Charlene Scott
Houston, TX 77070
PH:281-***-****
acudft@r.postjobfree.com
OBJECTIVE
Diligent, detailed oriented professional with knowledgeable of all office functions. Excels at multi-tasking in a fast-paced environment, completing projects within time and budget constraints, while assisting team with daily work flow issues. Superior intrapersonal skills and very dependable.
OFFICE SKILLS
Technical Skills
All Microsoft Applications
Production Targeting
Problem solving
Customer Service
Goal Oriented
EDUCATION
Medical Office Specialist - American Commercial College - Shreveport, LA 2006-2007
R.H.I.T- Lonestar Community College- Houston, TX, Tentative Graduation date May 2016
EXPERIENCE
Patient Accounts Rep II Baylor College of Medicine– Houston, TX 2015
Undertake special projects as assigned
Investigate claim denials & rejections
Respond to payer correspondent/EOB
Analyzed patient accounts to determine patient responsibility.
Resolved patient responsibility balances through proven debt collection techniques. Payer accounts included all Managed Care payers, including HMO, PPO, and POS benefit plans.
Performed area-specific functions to ensure adequate reimbursement
Assisted with day-to-day planning, operation and problem-solving
Follow up claim status
Preform adjustment/write-off
Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
Identifies patients accurately and assigns the patient a unique identification number
Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion
AR follow-up Contacts insurance companies via telephone /website concerning unpaid accounts receivables.
Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims
Assists with inquiries from outside parties regarding account status
Drafts letters to the insurance company's Medical Review Board to expedite payment
Evaluates if payments were made according to contract. Researches and appeals insurance denials
Resolves any unusual denials, low payments, or requests for information, including appeals
Worked with Medicaid, Medicare, And Commercial Payers such as BCBS, Tri-Care, United, Aetna etc
Patient Accounts Rep II Dean's Professional Services (Baylor)– Houston, TX 2014
Undertake special projects as assigned
Investigate claim denials & rejections
Respond to payer correspondent/EOB
Analyzed patient accounts to determine patient responsibility.
Resolved patient responsibility balances through proven debt collection techniques. Payer accounts included all Managed Care payers, including HMO, PPO, and POS benefit plans.
Performed area-specific functions to ensure adequate reimbursement
Assisted with day-to-day planning, operation and problem-solving
Follow up claim status
Preform adjustment/write-off
Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
Identifies patients accurately and assigns the patient a unique identification number
Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion
AR follow-up Contacts insurance companies via telephone /website concerning unpaid accounts receivables.
Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims
Assists with inquiries from outside parties regarding account status
Drafts letters to the insurance company's Medical Review Board to expedite payment
Evaluates if payments were made according to contract. Researches and appeals insurance denials
Resolves any unusual denials, low payments, or requests for information, including appeals
Worked with Medicaid, Medicare, And Commercial Payers such as BCBS, Tri-Care, United, Aetna etc.
Medical Collector 1960 Family Practice – Houston, TX 2012-2014
Collected on insurance and patient accounts for all physicians
Worked with Medicaid, Medicare, And Commercial Payers such as BCBS, Tri-Care, United, Aetna etc.
Interprets and enforces third party payer rules and regulations; including Medicare requirements.
Works with physician offices to resolve coding issues to ensure claims were paid
Responsible appeals and denials on claims
Worked OON Claims including Follow up
Followed up on all insurance including Government Insurances
Worked AR 14,30, 60 and 120 days which most of the review and follow up was online at the payer website, called only when consistent mistakes were made by payer or if claims were not paid timely
Audits accounts to assure compliance with applicable laws and regulations relative to fraud and abuse issues.
Monitors Medicare reimbursements and maintains files.
Worked UB04 and HCFA 1500
Knowledge of coding policies and procedures; established in accordance with HCFA and third party payers.
Maintains knowledge of Medicare and third party contracts as it relates to ASC’s.
Assisted with day-to-day planning, operation and problem-solving
Assists Director and Revenue Manager with all updates on the process of new providers.
Follow up claim status
Submit appeals on denied claims
Preform adjustment/write-off
Medical Collector Addison Group – Houston, TX 2012
Undertake special projects as assigned
Investigate claim denials & rejections
Respond to payer correspondent/EOB
Submit appeals for denied claims
Analyzed patient accounts to determine patient responsibility.
Resolved patient responsibility balances through proven debt collection techniques. Payer accounts included all Managed Care payers, including HMO, PPO, and POS benefit plans.
Performed area-specific functions to ensure adequate reimbursement
Assisted with day-to-day planning, operation and problem-solving
Assists Director and Revenue Manager with all updates on the process of new providers.
Follow up claim status
Submit appeals on denied claims
Preform adjustment/write-off
Medical Billing and Coding Instructor American Commercial College - Shreveport, LA 2011
Prepares lesson plans using industry-standard approaches (e.g., multimedia, adult learning methodology).
Teaches courses as assigned, instructs and evaluates students, develops students’ skills and encourages growth, and tracks their attendance, performance, and grades.
Participates in various administrative activities (e.g., attends faculty/staff meetings or in-service meetings).
Participates in graduation ceremonies, as assigned
Participates regularly in continuing professional development activities.
Performs other duties or special projects as assigned.
Contract Medical Biller XAM – Houston, TX 2008-2011
Billed/Coded Insurance Claims (Medicaid & Medicare)
Basic level-specific activities related to research projects and studies
Data Entry/I 0 Key
Abstracts and/or assigns appropriate CPT 4 and ICD 9 and ICD 10 codes
Resolved Grievances and appeals
Worked on SSI(Medical billing software), and Meditech
Assisted with day-to-day planning, operation and problem-solving
Assists Director and Revenue Manager with all updates on the process of new providers.
Follow up claim status
Submit appeals on denied claims
Preform adjustment/write-off
Undertake special projects as assigned
Investigate claim denials & rejections
Respond to payer correspondent/EOB
Submit appeals for denied claims.
Analyzed patient accounts to determine patient responsibility.
Resolved patient responsibility balances through proven debt collection techniques. Payer accounts included all Managed Care payers, including HMO, PPO, and POS benefit plans.
Performed area-specific functions to ensure adequate reimbursement
Medical Billing and Coding Instructor Remington College - Shreveport, LA 2010-2011
Prepares lesson plans using industry-standard approaches (e.g., multimedia, adult learning methodology).
Teaches courses as assigned, instructs and evaluates students, develops students’ skills and encourages growth, and tracks their attendance, performance, and grades.
Participates in various administrative activities (e.g., attends faculty/staff meetings or in-service meetings).
Participates in graduation ceremonies, as assigned
Participates regularly in continuing professional development activities.
Performs other duties or special projects as assigned.
Insurance Clerk/Receptionist Dr. Mitchell & Dr. Montgomery - Shreveport, LA 2007-2008
Greeted Patients
Scheduled patients
Billed/Coded Insurance Claims (Medicaid & Medicare)
Utilize PC to enter and retrieve patient data
Answer multi-line phone, operate fax and copy machine
Data Entry/I 0 Key
Collected on accounts
Financial Advisor Jean Simpson (Brentwood) - Shreveport, LA 2006-2006
Answered phone
Collected on accounts
Updated patient charts
Admitted & Discharged Patients
Data Entry/10 Key
Handled large amounts of cash
Contract Medical Biller Healthcare Revenue Resources - Shreveport, LA 2005-2006
Billed/Coded Insurance Claims ( Medicaid & Commercial )
AR Collections specialist
Answer multi-line phone, operate fax and copy machine
Data Entry/10 Key
Assisted with day-to-day planning, operation and problem-solving
Assists Director and Revenue Manager with all updates on the process of new providers.
Follow up claim status
Submit appeals on denied claims
Preform adjustment/write-off
Worked on SSI(Medical billing software), and Meditech