Us Remote Data Entry
Resume:
Glynda Peck
Sun City Center, FL *****
************@***.***
Seeking a position as a
(Medical Claims Biller, Collector & Denials Specialist (US Remote) With a progressive and innovative organization that;
• Provides quality leadership
• Values employee input and loyalty
• Has a within-company, career-ladder program
• Encourages and supports job-related education
Experience/Training:
Preparing HCFA’s, UB04 for billing and collecting, denials, including Medicare/Medicaid, VA claims, and commercial insurance. Worked both Physician and Hospital accounts. Patient Statements, and electronic billing, setup payment arrangements, posting payments, claims processing, customer service, Transplant scheduling, Excellent Communication skills, refunds, data entry, and prior authorizations and CMNs. Knowledge of HMO’s, PPO’s, work comp denials & appeals, personal injury liens/hardships, appeals and outside collection agencies. Worked with EOB’s/MEOB’s and knowledge of using CPT/ICD-10/HCPC books. Other skills, using Excel, word, PowerPoint, outlook email, E-Fax, and most office equipment. Currently working remotely on EPIC internal ACE, also attend meetings thru Zoom and Google. Work Experience
Revenue Cycle Specialist II
Tandym Healthcare - South Carolina
May 2023 to Present
Remote-Working in Epic system old A/R accounts no response Work Queue all accounts. Verified if the insurance has paid and if the money was posted. Using the insurance Websites and calling insurance companies to verify eligibility and verify if they have the claims. Edit the claims for rejections sending corrected claims that were denied, by electronic or paper. Sending appeals after research of denial to send corrected claim any documents needed to support the appeal. Claims Resolution Specialist
EnableComp-ArgosHealth - Remote
December 2021 to May 2023
Job Duties: Call insurance to see if they have received our Work Comp bill, Itemized bill and Medical Records. If they have is it being processed or denied. Will send appeals or reconsiderations, to show this has good cause to be paid. Using insurance websites to resubmit bills thru them or our electronic billing or faxing. Closing accounts with payments and moving money, posting adjustments. Verify with the Fee Schedule from different states if the claim was paid correctly. Adding insurance and moving to the 2nd insurance after payment or denial. Claims Analyst
RTR Financial Services
March 2021 to December 2021
Job Duties: Call insurance companies for physician’s unpaid medical bills. Working in a queue following up and billing VA claims, Medicare and commercial insurance companies claims. If they have been paid, check to see if they paid according to the contracts or policy guidelines. Sending appeals for denied claims. Payment posting, take adjustments, and move money to patients or 2ndary insurance if money is due for copay, coinsurance, or deductibles Reprint claims (HCFA 1500) if needed, send medical records and send any other information that is needed to get the claim paid. Send appeals requests to other department within the company to complete. Moved accounts to other work queues, due to company policy if they needed additional work. Worked closely with my team and other coworkers, attended meetings by Zoom. Remote work for the
Kentucky Medical Hospital, the physicians side.
(Temporary Contracted Position)
Patient Financial Specialists
SwedishAmerican Hospital - Rockford, IL
December 2016 to March 2021
Job Duties: Working in the Revenue Cycle department I work in a work queue following up and billing VA claims, Medicare and commercial insurance companies claims. If they have been paid, check to see if they paid according to the contracts or policy guidelines. Payment posting, take adjustments, and move money to patients or 2ndary insurance if money is due for copay, coinsurance, or deductibles. Add and change insurance on accounts, take our codes or diagnosis that need to be removed or add them. This is done with the close guidance of the coding department. Using the websites of all insurance companies, WPS, and VA check the status of claims and patient eligibility. Currently working all the VA Claims, checking with the Mediregs program for comparable payment. Changing claims over from Choice VA to TriWest and
Optum printing, appealing & billing Medicare, UB04’s with prior authorization and mail to them. Take appropriate follow-up actions on accounts to resolve claims and ensure payment on the first follow-up call or appeal. Printing medical records if the insurance company is requesting them or if sending appeals. Patient Financial Services
Banner Health Systems Boswell Hospital AZ
April 2015 to August 2016
Job Duties: Call patient to pre-register them for their upcoming appointments and collect any copay, coinsurance or deductibles that might be due. Work with the patients to help them, if they could not pay everything up front. Using a financial grid and if needed an attestation form to the physician for approval, if it is emergent. Run the patient’s insurance benefits to see if they are active and what deductible, OOP, coinsurance has been met and check copay amounts. Call insurance companies, to verify insurance information for procedures and request prior authorizations if needed. Transplant Scheduler
Mayo Clinic Hospital - AZ
July 2014 to February 2015
Job Duties: Schedule all appointments related to the transplant patients
(Pre/Post), including possible donors. Received heavy call volume from patients to schedule and reschedule their appointments. Worked with other departments, Radiology, GI, Cath Lab, and many others to get appointments scheduled. Received calls from doctors, nurses, and other internal departments, as they were requesting appointment changes, Additional procedures and cancellation.
Health Service Coordinator
MMSI (Mayo Clinic) - AZ
October 2010 to July 2014
Job: Duties: Data entry for everything that was received, prior authorizations by fax/eFax, and enter them into the computer system. If we would need more information or medical record the request was sent back to the provider by fax.
Once everything is received, it was given to the nurse case managers. They would determine if it was approved or denied and I would close it out in the system and fax back to the provider. I would help in coding and data entry, start conference calls, and help with power point presentations. Administrative duties when needed and computer training for other coworkers. Education
Bachelor's degree in Health Information Administration University of Phoenix - Phoenix, AZ
February 2016 to June 2020
Glendale College - Glendale, AZ, US
High School Diploma
HARLEM SENIOR HIGH SCHOOL - Loves Park, IL, US
Extensive Medical Billing
Rock Valley College - Rockford, IL, US
Skills
• CPT Coding
• ICD-10
• Medical Billing
• ICD-9
• OOP
• Medical Coding
• EMR Systems
• Multi-line Phone Systems
• Insurance Verification
• Medical Terminology
• Medical Records
Certifications and Licenses
Medical Billing Certification
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