Insurance Specialist

SAMANTHA SMITH

***** **** **** *** **

Houston, TX 77090

Phone: 281-***-****

Email: **********@*****.***

PROFESSIONAL EXPERIENCE

Victory Hospital - Houston, TX

Nov 2014 - Jan 2015

Collection Specialist (Contract)

. Maintains A/R days against company guidelines for assigned carrier

. Make timely inquiries with third party insurance companies on charges

via telephone, on-line services, e-mail, etc.

. Follow up on claims status

. Conduct claims telephone or written appeals.

. Validate Insurance Payments making sure claim paid per contract

Christus Health - Houston, TX

May 2014-Nov 2014

Collection Specialist (Contract)

. Maintains A/R days against company guidelines for assigned carrier

. Follow up on claims status

. Conduct claims telephone or written appeals.

. Validate Insurance Payments making sure claim paid per contract

. Gather materials for and apply to insurance company for

reconsideration/appeal of payment on claims, as needed

Global Healthcare Alliance - Houston, TX

Jan 2013 - May 2014

Collection Specialist

. Maintains A/R days against company guidelines for assigned carrier

. Make timely inquiries with third party insurance companies on charges

via telephone, on-line services, e-mail, etc.

. Review all zero paid or incorrectly paid EOBs through resolution of

account

. Gather materials for and apply to insurance company for

reconsideration/appeal of payment on claims, as needed

. Track carrier trends and report negative effects on payment trends in

a timely manner

Christus Health Hospital District - Houston, TX

Nov 2007 - Jan 2013

Patient Financial Services

. Follow up on claims status.

. Validate Insurance Payments making sure claim paid per contract.

. Place accounts to Bad Debt Department.

. Conduct claims telephone or written appeals.

. Obtain precertification, medical necessity and other require documents

. Correct patient insurance data in system.

. Mail letters to patients.

. Fully documents all patient accounts.

Office Team - Houston, TX Jan

2007 - Nov 2007

Insurance Claims Follow Up Specialist (contract)

. Contact third party payers for status of outstanding claims.

. Correct patient information and resubmit claim.

. Entered charges and Post Payment in Centricity billing software

. Worked Zero EOBS

. Written Appeals and Telephone Appeals

. Submit charges EDI

. Check electronic claim submission daily for rejections

. Follow up on claim status

Physician Capital Group - Houston, TX Aug

2002 - Jan 2007

Claims Analyst and Collections Specialist

. Review patient accounts and follows up on all out outstanding claims.

. Work all zero EOB'S

. Print EOB'S out of EDI to file with secondary payers

. Electronic claims Submission

. Telephone and written appeals

Contact this candidate