Human Resources Follow Up
Resume:
LATONYA COATES
*** ********* **** * Bethlehem, GA 30620 * 678-***-**** * **************@*****.***
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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