Accounts Receivable Financial Service

Mary Ann Van Valkenburg

***** ***** ***** ***** ********, AZ. 85374

206-***-****

ad07q2@r.postjobfree.com

SKILLS: Epic/Resolute, E-Premis, Mindscape, Cerner, Orca, PFS, CD-Com, TUI, MS-4, Optum, DSG, CMS, Avility, Word/Excel, Share point, People Soft, Crystal, REG-ADT, Cerner, GE, Evident, T-system, Sorian, Medi Insurance verification system and Arizona Medicaid including all Medicaid and commercial provider portals. Accounts receivable and payable.

EXPERIENCE: *Developing relationships with clients and co-workers. *Organizing work and resolving problems. *Demonstrated record of high performance standards. *Attention to deadlines and quality of work. *Patient Registration in ER, Admitting, HOPD * Patient Access Representative * Referral Processing * Patient Financial Service’s: billing, insurance follow-up, intake and preauthorization * Patient Financial Service Counselor * Emergency Room (front and mid station) * Medicare (HMO, Advantage and Traditional) * Insurance Contracts either Medicare, Medicaid or Commercial Insurances.

CAREER HISTORY

February 2022-Current: Manager of 4 Sons on Bell/Reems. Daily duties included supervising 13 employees, payroll, daily deposits including balancing daily running retail and weekly retail. Running and maintaining the daily operations of the store. Working with employees from training and education along with corrective action when needed. Handles the process of hiring all employees. Writing checks for vendors, arriving new delivers. Stocking coolers and store daily. Weekly employee schedules, handling all issues at store and resolving them. Maintaining highest health department standards and store standards. Maintaining a working relationship with all venders, drivers and most all customers.

November 2021-February 2022: St. Josephs Emergency Room, Patient Access Registration (Per Diem). Checking in patients to ER, including arriving patients by ambulances and trauma’s. Complete registration of patients. Collecting insurance and processed benefits and collected all co pays and payments due at time of service. Completed all admit papers needed for patient staying in hospital, including IM, MOON and OBS forms needed for Medicare, also completed MSP’s for Medicare patients.

November 2018-November 2021: PHI Air Medical PFS Teams Operations Coordinator: Under the direction of the Manager of Patient Financial Services provides operational oversight of billing and collection procedures to include electronic and paper billing, pre-billing reviews, auditing and training, employee workflows, accounts receivable review and systems monitoring. Duties include: Performs an understanding of insurance collections to include; payment in full (negotiation) offers, overpayment reviews and approvals, next action on correspondence, insurance types, insurance classes, in compliance with PHI's billing policies and procedures. Maintaining a professional relationship and effectively communicating with first responders, facilities, PHI agencies, entities, insurers, attorneys and patients. Draft correspondence to patients and payers including 1st level appeals for technical denials, and identify accounts to refer to Appeals Department for escalation. Review and interpret explanation of benefits to determine contractual compliance, accuracy of payment received, true patient responsibility, status of denied or reduction of service coverage and follow up appropriately. Effectively discuss outstanding claims with payers related to slow payments, underpayments, denials and to ensure claims are processed compliantly and paid appropriately. Identify, collect and confirm insurance coverage to include obtaining prior authorization, third party liability and coordinator of benefits. Being a patient advocate to obtain additional information and support for claims processing, or to discuss outstanding patient balance with options. Maintains a professional relationship and effectively communicating with first responders, facilities, PHI agencies, entities, insurers, attorneys and patient's. Monitors daily billing and collection activity to ensure benchmarks are met. Communicates daily with team members and management to share priorities, issues and accomplishments. Performs daily and weekly monitoring of account receivable and/or billing to include queue reviews, payer issues and aged accounts. Demonstrates detailed knowledge of regional insurance requirements. Acts as a liaison for outside collection agencies, partner facilities and other providers by assisting with requests and questions. Demonstrates ability to take direction, coordinate projects and prioritize assignments on individual and departmental level.

April 2018 to October 2018- Dignity Health-Patient Access Representative ER, Admitting, HOPD and Hospital (Per-Diem). Duties included quick registration to ER, complete registration of patients including updating and processing insurance. Collecting deductibles, co-insurance and co pays. Discharging patients and account review. Completed bridge orders to admit patients to Hospital including complete paperwork to Admit. Medicare MSQP’s. Cash reconciliation end of day, Census reports. March 2018 to Current- Safeway-Lead Support for Purchasing and Employee’s (Part-time): Cashiers, GM and Floral Operations duties include cashiering, stocking, ordering of product. Warehouse: receiving and stocking of goods from venders. Front-end support included fillings til’s, collecting cash. Loomis arrivals of cash and pickups of cash.

August 2017 to February 2018- Banner Health Corp, Mesa Patient Financial Service Supervisor- duties included calling and checking on the status of claims on Medicare and Commercial insurances, resolving all issues in regards to the claim. Sending Medical Records, resolve coding issues, short pays, write offs, process requests from Insurance to ensure payment of claim. Took all inbound customer calls resolving their issues with their account. Responsible for claims billed to UHC and Medicare plans, performed all follow up on claims billed. Status, requests medical records. Filed reconsiderations on denied claims, filed Appeals, disputed short pays, called insurance for benefits and coverage. Called patients in regards to account. Took all inbound customer service calls in regards to patient’s accounts. Submitted write offs, audited accounts for coding and DX issues. Dropped balances to patient responsibility. Verified that primary insurance paid correctly, either Medicare or commercial insurance. Responsible for resolving Medicare billing issues, such as non-covered services, Revenue code issues, DX and coding issues that result in nonpayment from other insurance patients have. Supervisor duties included payroll, assigning daily work. Meeting financial goals monthly for company. Reviews.

September 2013-September 2017 attended College working on Bachelors in Business.

July 2013 to June 2-17 Tahoma Doyon Real Estate and Property Management Property Manager- duties include booking of properties, maintaining the property, and handle all concerns or issues in regards to property and tenants. Prepared and cleaned properties for incoming guests.

January 2006 to May 2013 Virginia Mason Medical Center Patient Health Unit Coordinator (Patient Access Representative) for Oncology- duties included answering all phones, requesting medical records for doctors. Provided full clerical back up for nurses and techs on the floor. Ordering supplies for patients and staff members; arranged for transport and discharge. Ordered supplies for the floor, cleaned rooms as needed. Arrived and discharge patients from the system that also included transfers within the hospital. Verifying Medicare inpatient IM forms have been completed and signed. Patient Account Specialist II/Patient Financial Services-Call Center Patient Financial Services took inbound customer service calls, collected balances, billed and rebilled insurance for denied claims. Filed appeals and processed all customer requests. Reviewed and processed Charity applications. Received and posted credit card payments to patient’s accounts, including contractual adjustments, write offs and patient discounts for Medicare and Commercial insurances.

December 2007-September 2011 Swedish Hospital First Hill Emergency Room and Ballard Health Unit Coordinator and Patient Access Representative: duties included registration patients in the ER and outpatient services at Ballard Emergency room. Arrived patients in the ER, collected insurance information and input new insurance and new information. Collecting co pays for Medicare and Commercial insurances. As Health Unit Coordinator in the ER, duties are inputting orders from Emergency Physicians and nurses. Collect lab's, conduct ECG's, clean rooms and transport patients. Responsible for the interviewing of patients and family to obtain required demographic and financial data, completing consents, escorting/directing patients and collecting valuables and deposits. Initial contact for any patients/visitors with billing, insurance or collection questions/concerns. Assists all patients requesting financial assistance through financial aid programs, processing all necessary paperwork, and in addition, assists patients in determining alternate sources of coverage for hospital stays as well as payments arrangements for private pay accounts. Served as the POS team expert to facilitate all aspects of registration and financial counseling functions for patients during their hospitalization. Coordinates coverage issues with the Physician Offices and the POS Team members, is accountable for assuring timely and accurate patient information flow.

11/06-11/07 UW School of Dentistry Patient Financial Service Counselor/Patient Financial Services Lead- duties are coding and inputting patient charges for patients seen at SCCA. Bill and process all medical and dental insurance claims for Medicare and Commercial insurances. Post daily payments to patient’s accounts. Review accounts for collections, write offs and other adjustments as needed. File appeals to insurance carriers. Call insurance companies to check on the status of claims. Resolve all customer service issues related to services and charges. File probates and complete Bankruptcy claims and documents. Collect payments and process credit card payments for patients. Work all credit balances. Register and update all patients’ demographics and insurance information in main system. Coordinate the delivery of medical and nursing care and the patient's access to health care, including the patients' entry into and through the spectrum of clinical services of the health care system. Primary responsibilities include care coordination, referral management, appointing, office tasks, and other duties as assigned.

08/01-09/06 Seattle Cancer Care Alliance Patient Finance Coordinator/Patient Financial Services Lead Assure financial clearance or secure deposits of funds prior to treatment for all transplant and medical oncology international and self-pay patients that receive services at the center, this included Medicare and all other Commercial insurances. Communicate issues related to financial clearance to appropriate internal and external contacts, and use independent judgment to identify issues that need to be brought to the attention of the supervisor and/or director. Provide price estimates and formal quotes; collect payments and set-up payment plans. Acted as a liaison to the billing department, and performed other duties associated with providing customer service within the facility. Helped patients apply for DSHS, including application processes and providing DSHS with the necessary information to process the patients application. Assessed and determine Charity, eligibility. Account reconciliation as needed until accounts are paid in full. Work with international embassies and/or insurance case managers to obtain insurance approval for searches. Coordinate financial issues with Patient Coordinators, Clinical Coordinator and Clinical Specialist prior to arrival of the patient. Evaluate benefits (if any) to identify shortfalls and work with patients to procure shortfalls and other sources of funding according to department policy. Communicated receipt of deposits to UWSP, UWMC, CHRMC and CUMG. Paid all outstanding charges to facilities with funds collected from the patient and other outside providers. Coordinate the delivery of medical and nursing care and the patient's access to health care, including the patients' entry into and through the spectrum of clinical services of the health care system. Primary responsibilities include care coordination, referral management, appointing, office tasks, and other duties as assigned.

11/00-08/2001 Seattle Cancer Care Alliance/ Patient Financial Services Commercial Insurance Follow-up Specialist-Determine that all insurance’s (Medicare and Commercial insurances) have been billed, follow-up billing and corrections that are needed to make sure that all charges are processed and paid correctly, apply insurance discounts as contracted. Verify insurance coverage and update all information in main insurance system. Update all financial code corrections needed for other staff members. Maintain all Loa’s and one offs with non-contracted insurances. Handle and worked all commercial insurance correspondence, from billing with correct ICD and CPT codes, filing appeals and requesting medical records. 09/00-02/01 Patient Accounting Service Center Collector/Back up Lead-As a collector duties included reviewing of entire accounts to determine appropriate collection activity. Billed primary and secondary insurance’s. Called insurance to determine patient eligibility, why claims were denied or not processed. Reviewed EOB’s to determine if contractual allowances were applied correctly. Worked all correspondence from insurances, attorneys and third party insurances. Called patients for insurance information and for payments on balances after patient responsibility has been determined. Back up lead duties included: taking client calls, training new employees on procedures and policies and computer training. Assisted and resolved all employee work related issues.

3/1990- 2001 UWMC/HMC Patient Financial Services Collections Specialist and Lead-Processed and resolved accounts receivable for all contract payers (Medicare, Medicaid and Commercial) and self pays. Billed both primary and secondary insurances. Reviewed entire accounts to determine whether appropriate action by payers has been taken place. Provide appropriate follow-up action to assigned accounts to assure prompt and complete payment based on reimbursement rate received. Analyze and act on reimbursement discrepancies from contract payment schedules. Prepared and resubmitted claims as required by adjustments over the phone and hard copy claims. Composed letters of appeal for denied claims or letters of adjustments to request corrected reimbursements per contract provisions. Access computer databases to obtain eligibility information and claims status as appropriate. Skip traced and collected on all accounts that have been determined to be patient responsibility. Determined which accounts are assigned to collection agency. Processed credit card payments. Inputted all payment contracts. Updated all new patient information, including insurance changes.

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