook, Microsoft Access
Software Experience: Medical Billing: DDE for BC, MDX for Med-iCal, Medical Manager for Physician Billing, SMS, Mutual of Omaha for Medicare, Epic Resolute Professional and Hospital Billing at Kaiser Permanente, AS400, Medtech, E-Premis, CPSI similar to SMS system, Palmetto GBA for Medicare, Advance MD.
Office Skills: Typing speed 50wpm and 10 Keys 10,000 strokes per minutes.
Education: Gardena High School, Gardena, CA
Compton Community College, Compton, CA
Cal State University L.A, Los Angeles, CA
Orange County ROP, Medical Coding –Anaheim, CA
Medical Terminology – Mt Sac Community College, Walnut, CA
Associate of Arts Degree – Psychology, Compton, CA
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