Customer Service Medical

Cynthia Graze

Medical Biller/Patient Account Representative

Hayward, CA

*******@*****.*** - 408-***-****

Seeking a challenging position where my Medical Biller skills and experience will greatly enhance the company's success and my own personal growth.

Authorized to work in the US for any employer

WORK EXPERIENCE

Medical Billing Specialist

Alameda Health System - San Leandro, CA - February 2016 to April 2016 Responsibilities

Billing, posted insurance payments. Following up on denied claims. Appealed denied in correctly. Billing specialist

stanford - Palo Alto, CA - October 2014 to January 2016 Responsibilities

Follow up on unpaid and under paid claims, verified patients insurance, appeals, phone call it insurances to follow up on claim .

Medical Biller/Patient Account Representative

CHME - Foster City, CA - December 2010 to December 2013 Answer incoming patient phone calls with courtesy and helpfulness (80-100 daily calls).

• Resolve and reconcile incoming phone inquires efficiently and courteously in timely manner or create a backlog to be researched.

• Handle Commercial and Medicare INS patient's inquiries, by clear oral or written communication in timely manner.

• Make necessary demographic additions, deletions and changes per oral or written requests.

• Follow acceptable procedures for invoices that are zero (0) to sixty (60) days old using the Paperless Collection System (as scheduled by your Patient Accounts Coordinator or Patient Accounts Supervisor.

• Reconcile credit balances and process valid refunds from the Daily Credit Report within seven (7) working days.

• Authority to write-off an invoice with reasonable proof and justification neither up to $2500.00 nor as directed by Patient Accounts Coordinator or Patient Accounts Representative.

• Attend weekly Dept meetings with questions and concerns. Medicare Billing Specialist

Cigna Healthcare - San Francisco, CA - February 2010 to October 2010 Worked on claim Adjustment Report (COB15, MCCB) to have bad debt written off.

• Confirmed patients claim was Rolled (CO45) to correct Secondary payer for billing.

• Worked on Split project report to have unpaid claims be re-billed on a separate new claim.

• Make necessary demographic additions, deletions and changes per oral or written requests.

• Direct incoming phone calls, if necessary, to appropriate staff members with courtesy.

• Handle Medicare INS patient's inquiries, either by clear oral or written communication in timely manner.

• Make necessary Medicare insurance (Contact, Commercial) additions, deletions and edits.

• Work efficiently as a team member, offering support, make suggestions, and accept change.

• Clearly communicate to the Medicare Dept Supervisor any back log, system or work related problems. Billing Representative

UAS - San Jose, CA - May 2008 to October 2010

Contacted payors to verify coverage (Medi-cal, Medicare, PPO, HMO) and eligibility requirements of patients.

• Obtained verbal/written insurance authorization for patient's medical treatment and resolved discrepancies as needed.

• Processed and billed Medi-cal, Medicare, PPO and HMO insurances for inpatient and outpatient medical treatment

• Ensured correct CPT, ICD-9, HCPC codes were completed accurately on 30-1 and 1500 claim forms for A/R close.

• Confirmed that the correct payor and benefit level had been selected in system to ensure proper revenue recognition.

• Responsible for management of Authorizations report to include all expirations and re-authorizations as needed.

Medical Biller

Lighthouse Management - Milpitas, CA - November 2007 to February 2008 Contacted insurers to verify coverage (Medi-cal, Medicare, PPO, HMO) and eligibility requirements of patients.

• Obtained verbal/written authorization for patient's medical equipment and resolved discrepancies as needed.

• Confirmed correct ICD-9, CPT, HCPC, Payor and benefit level had been selected to ensure proper revenue recognition.

• Responsible for management of Held Revenue report to include all expirations and re-authorizations required.

• Responsible to maintain and minimize second request holding accounts.

• Notified patients of their insurance eligibility and benefits coverage for DME equipment.

• Back-up telephone assistance for Customer Service Dept and processed work orders for patients when needed.

• Attended monthly staff meetings and perform other related duties as directed by supervisor. Billing Representative

Advantacare Medical - Monterey, CA - March 2005 to September 2007 Contacted payors to verify coverage (Medi-cal, Medicare, PPO, HMO) and eligibility requirements of patients.

• Obtained verbal/written insurance authorization for patient's medical treatment and resolved discrepancies as needed.

• Processed and billed Medi-cal, Medicare, PPO, HMO insurances for patient's medical equipment claims.

• Ensured correct ICD-9, CPT, HCPC codes were completed accurately on 30-1 and 1500 claim forms for A/R close.

• Confirmed that the correct payor and benefit level had been selected in system to ensure proper revenue recognition.

• Responsible to maintain and minimize second request billing/holding accounts.

• Responsible for Held Revenue Report and Follow-Up Management.

• Back-up telephone assistance for Customer Service Dept.

• Attended monthly staff meetings and all other tasks assigned by supervisor.

• Processed and collected on 30-1 and 1500 patient claims from Medi-cal, Medicare, PPO, HMO health insurances.

• Worked directly with health insurance's on improving measures of past due accounts.

• Provided customer service, research of contract's policies, patient claims on a daily basis.

• Ensured correct ICD-9, CPT, HCPC codes were completed accurately on 30-1 and 1500 claim forms for A/R close.

• Responsible to maintain and minimize second request holding accounts.

• Generated Write-Off memos, request claim changes, record and follow up on all disputes. Collections Representative

MHCS - Modesto, CA - October 2003 to December 2004 Processed and re-billed patient claims to health insurances.

• Work directly with health insurance's on improving measures of past due accounts.

• Provide customer service, research of contract's policies, patient claims on a daily basis.

• Generate Write-Off memos, request claim changes, record and follow up on all disputes. Accounting Specialist

Peninsula ENT - Burlingame, CA - January 2003 to October 2003 Invoiced daily drop shipments.

• Matched and processed Vendor Invoices, Credit & Debit memos.

• Maintained Invoice packet files and archived as necessary.

• Researched discrepancies between Purchase Orders & Vendor Invoices.

• Processed Purchase Orders and Sales Orders for our Vendors. Credit/Collections Representative

Med Accounts - Pleasanton, CA - November 2002 to January 2003 Collected from over 280 accounts, with monthly account balances of well over 8 million dollars.

• Provided Customer Service, research of the contracts' policies, invoicing, etc. on a daily basis.

• Created Credit & Debit memos, Invoice change requests, recorded and followed up on all disputes. Billing Representative

Dameron Hospital - Stockton, CA - November 2000 to January 2003 Provided Customer Service, with past-due letters, statements, reports and contract policies.

• Worked directly with external patients on ways to improve billing process.

• Generated Financial Reports, Credit & Debit memos. Credit/Collections Representative

Bay Area Home Tech - Sunnyvale, CA - October 1995 to October 1996 Collected from over 600 accounts, with account balances of well over 5 million dollars.

• Provided customer service, research of contract's policies, invoicing, etc. on a daily basis.

• Generated Credit & Debit memos, created Invoice change requests, recorded and followed up on all disputes.

• Provided customers with Dunning letters, Invoices, statements and reports.

• Worked with clients upper Management to secure payment in a timely manner.

• Responsible for the billing and collection activity for the North Atlantic region. (Company's largest portfolio)

• Handled corporate customers, including Marriott, Hyatt, Hilton, Holiday Inn, etc.

• Collected amounts in excess of $2.8 million for the company on a monthly basis.

• Analyzed problematic accounts and partnered with peers to devise solution strategies.

• Provided cash forecast analysis and corporate collections, including competitive analysis, cash flow analysis, and credit evaluations, to CFO and upper management.

• Worked directly with internal and external clients on ways to maximize and improve collections process. Application Knowledge:

Oracle ERP 11, QAD (MFGPRO), CITRIX, Mestamed, Brightree, ASC, EPIC, PeopleSoft, IDX, Windows NT/98/95, MS Office (including Excel, Word, Outlook and PowerPoint). EDUCATION

Ashford University

January 2012 to Present

Community Business School - Modesto, CA

June 2002 to December 2002

ADDITIONAL INFORMATION

SUMMARY OF SKILLS

• Experienced at improving collections/billing through applications of analytical and business development techniques.

• Proficient in using PC technology to enhance data and work flow management.

• Advocate of quality customer relations.

Contact this candidate