BILLING REPRESENTATIVE – FOLLOW UP

Trusted Medical Insurance Representative that is highly experienced with knowledge of Workers Compensation, Medicaid, commercial insurances for reimbursement and self-payment accounts. Team leader and mentor with the ability to communicate effectively at all organization levels.

EXPERIENCE

ORTHOPEDIC ASSOCIATES OF HARTFORD/JMORRISSEY, Farmington, CT February 2023 – Present

Billing Representative – Follow Up

Worked as a Billing Representative partnering with Workers Compensation companies to ensure payments have been applied and to ensure patient accounts are up to date with the correct insurance type. Coordinated with adjusters to ensure claims are accurately reflected to the patients injured bodily part. Contacted physicians when applicable for denial explanations of the claim if and/or when changes to the operative notes are necessary.

UCONN HEALTH/STAFFING SOLUTIONS, Farmington, CT December 2021 – Present

Office Assistant – Follow Up

Currently working as an Office Assistant partnering with various insurance companies to ensure payments on patient accounts have been applied and to ensure patient accounts are up to date with the correct insurance type. Additionally, work to certify proper materials and/or requests are sent to appropriate agencies (e.g., primary/secondary insurance, STAT for patient medical records, UBs and primary EOBs). Request payment EOBs from the insurance companies to show proper deductible, co-insurance and/or payment and send all EOBs to cash research for proper posting.

WATERBURY ORTHAPEDIC ASSOCIATES PC, Waterbury CT September 2017 – March 2020

Billing Representative

Worked as a Billing Representative applying commercial insurance company payments to the appropriate patient’s account. Responsible for obtaining correct demographics on patients, proper insurance information, and verifying insurance benefits according to each patient’s plan. Responsible for frequent follow ups with insurance carries and auditing professional bills in accordance with medical compliance. Direct payer liaison to handle Motor Vehicle claims/denials, as well as but not limited to Aetna, Cigna, etc. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts to ensure a shorter margin of error.

ST. MARY’S HOSPITAL, Waterbury, CT November 2004 – September 2017

Patient Financial Representative

Worked as a Patient Financial Representative collecting payments from patients and insurance companies. Processing appeals for customers when insurance companies denied claims. Resolving patients and insurance company claims to ensure payments are collected by the hospital.

Posting Department Team Lead December 2004 – February 2008

Managed incoming cash flow and balanced accounts receivables for collected payments from patients and insurance companies. Coordinated the process to debit, credit, refund, and transfer funds to both insurance companies and appropriate accounts.

PROFESSIONAL SKILLS

Commercial Insurance (10+ years)

General Medical (10+ years)

Medical Terminology (10+ years)

Medicare (10+ years)

Office Medical (10+ years)

FISS Portal related to Medicare Interchange portal Star Paragon NGS/Medicare

EDUCATION

Tunxis Community College – Medical Specialist

Naugatuck Valley Community College – Medical Billing

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