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Collection Coordinator Insurance Claims

Location:
Miami, FL
Posted:
November 14, 2023

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Resume:

Peter Moncada

ad047w@r.postjobfree.com

305-***-****

SUMMARY:

Experienced analyzing credit for customers in Latin America and Miami- (Colombia, Mexico, Brazil, Puerto Rico, Argentina)

Prepared weekly forecasts for collection.

Established policies for collateral secured credit lines (credit insurance with Euler Hermes) with all international customers.

Accomplished to reduce delinquency by 30% and effectively reduced DSO from 71 to 46 days on average.

EDUCATION:

Fort Lauderdale College

Bachelor ‘s of Business Administration

PROFESSIONAL EXPERIENCE:

Sanitas Corp & Keralty Hosp Nov '22 - Present

Medical Collection Coordinator

Identified coding or billing problems from EOB and worked to correct the error in a timely manner with audit team or client,

Monitors Insurance claims by running appropriate report and contacting insurance to resolve claims that are not paid

Billing and Collections of Medicare, HMO, Worker; Comp, Self-Pay

Analyzed aging AR and monitor accounts for non-payments and collect on daily basis.

Identified coding or billing problems from EOB and worked to correct the error in a timely manner with audit team or client,

Collecting delinquent payments, making payments arrangements, and or recovery debt

Reprocessed claims for payment in a timely manner, and prepared client request forms

Prepare collection cases for litigation; and reviewed and processed bankruptcy petitions, skip tracing.

Prepare weekly forecasts for collection.

Mailed letters to insurance or customer to encourage payment of delinquent accounts, review and entry daily charges, modifiers and services

First Bank Florida Nov '17 - Aug '22

Credit & Collection Coordinator

A/R and Credit Analysis, debt income ratios, determines worthiness of the loan (auto & commercials)

Monitoring delinquent loan accounts (auto-mortgage-credit card

Collected Mortgage and /or Equity Loan Accounts and post ACH payments as needed, review escrow-and Review Direct Deposit Accounts for negative balance.

Collecting delinquent loan payments, making payments arrangements, and or recovery collateral.

Assign auto for repo/follow up on deficiency balance & total loss & insurance check reimbursement.

Prepare collection cases for litigation; and reviewed and processed bankruptcy petitions, skip tracing.

Prepare weekly forecasts for collection.

Review credit reports to decide necessary course of action.

CSI Caregiver Service 2015 - 2017

Medical Collection Specialist

Billing and Collections of Medicare, Medicaid, HMO, PPO’s, Worker’s Comp, Self-Pay

Monitors insurance claims by running appropriate report and contacting insurance to resolve claims that are not paid

Mail from letters to insurance or customer to encourage payment of delinquent accounts

Review, revise-reprocess and follow-up on all appeals / denials, process all claims Electronic/Web Portable or Paper

Identify coding or billing problems from EOB and work to correct the error in a time manner with audit team or client, respond to Insurance requests providing all necessary billing paperwork treatments and product.

Update claims billing notes in CPR T with the status detail notes

Analyzed aging AR and monitor accounts for non payments and collect on daily basis.

Imperial Business Solutions Inc. 2010 – 2015

Credit & Collection Consultant – Medical & Commercial Accounts

Provide business consulting, credit analysis, audits and litigation support for domestic & International accts in all industries and of all size. Recommend new techniques for improved credit and collection performance

Analyze AR aged trial balance, working knowledge of federal,state and local rules concerning billing & collections UB04 & HCFA1500 forms, monitors billing and others processes on daily basis to prioritize work flow identify problems- Collections of -60+ accounts

Private Insurance Medicaid, Medicare and Self Pay accounts, Medicare Contact Attorney for letter of protection, review claims to determine reason for denials

Reprocess claims for payment in a timely manner, and prepare client request forms

Conduct benefits investigations, verify insurance benefits for patient and physicians office, and submit prior authorizations as required payer.

Obtain recertification for cases required extended/treatment (blood/cancer/heart diseases etc coverage beyond the expiration of original approved.

Frequent follow up activities to obtain reimbursement from Payor and for patients

Consulting for the following companies: Kira Inc., Trial Graphix, Olympus Latin A, First Florida Bank, HealthSouth Rehabilitation Center, Sign Supply Co, First FL Funding Service, BrightStar, Eduardo Soto PA,Exclusive Auto Inc., ARC Medical Recovery

Agrizzi Enterprises Corporation, Miami, FL

Credit Manager 2007- 2009

Reviewed credit application, established lines of credit and conducted financial analysis

Negotiated credit terms with multiple equipment providers

In charge of collections for Latin America and Miami- (Colombia, Mexico, Brazil, Puerto Rico, Argentina)

Review collection reports to ascertain status of collection and balance outstanding and to evaluate effectiveness of current collection procedures

Prepared weekly forecast for collection and provided reports to executive team

Assisted on Month end closing for the entire region

Review collection reports to ascertain status of collection and balance outstanding and to evaluate effectiveness of current collection procedures- weekly forecast for collection

Reduced delinquency by 30% and effectively reduced DSO from 71 to 46 days on average

DHL- Danzas Air & Ocean, Miami, FL 2002 – 2007

Credit & Collection Coordinator

Work directly with Sales Manager & Team to ensure all shipments are handled as per SOP

Establish credit and collection procedures. Prepare collection report for Management

Prepare collection cases for litigation; and reviewed and processed bankruptcy petitions, skip tracing

Responsible all Conglomerates Hasip, National accts &. Domestics, Totaling $ 35 Million

Analyze financial statements and credit analysis. Major control A/R credit & collection audits

Responsible for ensuring all invoices & unresolved issues for department Imports, Domestics Brokerage

Preferred Home Care of America, Miami, FL 1988 - 2002

Credit & Collection Coordinator

Analyzed the account receivables and aged trial to provide a collection strategy and evaluation of the credit limits with financial statements and D & B Reports.

Prepared collection cases for judgments and suits, appeared in small claims court for firms.

Direct and assist with month-end closing for account receivable

Collected on various conglomerates and government agencies

Education & Training

Bachelor of Business Administration, Ft Lauderdale College

Completion training programs in the areas of Credit & Collections Supervision, Sales, Marketing, and Financial International Trade, Lien Laws, and Credit Insurance..

Additional Relevant Skills

MS Office Applications, PowerPoint, Bi-Lingual: Spanish & English



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