Medical Billing
Resume:
LESLIE WILLIAMS
League City, TX *****
acqq9u@r.postjobfree.com
S K I LL S / Q U A L I F I C A T I O N S
Problem resolution and reducing accounts receivable
Highly motivated team player with excellent work ethic and reliable attendance record
Ability to think independently and make decisions as necessary to meet deadlines
Excellent time management skills for coordinating and prioritizing
Knowledge of EOB’s, CPT & ICD-9 codes, HCFA’s, UB04s, HCPCS, DRGs, authorization/referrals and medical terminology .
P R O F E SS I O N A L E X P E R I E N C E
University of Texas Medical Branch- Galveston, TX 9-2013 to present
Revenue Cycle Operations-Hospital Account Specialist
(Tools-Epic, Med Assets, Epremis)
-Responsible for Medicaid, CHC Chip Perinatal, Chip, Star and Beacon accounts.
-Have assisted in resolving Molina and Superior accounts.
- Performs follow-up activities and identifies medical reimbursement issues affecting outstanding hospital accounts.
- Research explanation of benefits and followed up to ensure proper account resolution.
-Verifies eligibility for coverage with any commercial insurance, government programs.
-Process account adjustments according to policy and procedure.
-Validate accuracy of payments and/or adjustments and resolve credit balances on accounts utilizing contractual terms.
-Resolves outstanding AR accounts at a defined level of productivity and maintain comprehensive knowledge of the work unit assigned.
-Responsible for billing and collecting of all account types in a timely manner and for obtaining accurate reimbursement of all charges
generated from patient treatment, as permissible by contract or law.
-Assist in training and mentoring of new employees.
-Maintains and enforces the University’s security and privacy procedures.
Addison Search-Houston, TX 8-2013 to 9-2013
Southwest Cardiovascular-St Luke’s Hospital
Insurance Verification/Pre-Certification/Collections Coordinator
-Verified Commercial, Medicare, Medicare Replacement, Medicare Supplement, Medicaid and OON insurance on all inpatient and
outpatients.
-Set up billing accounts on all patients, enter insurance verification and updated this information in their medical record. Pulled all medical
records for the next day appointments.
-Determine amount to collect upon for testing inpatient and outpatient procedures. Reviewed patient accounts for bad debt or
outstanding balances.
-Called patients two days prior to appointments or testing if they were responsible for more than their copay.
-Assisted the front desk with checking out patients, including collection outstanding balance on account, co-pay and deductibles as
patients were seen in the clinic.
-Responded to patient phone calls with regards to their accounts, sent collection letters and correspondence about delinquent accounts
or problems with the insurance claims.
Resource Corporation of America- Clear Lake Shores, TX 12-2012 to 4-2013
Patient Support Representative-Lien Specialist
(Tools-Artiva, Secure, Microsoft Outlook)
-Responsible for using third party liability claims to file hospital liens in connection with motor vehicle accidents.
-Negotiated with the insurance company and attorney for maximum reimbursement.
-Notified appropriate insurance companies and/or attorneys of any liens filed and/or released.
-Reviewed in-house census/referrals to identify if patients were eligible for third party collection activities.
-Contacted patient by phone and mail to obtain auto accident details. Researched police reports and skip traces to obtain patient
information.
Farmers Copper- Galveston, TX 5-2012 to 12-2012
Inside Sales Representative
-Responsible for all customer quotes and purchase orders; ensuring prompt response to any customer inquiries.
-Provided the customer the material they needed in the size they were requesting as accurately as possible.
-Created quotes for price and delivery for items that were outsourced from different mill locations.
-Ensured positive public relations when dealing with customers.
Patient Account Services- Houston, TX 6-2011 to 5-2012
Insurance Follow-up Representative
(Tools-Epic, IDX, Navinet, MS Office, CU Emulate, TX Medicaid-TMHP)
-Responsible for all high dollar third party- billing for a large hospital in Colorado.
-Billed via electronic and hard copy submission on all commercial insurance including all the Medicaid rebills.
-Researched explanation of benefits and followed up to ensure proper account resolution.
-Reviewed and interpreted contractual terms for Managed Care, Commercial, Medicare, Medicaid and Worker’s Compensation.
-Responsible for ensuring the timely filing of all facility claims to third party payers.
-Identified and posted contractual and administrative adjustments and patient liability.
Action Physical Therapy and Houston Hand Therapy- Houston, TX 1-2009 to 1-2011
Billing Office Manager/Patient Account Representative
(Tools-PTOS, Ivans, Payerpath, FISS, PCP Print )
-Managed the Business Office for four physical therapy offices and one hand therapy office.
-Reduced accounts receivable over 120 days from 54% to 15%.
-Facilitated the development of procedures and policies that needed to be updated ensuring compliance with company rules and
regulations.
-Managed all department in-service meetings, hiring, training all Business Office personnel.
-Obtained accurate reimbursement of all charges generated from patient treatment, as permissible by contract or law.
-Responsible for compiling and preparing detailed daily/weekly/month end reports accurately and in accordance with deadlines for
submission.
-Posted all payments from the patient and insurance companies. Ensured deposits and money transfers were made daily.
-Responsible for billing, collecting and insurance follow up of all account types including Medicare Part A with correct CCI edits.
-Worked with Directors/Human Resources in regards to employee disciplinary and grievance issues.
FHN-Freeport Regional Healthcare Foundation -Freeport, IL 10-2007 to 10-2008
Patient Account Representative II-Client/Employer Billing
(Tools-Meditech, LSS, Mysis)
-Responsible for all client/employer billing for a 100 hospital accounts and over 200 physicians accounts including workman's
compensation.
-Created policy and procedures for how each client would be billed and how the facility would be reimbursed.
-Resolved accounts that had not been worked on for over four years.
-Posted accounts receivable/revenues and reconciled receipt batches.
-Billed Part A Medicare patient charges to skilled nursing facilities.
-Applied new encounters and episodes for charge corrections and assisted with corrections/coding logs and adjustments.
-Assisted the customer service department with patient calls/concerns, filed insurance claims, and insurance follow up.
EDUCATION/TRAINING
ROCKFORD COLLEGE- Rockford, Illinois 1996 Bachelor of Science - Business Administration and Psychology
H & R BLOCK-Freeport, Illinois 2006-2007 Tax Professional Certification
Contact this candidate