Customer Service Medical Billing
Resume:
Tarsha Hightower
Grand Prairie, TX *****
ad0cye@r.postjobfree.com
To utilize my professional experience, knowledge and skills in a reputed health organization to manage the organization in an efficient manner
Authorized to work in the US for any employer
Work Experience
Medical Billing Specialist Lead
Destination Life Therapy and Wellness - Arlington, TX August 2020 to Present
• Screens referrals as potential new patients for acceptance to be treated by the clinician and occupational therapist
• Documents all referral related information, actions taken, and follow-up required in the medical record in a timely and accurate manner
• Provides excellent customer service to the clients parent/guardian, provider or and any other individual involved in patient’s care coordination
• Scheduling and confirming appointments
• Provide intake services to patients.
• Verifying insurances
• Be able to explain insurance benefits to patients and their families.
• Maintaining confidentiality and distribution of medical records
• Managing incoming/outgoing faxes
• Answering incoming calls, operating multiline telephone system
• Collecting co-pays/ balances and preparing daily balance reports. Assisting with billing and collections as needed
• Orient and train new employees
• Inventory and supply management
• Insurance prior authorizations/ Referrals
• Creation and maintenance of spreadsheets, forms and checklist for personal use
• Point of Liaison between team, client and outside facility and clients
• Medical Billing
• Collect any payments due to the practice at the time of service
• Organize the business area and waiting rooms to maintain a clean environment for visitors and patients
• Manage all customer communication including answering phone calls, setting out of office messages, and addressing messages
• Receive any deliveries and place in safe area to keep walkways and patient areas clear
• Schedule management including schedule blocks, patient cancellation and rescheduling Patient Access Manager
City Hospital Emergency Care Center - Grand Prairie, TX January 2016 to August 2020
• Serve as a resource for Patient Access Representatives and ensure that each team member is providing the highest level of customer service
• Supervises and trains front desk staff to ensure that all financial policies, timekeeping/attendance, established practices, and standards are followed.
• Managing individual or team performance including managing visitor issues or complaints and providing necessary follow-up training to staff when needed.
• Creates a work schedule for all patient representatives based on clinic needs.
• Provides conflict resolution for facility resource issues and collaborates with Facility Administrator to ensure facility performance standards
• Maintain consistent communication with the department and is responsible for implementation and education of all new front office policies and procedures
• Assist Facility Administrator in addressing complaints within the department
• Collaborates with the Facility Administrator in hiring and termination decision for department staff
• Use EMR software to modify patient records; reinforced and upheld patient confidentially as required by HIPPA and clinic
• Ensure accuracy in all accounting, coding, and billing related procedures arising from the facility resource department. Knowledge of CPT Codes and ICD-9/10 Codes
• Responsible for reconciling cash flow paperwork, depositing cash, posting payments and scanning bank receipt to accounting
• Prepares initial monthly work schedule for the department; includes scheduling PTO and minimizing overtime
• Submit and track clients prior authorization/ pre-certification. Verified health insurance policies for all major Commercial, Managed Care, Medicare and Medicaid plans
• Explain insurance benefits to patients and their families. Front Office Team Lead/Ins Verification
Medical Arts Family Clinic - Trinidad, TX
April 2004 to December 2015
• Monthly QA on all Registrars
• Mentor and coach staff to develop their productivity, accuracy and expertise on hospital wide registrations with additional focus on patient privacy and customer service
• Orient, train and evaluate new staff
• Submit and track clients prior authorization and pre-certifications
• Collect personal medical and insurance information from patient and family
• Managed Care, Commercial Insurance, Medicare and Medicaid plans
• Assist with Interviews of New Prospects for Registrar Positions
• Obtaining the proper insurance referrals and prior authorizations before patient visit/treatment/ procedures and diagnosis codes
• Knowledge of CPT Codes, ICD-9/10 and billing
• Prior Authorization/Referrals
• Schedule management including schedule blocks, patient cancellation and rescheduling
• Responsible for ensuring compliance regulate during patient contact or medical files • Responsible for obtaining accurate information regarding insurance verification
• Explained financial requirements to the patient or responsible party.
• Responsible for obtaining correct insurance and plan codes with procedures or service
• Verified patient client demographic information
• Complete daily urgent reports to inform patient and management of high deposit amounts Insurance Verification Specialist
Baylor Medical Center of Dallas - Dallas, TX
January 2000 to March 2004
• Notify manager with patient account and insurance issues
• Ensure and assist patient in obtaining proper insurance referrals and prior authorization before their visit
• Input patient demographic and insurance information into computer system
• Adhere to the Tenet HIPPA Compliance Plan and Privacy Standards Confidentiality Agreement
• Coordinate registration of new patients via phone call or in office/hospital
• Assist patients in understanding financial obligations; collected co-payments, self-pay deposits, patient balances and posting payments
• Obtained/updated verification of benefits
• Explain insurance benefits to patients and their families.
• Submitted and tracked necessary prior authorizations/ pre-certification needed to provide patients with service
• Knowledge of CPT Codes and ICD-9/10 Codes
Education
Associate Degree in Medical Office Administration
Trinity Valley Community College - Athens, TX
August 2018 to December 2020
Diploma
Malakoff High School - Malakoff, TX
August 1991 to May 1995
Skills
• Self-Motivated, enthusiastic and detailed oriented with great organizational skills who works well with other (10+ years)
• Knowledge of basic medical terminology (10+ years)
• 45 WPM (10+ years)
• Ability to multi-task, manage details and organize efficiently and effectively (10+ years)
• Possesses a strong work ethic and high level of professionalism (10+ years)
• Knowledge of the content, intent and application of HIPPA (10+ years)
• Knowledge of Managed Care, Commercial Insurances, Medicare and Medicaid plans (10+ years)
• Insurance Verification (10+ years)
• Knowledge of CPT Codes & ICD 9/10 Codes (5 years)
• Adaptable to change in a rapid growing company
• Knowledge of computer software Excel, Outlook and Microsoft
• Knowledge of Availity (10+ years)
• Passport (10+ years)
• Evident (10+ years)
• Centricity (10+ years)
• Epic (10+ years)
• Meditech (10+ years)
• Conflict Management (10+ years)
• EMR Systems (10+ years)
• Hospital Experience (10+ years)
• ICD-10 (10+ years)
• Medical Office Experience (10+ years)
• Medical Records (10+ years)
• Medical Billing (10+ years)
• Medical Coding
• Office Administration (10+ years)
• Patient Care (10+ years)
• Triage (7 years)
• Transcription
• Clerical Experience (10+ years)
• Medical Scheduling (10+ years)
• Vital Signs (10+ years)
• Multi-line phone systems (10+ years)
• Care plans (3 years)
• Phone Etiquette (10+ years)
• Quality Assurance
• Supervising Experience (10+ years)
• Experience Administering Injections (7 years)
• Schedule Management (7 years)
• Documentation review
Certifications and Licenses
CPR Certification
Additional Information
Prior Authorizations for Occupational Therapy, Radiology and Physician Office experience.
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