Medicare Billing Specialist

KATHERINE SMITH

404-***-**** • **********@*********.***

Experienced professional with an extensive background in healthcare, accounting, insurance and

Medicare. Creative problem solver with ability to increase productivity and work efficiently under

stress. Flexible, quick learner who is able to multi task in a rapidly changing environment.

Exceptional customer service skills.

EDUCATION

DeKalb College Clarkston, GA

Nursing – 09/80 06/83

DeKalb Technical College – Clarkston, GA

Medical Terminology – 06/99

PROFESSIONAL EXPERIENCE

HCA Patient Account Service Center Norcross, GA

09/01 present

Medicare Billing Specialist

Works all identified insurance requirement edits through the electronic

billing system.

Works rebills submitted to the billing department through the electronic

billing system.

Posts late charges to accounts and maintains daily follow up.

Communicates issues with patient access and facility departments.

Quality Assurance Analyst

Monitored accounts, calls, collections and patient access using established

formats in score for quality and accuracy using exceptional customer

service skills.

Objectively recorded and reported results of quality monitoring within the

PASA guidelines.

Provided detailed documentation on areas of delinquency and elaborate on

errors as needed.

Balancer/Discrepancy Analyst

Worked discrepancy reports and assigned appropriate reason codes.

Balanced the daily electronic Medicare remits to RAC, the mainframe

systems and general ledger.

Resolved balancing using Microsoft Excel.

Completed recalculation of logs after contract or reimbursement

changes/updates.

Bad Debt Analyst

Prepared and reviewed reports for hospitals for Bad Debt reporting of

Government insurance accounts.

Researched individual patient accounts for eligibility to be placed on the

Bad Debt reporting list.

Completed and provided monthly spreadsheets for audit by Corporate

Accounting Controller.

Managed Comp Insurance Atlanta, GA

11/99 – 09/01

Claims Assistant

Set up first injury reports and loaded into database to be processed by

claim adjustors.

Calculated mileage and prescription reimbursement for workers’

compensation clients.

Dispensed payout compensations on loss time claims and medical

coverage.

Answered customer calls and provided updates as needed.

Underwriting Assistant

Reviewed new business submissions and entered into the Compass system

for review.

Manually rated policies to give potential clients rate quotes for services

requested.

Processed and distributed policies, endorsements and audits to existing

clients

Assisted sales brokers, clients and the government bureau with loss

requests.

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