Tonya Oliver

Seasoned Accounts Receivable, Medical Collector

Temple Terrace, FL 33637

acp907@r.postjobfree.com - 813-***-****

I have worked in the health care industry for 10 + years. I have been in several specialty practices. My main goal

is to help medical practices profit by teaching them how to be proactive with their AR. Placing new procedures

and goals in place for success and to build a strong, long lasting team! Whether you are a new practice starting

out or a practice that is trying to re brand and rebuild, I have the tools to achieve a thriving, profiting practice.

A strong practice equates to happy patients.

Computer Skills include Emdeon,Greenway, Epic, Advantx, HST, Medisoft,Centrix,Camis,E Clinical Works

Claims Master,Medical Manager Next Gen & Ingenix Coder, Proficient in Microsoft Word, Excel, EDI

experience Highly Efficient in auditing and researching complex issues .

I am currently seeking employment that will provide challenge, longevity and continued advancement.

Authorized to work in the US for any employer

WORK EXPERIENCE

Collector

Anesthesia Billing Solutions - Tampa, FL - October 2014 to Present

Processed refund requests verified insurance coverage with Medicare, Medicaid and most commercial

insurance carriers called insurance companies/ patients

Researched accounts that show no payment

Re-submitted claims to insurance Researched denials

Billed insurance companies and/or patient for unpaid balances

Set Up payment arrangements on past due accounts

Audit Recovery Specialist

Emdeon - August 2012 to September 2014

Identifying and resolving over and under payments of claims; Resolve claims audit issues; Review notes,

payments, refunds, recoups, etc. calculate reimbursements, payments, etc.; Review variances and take

appropriate action, Working knowledge and understanding of Medicare (DRG, OPPS, APC, RBRVs) and

Medicaid (APG, FFS, PAS)- Perform daily review of high dollar UB04 hospital inpatient and CMS1500

medical claims forms in Macess, for payments in Facets to providers and facilities, involving analysis of

previous monthly payment history, approved ICD-9/ICD-10 codes, covered dates of services, and application

of Coordination of Benefits. Identify problem accounts for discrepancies and potential Issues

Identify coding and billing issues from EOB's and Correspondence

responsibilities included review of account to determine clinical denials such as no authorization, not medically

necessary, denied days, level of care, pre-cert penalties and pre-existing conditions. Insurance follow up to

obtain detailed authorization information. Create appeal letters and send to insurance and follow up on the

appeal until appeal is approved and payment is reviewed. Request medical records from facility and work with

RN/LPN to appeal based on medical necessity, denied days and level of care.

Collections Specialist

American MRI - July 2008 to August 2012

Reviewed Claims and Patient Accounts for Proper Processing and Resolution

Contact Insurance Companies to resolve claims not paid in a timely manner

Work EOB's both paid and denied to assure proper resolution was complete

Updated and noted action taken on accounts Working Knowledge of PIP, Commercial Insurance, and Private

Pay.

Collections Manager

Advantage Open MRI - May 2004 to June 2008

Knowledge of Insurance Billing & Collections Office Policies and Procedures and compliance.

Run Daily Collection & A/R Reports, Review accounts to resolve all payment issues from Insurance Companies

Initiate appropriate Collections actions on self pay accounts, File and follow up on appeals. Knowledge of

Personal Injury Protection Insurance (3rd Party), Commercial Insurance, and Private Pay. Posting payment to

patients accounts, Print and mail patient statements. Processing Incoming Mail. Daily Bank Deposits

EDUCATION

Diploma

Jefferson High School Tampa - Tampa, FL

August 1986 to June 1989

ADDITIONAL INFORMATION

KEY SKILLS & CORE COMPETENCIES

Clear and thorough communication

Strong Decision Making Ability

Multi-tasking

Strong Project management and Leadership Skills

Accuracy and punctuality

Computer Software: Emdeon, Greenway, Advantix, E Clinical Works, HST, Medisoft, Medical Manager, Claims

Master, EPIC, Centrix, Camis

Contact this candidate