Sonda D. Williams

*** ******** ****

Conyers, GA 30094

Home: 678-***-****

Email: acdqfy@r.postjobfree.com

EXPERIENCE

Expeditive, Princeton, NY

*/****-*******

Billing/Collection-A/R -Cash Acceleration Team Lead

. Worked as a Consultant at Downstate Hospital Brooklyn, NY, and Mount

Carmel Medical Columbus, OH, Winchester VA. Successfully recovered

10million dollars from insurance back log. Prepared inpatient,

outpatient claims that was 60-180 days old to Medicaid HMO, Medicare,

and Commercial insurance companies. Performed various collection

actions including contacting patients and insurance companies by phone

and letter. Resolved claim issue on a day to day basis

. Corrected and resubmitted claims by written appeals, and coding

referral to HIM.

. Maintains strictest confidentiality; adheres to all HIPAA

guidelines/regulations

. Answers questions from patients, clerical staff and insurance

companies. Identifies and resolves patient billing complaints.

Evaluates patient's financial status and establishes budget payment

plans. Follows up and check weekly report status of delinquent

accounts. Post payments and adjust accounts that need adjustments

DKing Consultant, Dallas, TX 5/2009-

12/2011

Billing/Collection Project Manager

. Handled all collections and oversee the coding, unbilled reports and

was able to get the bills out in a timely manner.

. Ensured charge information provided is correct and accurate. Improve

productivity and be a Strong Leader and influence/motivate staff

. Enters charges into the Practice Management System and Balances Charge

Summary to tickets keyed before updating charges

. Assisted in charge capture by reviewing provider documentation and

patient charts

. Worked in conjunction with A/R team on follow up and resolution of

coding related denials and rejections. Also provided AR management for

self pay accounts and balances.

. Coordinates with front office staff on payment/billing issues.

Identified quality issues with registration and scheduling activities.

. Consultant at Robert Woods Johnson University, University of

Pittsburgh Medical Center, North West Health Systems in Fayetteville,

AR, Washington Region in Fayetteville, AR.

HCA (All Medical Personnel), Atlanta, GA

5/2008-5/2009

Appeals Collector/Biller

. Collected on denied claims from the different insurance companies;

familiar with Re-billing, Appeals and the process and forms; A/R,

knowledge of Policies and Procedures. Knowledge of CPT & ICD-9 coding

and Explanation of Benefit and credit balances and refunds

. Reviewed and determines appropriate strategy for response to denials

of reimbursement for clinical appropriateness and/or level of care

issues

. Prepared appeal for denied records, citing relevant clinical

documentation to support level of care and billed charges. Assured the

appeal submitted before the deadline for all cases.

. Works with the Medical Director of Case Management, other physicians

(including specialists and the attending physicians for denied cases),

Case Management nursing leadership and other disciplines as

appropriate in order to complete and submit an appeal for every case

where an appeal is appropriate.

. Performs continuous analysis of data and prepares reports for Fairview

Park Hospital, Doctors of Augusta, and Eastside Medical Center. Works

with Clinical Departments and other services on the development of

corrective action plans and implementation of solutions to specific

problems identified from trended data.

Baptist Health Systems (DDS Medical Staffing) Atlanta, GA

10/2006 - 4/2008

Reimbursement Specialist Team Lead

. Demonstrated proficiency, and accuracy in all billing or follow-up,

cash processing, and collection. Understand both internal and

external customer needs, anticipates their needs and works to exceed

organizational needs at all times and the ability to review and

correct Medicaid claims (on-line)

. Possess proficiency in Medicaid regulations & guidelines and completed

complex problem resolution; investigated, and resolved documents

issues in timely manner. .

. Prepared and balances daily and monthly cash reports in an accurate

and efficient timely manner to ensure continued cash flow and Hospital

viability.

. Submitted bills to appropriate payer through the use of electronic or

manual claims processing, reviewed electronic claim error

reports or in-line systems and made necessary changes.

Sheakley Group, Pittsburgh, PA

10-2000/04-2005

Senior Claims Recovery Specialist II

. Processed all forms for account receivable documentation, and

investigated claims, coverage analysis, damage evaluation.

Negotiated and disposition of Multi-party. Recovered denied claims

and identified research, analyzed and corrected problems with

overdue/unpaid patient accounts.

. Utilized, ICD9/CPT coding procedures for inpatient and focus on

Medicare Part A & Part B

To accurately review and correct claims

. Submitted insurance claims to first, second and, third party payers

and applied, payments to account/correct fund or revenue source and

assist in the monitoring of the issuance of all patient bills for

service.

. Examined claim submissions for proper coding and charges. Managed

unbilled on daily basis

. Possessed thorough knowledge of Benefit Plan for assigned secondary

account

. Evaluated medical records for billing appropriateness and screen for

medical necessity

EDUCATION

Community College of Allegheny

County

Pittsburgh, PA

Business Accounting: Certificate, 2002/Real Estate: Certificate,

Sawyer Business of

School

Pittsburgh, PA

Business Management, Certificate

Training

Incorporated

Pittsburgh, PA

Medical Coding/Medical Office Management, Certificate

SKILLS

Fluent in using MS-Office Suite,MS-Project98, Excel, Insurance Verification

& Scheduling, Accounting software, MS Windows, UNIX OS, Caremedic, Med

soft and Epic, Medicare, Medicaid,DME Billing System, Siemens-Invision

ICD-9-CM and, CPT-4 & Modifiers, HCFA1500, Florida Shared System (FSS ),

Meditech, NPR, McKesson Star, HPF,AS400, Emdeon Claim Master, Patient

Registration, Medical Manager, SSI, Allscripts, E Clinical Work, MediTouch,

NEXGEN

REFERENCES AVAILABLE UPON REQUEST

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