Customer Service Medical
Resume:
ANGELA S. SIMMONS
DENVER, COLORADO 80231
CELL 832-***-****
******.***@*****.***
SUMMARY
Experienced in financial and accounting principles. Over 15+ years of experience in revenue cycle reporting. Over 15+ years of experience in Medicare, Medicaid, and Managed care eligibility, and billing. Proficient in HCPCS, ICD-10, and CPT coding. 15+ years of experience in Clinical appeals. 20+years of experience in Customer Service. 20+ years of experience in Account Payables/ Receivables. 10+ years of Cash Posting experience. 10+ years of experience working in high volume call center for patients with questions and or concerns regarding their accounts. Editing and posting charges into Medicare DDE system. Extensive knowledge of EMR data systems. Resolving patient and provider issues. Researching account and payment issues. Extensive insurance follow-up. Documenting patients accounts. Extensive knowledge of UB-04 and HCFA1500 Claims. Discrepancy Analyst. Research and Resolution of patient accounts.
TECHNICAL EXPERIENCE/ SOFTWARE/ PROGRAMS
Multiple HCA web based programs, Legacy Collection System, HOST, Proficient with all Microsoft Office Products, Expert in Excel, Accounts Payable/ Receivable, Auditing, Bookkeeping, C-Meds, Customer Service, Data Entry, Medical Assisting, Medical collections, Medical Billing, Med-soft, record keeping, Peachtree, Medi-tech, Xactimed, Medicare DDE system, Med-asset Revenue System, SSI Billing Systems, Collect Logics Patient Accounting System, Epic patient account system.
EDUCATION
05/1987 E.E. Worthing High School Houston, Texas
1988-1990 Lee Community College Baytown, Texas
1/2002 National Institute of Technology Houston, Texas
WORK EXPERIENCE
09/2014- Present Cordant Health Solutions Denver, CO
Workers Comp Billing Supervisor
Advises departments about the status of claims, loss experience trends and program costs
Reviews and approves all claim settlements proposed by the third party claims adjusting administrator as per contract rate.
Directs and monitors the activities and performance of the workers' compensation third party claims adjusting administrator to ensure compliance with applicable regulations.
Develops and provides or arranges for training programs relating to workers' compensation laws, benefits, policies and loss control.
Re-bill claims, refund payments, research error and denied claims.
Generate spreadsheets to reflect account progression
1/2013- 10/2014 Surgical Center Biller/ Claims Auditor Englewood, CO
Billing/Payment Resolution/Customer Service/Collector/ Insurance Follow-up
Resolving issues on the aging report
Collector
Patient verification of Benefits
Receive, Resolve, and document patients/carrier calls regarding accounts
Provide resolution of accounts
Research outstanding balances
Re-bill claims, refund payments, research error and denied claims.
Administrative assisting
Generate spreadsheets to reflect account progression.
8/2012-1/2013 Haxtun Hospital District Haxtun, CO
Business Office Director: Temp Position via Robert Frasier Healthcare Consultants
Oversees all functions within a hospital's business office.
Managed the financial performance of the revenue cycle
Supervision of patient scheduling, registration, financial counseling, medical records, billing and collection, data entry and processing, and cash posting
Develop, implement and maintain office policies and procedures
Interview, hire and train a productive medical office team and conduct performance reviews
4/2011-5/2012 Christus Healthcare Houston, TX
Commercial Billing Specialist II
Balanced all confirmation reports to general ledger and SSI billing system totals
Review, correct and/or appeal all denied claims
Maintained daily spreadsheets/reports of unbilled, error claims
Ability to resolve credit issues.
Work with payment resolution team to resolve refund and payment issues.
Answer questions for patients regarding balances and or credits issues.
12/2005-1/2011 HCA /Huntsville Memorial Hospital Huntsville, TX
Government Billing Specialist/ Discrepancy Analyst
Maintained 72 Hour Rule log with daily reports. Maintain daily census reports/ logs (manually)
Maintained daily spreadsheets/reports of unbilled, error claims
Research and resolve credit balances on State and Federally paid accounts
Generated, analyzed, and balance revenue cycle reports for CFO’s of 26 facilities in the Gulf Coast region
Ability to speak with patients regarding account issues.
Set up payment plans for patients to resolve outstanding balances.
2/2003-11/2005 Northeast Community Health Clinic Houston, TX
Financial/Business Office Director
Supervision of clinic staff of 15+ employees.
Responsible for managing the clinics financial resources.
Responsible for revenue cycle reporting, recording, and daily balancing.
Responsible for generating reports for the State of Texas and the Board of Directors to reflect all financial invoicing of incoming revenue vs. outgoing revenue.
10/2000-04/2003 PAS/ACS Houston, TX
Medical Biller (High Dollar Claim Division)
Checked claims for errors, corrected, submitted claims to various insurance companies, verified insurance information, billed for physician, and facilities all over the country, familiar with Champus, Champa, Medicaid, Medicare billing.
Revenue cycle reporting for 9 facilities
Followed up with insurance companies, checked claim status.
Supervised team of 20+ billers and coders
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