LATONYA COATES

*** ********* **** * Bethlehem, GA 30620 * 678-***-**** * ad1n7s@r.postjobfree.com

Summary of Qualifications

Offering excellent analytical skills with experience in project development and implementation of paperless claim submittal environment. Specializing in office management, human resources, employee relations for primary care and occupational medicine companies. The ability to handle high levels of stress and be congenial with other employees/clients at all times.

Areas of Expertise

Over 20 years experience in medical collections of government, private insurance, third party administration and worker’s compensation.

Particularly strong in staff development, including training, coaching, and evaluation.

Highly focused and results-oriented in medical collections.

Possess a sound understanding of all billing and collection practices.

Exceptional work ethic, demonstrating a sense of urgency to display professional conduct at all times through appearance and behavior.

Succeeded in increasing company revenue through accurate medical service billing.

Created training manuals to assist with training of new and seasoned employees.

Team player with great attention to detail, follow through and can quickly adapt to change.

Experienced in Electronic Medical Records (EMR)

Education

Mergenthaler Vocational High School Baltimore,Maryland 1980-1983

Southern New Hampshire University currently enrolled

Professional Experience

Crossroads Hospice of Atlanta Tucker, GA 2014-2016

Billing Coordinator

Verify insurance coverage for pending hospice patients.

Complete Medicaid Communicators forms for Room and Board services

Verify coverage for GIP patients

Register new patients into All scripts system

Collect information for Respite/Inpatient patients

Complete Physician Certification forms for new patients

Key activity of daily activity logs for payroll

Assistant in Accounts receivables for nursing homes and private pay patients

Follow up on Commercial Insurance patients

Submit clinical notes to insurance company for authorization coverage

Experience in Electronic Medical Records (EMR)

Process and follow up on all Medicaid and Medicare

Visiting Nurse Health System, Atlanta, GA 2011-2014

Insurance Verification Coordinator

Worked account receivable reports for Medicaid accounts over $10,000

Follow-up with aged billing over 120 days to receive payments from insurance carriers.

Responsible for all aspects of daily office operation at this high-volume practice with a

Diversified medical staff (Orthopedics, Neurology and Pain Management).

Billing: Pre-certify all inpatient and outpatient medical tests) and medications.

Handle HMO/PPO, Workers' Compensation, no fault, third party and private pay accounts.

Duties include processing all incoming/outgoing referrals, verifying insurance information,

Obtaining authorizations for all procedures, ICD-9 and CPT coding, researching and resolving

Denied claims, writing appeal letters, issuing Requests for Review, obtaining reimbursements,

Referring delinquent accounts to collections, and submitting requests for hospice care and DME.

Administrative: Duties include researching and providing confidential clinical data for nurses,

Scheduling medical deliveries, processing laboratory and radiology tests, explaining insurance

Procedures and benefits eligibility to patients, updating account records, and special projects.

Liaison between patients, doctors, and nurses

Process and follow up on all Medicare and Medicaid

United Hospice Corporation, Norcross, GA 2007-2009

Collection Specialist

Worked account receivable reports for Medicaid accounts over $10,000

Follow-up with aged billing over 120 days to receive payments from insurance carriers.

Assist management with end of the month goals to meet all company expectations.

Electronic Medicaid billing through the GHP Web portal.

Developed a training program to assist social workers to sign up patients for Medicaid.

Billing, follow-up and/or collection step (s), including calling patients, insurers or employers as appropriate

Responsible for all daily recon

Analyzing previous account documentation in Webmats, HIS, and other available sources, in order to determine the appropriate action (s) necessary to resolve each assigned account

Working rejections, and other billing reports daily regarding Medicaid and Medicare billing

Follow-up with responsible parties to ensure the receipt of timely, accurate payments

Evaluates payments received for correctness and ensures that they are applied appropriately

Submit timely, accurate invoices to payer for products and services provided

Targets high dollar, over 120 days, accounts as a priority

Monitors accounts receivable, collections and billing services

Review all remittances for under and over payments and outright denials

Responsible for payment posting

Process and follow-up on all Medicare and Medicaid

.

Elite Sports Medicine, Dacula, GA 2006-2007

Office Manager

Strong contract negotiation skills to generate new lines of business.

Make weekly bank deposits for the branch office.

Implemented office policy and procedures to ensure accurate billing of all insurance carriers.

Consistently excelled in complex customer issues by investigating and problem solving all

transactions.

Gwinnett Resource Center, Lawrenceville, GA 2004- 2006

Account Resolution Representative

Managed claim resolutions for all government and commercial insurance accounts.

Performed electronic and paper billing process.

Provided “World Class Customer Service” to any inbound phone calls received in reference to accounts.

Collect and posted all payments to the system and made recommendations for adjustments/write off to management.

Emory Clinic, Decatur, GA 2000- 2003

Financial Counselor

Ensured accurate verification of insurance eligibility through insurance companies.

Implemented procedures for proper reimbursement of medical services.

Audit and review patient accounts prior to appointment to prevent billing errors.

Collect and post all payments due at the time of service.

Monitored patient accounts to identify billing and collection problems utilizing reports.

Credit resolutions

John Hopkins University, Baltimore, MD 1997-2000

Collection Liaison

Recall accounts sent in error from all major collection agencies.

Refer physician accounts to collection agency

Supervised collection specialist to collect payments, post payments, make contractual adjustments and transfer outstanding balances to appropriate reports for follow-up.

Prepare refunds for patients, insurance companies when recommended.

Prepared legal actions for delinquent accounts

Representative for collection department for court appearances.

Credit resolutions

Additional Skills & Relevant Coursework

Seminars: HIPAA Education, Infection Control, Security Management, Effective Communication & Patient Quality Improvement, ICD-10

Computer Skills: MS Office Suite 2000/2003 & XP, including Word, Excel, PowerPoint, Access, Outlook, IDX and McKesson, E-Premus, Palmetto, VisionShare, EPIC, Allscripts

Coursework: Human Resources Management, Financial Management, Diversity in the Workplace, & Accounting. ICD-10 webinar

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