High School Customer Service
Resume:
Elaine Richardson
(Local in Lithonia, GA and immediately available to start remote) Available for Telephonic or Video Interview Monday through Friday with 24 hours prior notice Education:
● High School Diploma, Luther Judson Price High School, Atlanta, GA 1974. Skills:
● CPT Coding (10+ years)
● Medical Collection (10+ years)
● Medical Coding (5 years)
● Medical Billing (10+ years)
● ICD-9 (10+ years)
● Medical Records (10+ years)
● EMR Systems (10+ years)
● Hospital Experience (10+ years)
● HIPAA (10+ years)
● ICD-10 (4 years)
● Medical Scheduling (10+ years)
● Customer Service (10+ years)
● Quality control (10+ years)
● Typing (10+ years)
● Order entry (10+ years)
● Medicare (10+ years)
● Insurance verification (10+ years)
● Medical office experience (10+ years)
● Medical receptionist (10+ years)
● 10 key calculator (10+ years)
● QuickBooks
● Anatomy knowledge
● Patient care
● Physiology knowledge
● Documentation review
● Clerical experience
● Transcription
Experience:
Thriveworks Counseling & Therapy Aug 2022 - Present 1000 Jefferson ST Suite 2C, Lynchburg, VA 24504-1724 Billing Support Call Center
● Process patient account with national healthcare billing system solutions and Microsoft Office.
● Experience in strategic staffing models using a workforce management system.
● Strong organizational skills and attention to detail, with the ability to meet multiple deadlines.
● Computer skills and advanced use of Excel.
● Strong Analytical/Problem-Solving skills when working all email.
● Use excellent organizational and attention to detail skills when sending out email to clinic directors.
● Multitask with the ability to manage multiple and competing priorities.
● I have excellent time management skills when it comes to working the inbound calls
● Note patient files with excellent and written communication skills.
● Take initiative in processing claims and making payment for patient and insurance adjustment
● I work independently on all claim and inbound calls.
● I work oral with patients and, successfully, demonstrate an ability to work well with other professionals' insurance carriers with minimal supervision.
Delta Dental Insurance Company, Atlanta, GA Sep 2012 – Mar 2021 Reimbursement Specialist/Collections/Third Party Claims Processor/ Group Records Specialist
● Assured accuracy of patient data and prepared billing according to regulations.
● Prepared/ maintained billing files and records; understand net revenue schedule and unrealized contractual log in relation to patient accounts.
● Investigated delinquent accounts, making recommendation on disposition of outstanding balance; contact third party organizations when necessary to facilitate timely payment of
● Provided timely notation of action taken on patient accounts; process refunds to insurance carrier or patient; correct late charges; monitor insurance coding and effective/ exhaust
● Responded to patient account inquiries.
● Processed employees benefits forms and documents and assist employees in solving problem on health, life, dental, vision, retirement, flexible spending accounts, COBRA payments and coverage and HIPAA communicates with contract benefit providers to obtain information
● Assisted with new employee orientation and benefits, open enrollment programs generate correspondence and notices to employees concerning health care coverage, premium billings, insurance claims, COBRA and portability of coverage, coverage or payments for retirees and employees on unpaid leave and collect premium payments.
● Audited employee usage and claims, and balanced vendor billings for self-insured benefits programs.
● Entered and corrects computer data regarding employee benefits programs accesses HRIS to verify, view and provide employees with account information.
● Processed claims and provider information on flexible spending accounts.
● Researched publications and materials to obtain information and monitor compliance with federal and state benefit legislation and regulations; research employee files for benefits.
● Prepared reports on employee benefits activities and completed special projects. Rockdale Medical Center, Covington, GA Sep 2012 – Apr 2013 Reimbursement Specialist/Collections/Medicare Hospital Claims Processor
● Collection calls and billing out claims to healthcare providers, insurance companies, and individuals while updating billing information electronically.
● Looked up and attached correct medical coding to each account.
● Responsible for making outbound calls and sending letters to patients and third-party companies to collect and bill on delinquent medical accounts.
● Responsible for making outbound calls along with sending letters to patients and third-party companies to collect, appeal and bill on delinquent medical accounts.
● Post and make payment using Quick-Books.
● Utilized various software programs including Epremis.
● Perform various administration duties.
Piedmont Hospital, Atlanta, GA Mar 2009 – Jun 2012 Reimbursement Specialist/ Medicare Claims Processor
● Telephoned third-party payers to resolve claims in a timely manner.
● Use written follow-up to third-party payers when necessary.
● Looked up and attached correct medical coding to each account.
● Contact patients by telephone or in writing when pertinent information to claim processing has not been received by the payer.
● Learn and apply follow-up techniques for all third-party payers.
● Re-bill claims as needed, along with writing appeals.
● Collect over $150,000.00, in payments or more each month.
● Scan claim and post on spreadsheet daily payment and bank deposit payment.
● Utilized software including Epremis.
Blue Cross and Blue Shield, Atlanta, GA Mar 2006 – Mar 2009 Reimbursement Specialist/ Medicare Claims Processor
● Contacted insurance carriers, patients and clinics to resolve claim issues.
● Corrected accounts as necessary and resubmits claims according to the Process of Medical Commercial and Medicare payment posting and read EOB's for denial code.
● Work in a physician practice processing insurance claim, denials.
● Simple A/P invoice entry and check processing with QuickBooks before posting.
● Process appeals for denial of claims for payment.
● Handled outbound collections and inbound calls from customers calling about their bill. United Healthcare, Atlanta, GA Feb 2000 – Mar 2006 Medicare Billing /Collections/ Medicare Claims Processor
● Medicare Part B and Medicaid billing and coding work deny claims and follow up on claims.
● Knowledge of ICD-9-CT, ICD-9-CM, CPT codes, and Modifiers.
● Processing Medicare Part B appeals / redeterminations.
● Handled collections outbound and inbound calls from customers calling about their bill.
● Negotiated payments arrangement reducing an account's delinquency status.
● Customer service calls to patients for notice of payable and non-payable benefits.
● Processing suspended and deferred claims using the FEP Direct system.
● Developed spreadsheets for tracking claim checks for physicians.
● Research ICD-9 codes to verify if a code has been changed and entered, deposited and updated patients' demographics using the Medisoft pricing system.
● Used Medical Manager billing software for the billing process.
● Used Centricity software for posting payment into a patient account.
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