Insurance Medical

Holly Wilkey

*** ************ **., ********* *******, Florida 32701 - 407-***-**** (H) - 321-***-**** (C) –

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Professional Summary

Highly efficient Medical Biller with experience in Medicare and in non-Medicare billing. Excellent multi-tasker

and demonstrates a team player with a positive attitude. Seeking a challenging and responsible position with

professional growth and advancement.

Skill Highlights

● Familiar with commercial and private

● Composed professional demeanor

insurance carriers

● Office management professional

● Insurance and collections procedures

● Records maintenance

● Understands insurance benefits

● Patient chart auditing

● Billing and collection procedures

● Excellent problem solver

● Team player with positive attitude

● Resourceful and reliable

Professional Experience

All Seasons Health Care Sept 2013-Current

Billing Manager

Longwood, FL

Review all claims aging daily, review tracking logs daily for Doctors orders to be signed. Oversee chart auditors/coders daily.

Supervise all billing and medical records department. Process all denial claims for Medicare. Monitor outstanding claims

report, process all denials until account is paid in full. Perform billing adjustments as needed and ensure that all adjustments

are reported accurately and timely. Generate aging reports to maintain a 45/90 DSO and work until claim is paid in full.

Monitor and work RTP and rejected files on a daily basis directly in Medicare's program. Work closely with intake and billing to

resolve any billing errors. Performed quality control of the data entry system to verify that claims and payments were posted

correctly. Accurately entered procedure codes, diagnosis codes and patient information into Medicare billing software.

Interacted with providers and other medical professionals regarding billing and documentation policies .Precisely evaluated

and verified benefits and eligibility. Identified and resolve patient billing and payment issues. Act as a liaison between the

business department, billers and third party payers in resolving billing and reimbursement accuracy. Demonstrate professional

conduct and ethic according to the agency policy and procedures. Preform daily audits on all patients’ final claims for correct

frequency and orders from the physician for accuracy for submission to Medicare for payment.

Nurse On Call July 2008 to Sept 2013

Corporate Medicare Analyst

Maitland, Florida

Generate, review and make necessary corrections on all Raps and Final claims being transmitted to Medicare. Bill and collect

over One Million Dollars in revenue each month for each of my location that I am responsible for. Manually Code previous

claims that where billed to produce daily money report for corporate. Process all denial claims for Medicare. Monitor

outstanding claims report, process all denials until account is paid in full, perform billing adjustments as needed and ensure

that all adjustments are reported accurately and timely. Generate aging reports to maintain a 45/90 DSO and work until claim

is paid in full. Monitor and work RTP and rejected files on a daily basis directly in Medicare's program. Work closely with

intake and billing to resolve any billing errors. Performed quality control of the data entry system to verify that claims and

payments were posted correctly. Thoroughly investigated past due invoices and minimized number of unpaid accounts.

Accurately entered procedure codes, diagnosis codes and patient information into Medicare billing software. Interacted with

providers and other medical professionals regarding billing and documentation policies, procedures and regulations. Precisely

evaluated and verified benefits and eligibility. Identified and resolved patient billing and payment issues. Act as a liaison

between the business department, billers and third party payers in resolving billing and reimbursement accuracy.

Demonstrate professional conduct and ethics according to the agency policy and procedures.

June 2003 to May 2008

Summit Charter School

Executive Administrator

Maitland, Florida

In charge of accounts receivable and payable for over two hundred vendors. Made all bank deposits from all three schools

and posted all receipts. Ran reports from general ledger and bank reconciliation to ensure accurate account balance.

Thoroughly investigated past due invoices and minimized number of unpaid student accounts. Assist in the annual audit

process for the county. Recorded and filed student’s data. Completed registration quickly and cordially for all students.

Provided administrative support for three campuses. Initiated, performed and documented quarterly all students’ information

for FTE funding. Accurately generated student bills and posted payments weekly. Interviewed and processed new hire

employees payroll, benefits and annually contracts. Precisely evaluated and verified all students’ eligibility before entering

school. Maintained and updated collections tracking spreadsheet to help organize student's payment information. Evaluated

student's financial status and established appropriate payment plans. Reported directly to the school principal.

Physicians Administrative Support Services October 2002 to May 2003

Billing Specialist

Longwood, Florida

Responsible for the ICD9 coding and CPT codes for anesthesiologist specialty procedures. Post all payments and

adjustments for Medicare, commercial insurance and self-pay patients. Responsible for tracking all correspondence with

insurance companies and work all denied claims until resolved. Initiated, performed and documented quarterly coding audits

for physicians. Interacted with providers and other medical professionals regarding billing and documentation policies,

procedures and regulations. Accurately posted and sent out all medical claims. Responded to correspondence from insurance

companies.

Florida Hospital Home Care March 1998 to October 2002

Billing Supervisor

Orlando, Florida

Generate and reviewed request for anticipated payments to be transmitted to Medicare. Manually processed all denial

claims for Medicare and commercial insurance and processed until accounts where resolved. Generated and maintained

outstanding balance reports. Preform monthly audit on all patients’ final claims for correct frequency and orders from

physicians. Preformed accurately and timely billing adjustments as needed. Posted Medicare payments to patient’s

accounts. Posted all visits and supplies to patients account. Generated claims and audited patients records for correct

doctor frequency and orders signed. Verified patient’s insurance, Medicare and Medicaid coverage. Completed authorization

forms from insurance companies and obtained authorization for patient's visits and correct billing process to insure proper

payment. Reported directly to billing manager.

Florida Hospital Home Care April 1995 to March 1998

Department Secretary

Orlando, Florida

Maintained confidential personnel files. Processed employee time and attendance records for all clinical staff. Maintained on

call payroll, petty cash, salary slips, expense reports and employee evaluations. Ordered all office and medical supplies.

Preformed monthly audit for all patients. Generated weekly census and recertification reports. Responsible for maintaining

confidentiality of patient's medical records. Filling all patients’ documents. Accurately and timely tracked all physicians’ orders

and plan of care. Maintained an adequate supply of agency forms and patient admission packets. Assisted in dispensing of

patient's medical supplies. Reported directly to the director and completed any and all office functions as needed.

Education and Training

General 1992

High School Diploma

Orlando, Florida

Experience in DDE Medicare software, Host, Excel, Microsoft Word, Paradox, ProComm Plus, Quick Books, Stat

Hospital Program, Visitrax, PC-ACE 32, MVP Eslolutions, Episode Alert, Soneto, EMR, Care Voyant All Scripts and

Availability.

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