Sonda D. Williams
Conyers, GA 30094
Home: 678-***-****
Email: *******@*****.***
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