Patient Account Representative
Resume:
NIA HOFFMAN
BAYTOWN, TEXAS 77521
acowqd@r.postjobfree.com
OBJECTIVE:TO GAIN A SECURE POSITION THAT WILL CAPITALIZE ON MY THROUGH KNOWLEDGE OF MEDICAL TERMINOLOGY,
MANAGED CARE & GOVERNMENT BILLING/COLLECTION EXPERIENCE.
EDUCATION:SOUTHERN UNIVERSITY OF BATON ROUGE/NURSING PROGRAM
1989-1991
GPA 3.8
EMPLOYMENT: MEMORIAL HERMANN HEALTHCARE SYSTEM- HOUSTON, TX
PATIENT ACCOUNT REPRESENTATIVE II- 2008 TO 2014
*REVIEW MEDICAL CLAIMS FOR CORRECT PROCESSING OF MANAGED CARE & GOVERNMENT CLAIMS
*ANALYZE & RECONCILE MEDICAID & COMMERCIAL PAYOR CLAIMS
*INVESTIGATED & RESOLVED MEDICAID & COMMERCIAL PAYOR NON-COVERED ISSUES
*REPORT DENIAL TREND ISSUES TO MANAGEMENT
*REBILLED CLAIMS AS NECESSARY
*FILE APPEALS BEFORE FILING DEADLINE
*RECONCILE BALANCES FOR CORRECT ADJUSTMENTS & CONTRACTUAL POSTINGS
*NOTIFY BILLING DEPARTMENT OF ERRORS TO CORRECT TO ENSURE PAYMENT
*FOLLOW-UP ON OUTSTANDING CLAIMS WEEKLY
*CORRECT PATIENT DEMOGRAPHIC/HEALTH INSURANCE INFORMATION
*REVIEW HCPCS/ICD-9 CODES FOR ACCURACY PER MEDICAID GUIDELINES
*AVERAGE 46 CLAIMS PER DAY
*HIPPA & MEDICAID COMPLIANT
TENET HEALTHCARE ? NEW ORLEANS, LA
COLLECTOR, APPEALS, AND CLAIMS PROCESSOR ?2002 TO 2005
*PROACTIVE IN CLAIMS PROCESSING OF MANAGED CARE & COMMERCIAL PAYORS
*MAINTAINED ONGOING KNOWLEDGE OF UB04, HCFA 1500, AND OTHER MANDATORY STATE BILLING FORMS, FILING
REQUIREMENTS
*PERFORMED ALL DATA ENTRY OPERATIONS
*REVIEWED INSURANCE CLAIMS TO ENSURE PROPER REIMBURSEMENTS
*PERFORMED FOLLOW UP WEEKLY ON OUTSTANDING MEDICAL CLAIMS
*RESPONSIBLE FOR SEVERAL RECONCILIATION REPORTS
*TRAINED NEW EMPLOYEES
*ASSISTED PATIENTS WITH GENERAL CUSTOMER SERVICE & CLAIMS ISSUES
*GENERATED APPEALS IN TIMELY MANNER
*HIPPA, MEDICAID, AND MEDICARE COMPLIANT
*PROACTIVE IN CLAIM PROCESSING BY CALLING INSURANCE COMPANIES FOR CLAIM STATUS
*ANSWERED PATIENT AND INSURANCE COMPANIES INCOMING CALLS
TREADWAY PEDIATRICS- NEW ORLEANS, LA
MEDICAL BILLER/DOCTOR ASSISTANT-2000 TO2002
*ACCOUNT RECEIVABLE DUTIES
*BILLED MEDICAID, MEDICARE, & MANAGED CARE CLAIMS
*OBTAINED PRELIMINARY INFO FOR MEDICAL RECORDS & BILLING PURPOSES
*ASSISTED FRONT OFFICE WITH APPOINTMENT SCHEDULING, FILING, INSURANCE VERIFICATION, AND TELEPHONES.
*ORGANIZED SYSTEM FOR EOB & INSURANCE CORRESPONDENCE
OCHSNER CLINIC FOUNDATION ?METAIRIE, LA
CHARGE PROCESSOR ? 1995-2000
*PROCESSED EMPLOYEE PAYROLL
*PERFORMED ALL DATA ENTRY
SKILLS:MICROSOFT WORD, EXCEL, POWER POINT, HEALTH TRIO, SYNDICATED OFFICE SYSTEMS, HEALTH QUEST,
MULTI-TASKING, TYPE 45+ WPM
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