Medical Billing Customer Service
Resume:
JOI K. TOWNES
NC ***** 336-***-**** ad12ml@r.postjobfree.com
Career Summary & Objective
Accomplished medical professional with a unique combination of administrative, customer service and pre- authorizations and medical billing experience seeking to utilize technical expertise and work ethic to improve a healthcare firm’s bottom line.
Able to prioritize and organize multiple duties to achieve company objectives.
Proficient in Practice Suite, Elations, Next-Gen, Bright Pattern, Magna 5, MISYS, Med-data, Xo-Tech, Medic, Microsoft Office Suite 2007 (Access, Excel, Outlook, PowerPoint, and Word), Peachtree, Adobe Acrobat.
Types 45 words per minute.
Key Medical Skills
Medical Billing Medical Coding ICD-9-CM ICD-10-CM HCPCS CPT Medical Terminology Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway Managed Care (HMO, PPO, and POS) Government Payers Third Party Payers Worker’s Compensation Medicare and Medicaid CMS 1500 CMS 1450 (UB-04) Tricare EOBs Payment Posting Revenue Cycle Management Scheduling Meaningful Use Insurance Verification Insurance Billing Procedures Insurance Claim Processing Practice Management Medical Office Procedures Anatomy & Physiology HIPAA Compliance Co-Payments Deductibles Co-Insurance Superbills Academic History
Ultimate Medical Academy
Associate of Science Degree – Medical Billing and Coding, 2017 Medical Billing and Coding Diploma, 2013
Professional Experience
Proctor Loan Protector- Troy, MI
Insurance Processing Associate 2021 to Current
• Assist the team leader by helping to train new employees
• Maintain positive work environment by acting and communicating in a manner so that you get along with customers, clients, co-workers and management
• Process payment requests for premium
• Answer inbound calls and make outbound calls,
• Maintain and update on-line policyholder information
• Demonstrates full competency/mastery in own area of work
• Provides timely and accurate resolution of bill issues and adjustments regarding contracts and pricing
• Obtain insurance documents from various claim systems and add them to our processing system
• Respond to teammates regarding requests for documents and information and provide what it needed
• Identify various types of claims documents, such as police reports, estimates, damage photos and others then add these to our system
• Read through computer notes to look for specific information needed by our triage team
• Prepare files for demand by searching for damage documentation and then ensuring all financial information is accurate
• Update files in the client system and our own system using generated lists which provide the task to be processed
• Under the direction of the Team Leader and Personal Lines Marketing/Processor Manager, the New Business Policy Processor position will support the sales staff by uploading policy data from personal lines insurance applications to partner carriers’ proprietary systems the agency management system
• This role is also responsible for downloads, system audits within their area of expertise and other assigned projects
• Resolves low complexity and routine upload and download discrepancies with minimal direction
• Refers complex problems and client inquiries to the Team Leader or Marketing/Processor manager for resolution
• Monitor, organize, and distribute daily work to team members
• Demonstrate effective time management and organizational skills and ability to prioritize work to meet deadlines and complete tasks efficiently
• Document, implement, and communicate all program/processing changes to team members
• Position requires hands on responsibilities and will be required to perform any and all functions that would part of their direct report responsibilities
• Responsible for day-to-day adherence to processing standards and efforts made toward process improvement
• Communicate in a professional and consistent positive manner to motivate and direct associates Cityblock Health – Greensboro, NC 2019– 2020
Member Experience Associate
Key member of the care team and plays an important role in delivering a state-of-the-art experience to Cityblock members.
The initial point of contact in our clinical hubs by greeting every person as they walk in, but also play a vital role in the overall flow of the hub.
Welcoming members who visit the hub for a clinical appointment or who are taking advantage of the social and community services
Coordinating community-based programming in the hub and tracking member activity using both our EMR, Elation and Commons
Work collaboratively with other care team members to enroll new members to Cityblock, including scheduling appointments with clinical providers and participating in other enrollment activities as needed
Connect members with community-based organizations both inside and outside the hub;
Coordinate and co-facilitate hub-based educational programming for members
Prepare daily reports from the EMR in advance of the next day's visits and participate in daily team huddles with other care team members; participate in closing care gaps as needed under the direction of the Hub Operation
Check real-time member experience feedback and assist in resolving operational issues
Receive incoming phone calls/messages, complete requests for appointments, assist with administrative forms, and direct any requests for medication refills to the practice nurse
Facilitate external appointments with specialty providers, including submission of referral requests
Organize and distribute incoming communications to the hub, including mail and faxes.
Assist the Clinical Hub Manager with the management of office and ordering medical supplies, as needed LabCorp – Mc Leansville, NC 2018 - 2019
Accounts Receivables 3rd Party Denials
Perform specialized processing of complex accounts receivable issues. Including following standard operating procedures to determine next course of action for a denied claim (appealed or if additional information is needed for physician or patient) for insurance claims by researching for insurance and analyzing systems records / databases.
Contacting physicians, insurance companies and/or patient for additional information to process claim.
Building effective working relationships with internal and external team members to RCM. Facilitate meetings as needed.
Professional References:
Mrs. Tiffany Joyner (Manager City Block Health)
Mr. Anthony J. Warnsley (Independent Contractor)
Ms. Tamala Johnson (Supervisor Faneuil, Inc.)
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