Dawn Matthews

202-***-**** ad3wls@r.postjobfree.com

Dear Hiring Manager,

As a highly skilled Office Administrator. With more than 23 years of experience in a medical office, I have achieved gaining knowledge and skill to direct clinical staff in accomplishing a safe and productive environment. I am positive I have what you need and that I can make a valuable addition to your organization. My experience aligns well with the qualifications you are seeking. My role as a Medical Biller has allowed me to develop the skills to achieve accurate and timely reimbursement for medical services. Upon review of your posting for a Billing Specialist, I was eager to submit my resume for your consideration. With comprehensive experience and knowledge in accounts receivable and collections, along with my abilities in time management, communication, and leadership, I feel confident that I would significantly benefit your organization in this role. My extensive background in analyzing accounts, investigating discrepancies, identifying, resolving billing issues, and providing general clerical support has prepared me to excel in this position. With a strong foundation in customer account review and past-due collection, my problem-solving and project management abilities position me to thrive as your next Billing Specialist. Highlights of my background include:

● Ensuring billing operational efficiency and accuracy throughout my career in accounts receivable, skillfully analyzing and handling invoices, payments, and financial records.

● Identifying and recovering revenue deficiencies of up to $43K associated with canceled accounts.

● Communicating directly and courteously with customers to review and verify billing data and ensure timely bill submission.

● Interacting with a variety of professionals to gather information and spearhead collections organization and execution.

● Utilizing analytical, interpersonal, and organization skills to generate peak results and top performance levels.

● Completion of two years at the University of Maryland university college

● Member of the AAPC

● Typing speed of 45-50 words per minute

● Multiple billing and EMR systems Microsoft office, Medisoft, Mediplus, EPIC, MIMS, Winasap, Zap, CHCS, QuickBooks, Brightree, Athena and MyChart.

With successful experience in accounts receivable methodologies, coupled with keen financial acumen and dedication to achieving success, I believe I could quickly surpass your expectations for this role. I look forward to discussing this opportunity in further detail. Salary requirements range from ($52,000-$55,000) per year.

Thank you for your consideration

Sincerely, Dawn Matthews

Experience:

(October 2022- Current) Medstar Family Choice DC. Utilization management Coordinator Assistant:

Inbound calls to direct and navigate Providers and enrollees to proper department for assistance. Navigate Caremark Claims system to verify prescription claims status. Review and explain EOB’s to enrollees for paid and denied claims. Provide benefit and eligibility to providers and enrollees through the DC Department of health site. Initiate Prior Authorization request and update referrals status for enrollees Medical services. Assist enrollees with understanding of benefits for care management, care coordination and outreach for all enrollees including members suffering from BH/MH or SUD. Provide support and assistance with obtaining and maintain therapy, along with aftercare FU while in treatment for health issues and needs. Follow up with aftercare providers and enrollees to verify appointments are made and kept. Excel spreadsheet updated daily with enrollee information to allow proper FU for aftercare services. Provide monthly reports to DCHD to show compliance with FU for enrollees to assure proper assistance for care coordination. Navigate Authorization grid to confirm services that require Preauthorization.

(July 2021- August 2022)Bright Health Plan Provider Appeals & Grievances: Receive and investigate denied, underpaid and unpaid claims. Confirm that all necessary documentation is reviewed and attached for reimbursement. Determine if the claim can be resubmitted or upheld. Generate and submit letters to providers ensuring all actions that are required for the reprocessing of the claim are conducted. Documenting all data received and taking steps to resolve the case. Submit daily reports to confirm case actions and completion.

(November 2020-June 2021)Carefirst BCBS open enrollment (remote seasonal): Provide support to the health insurance organization through open enrollment season. Entering data in a timely manner and contributing towards the center’s achievement of providing exceptional quality. Provide, accept and act on performance feedback from peers, business partners, leadership and customer survey results. Demonstrate willingness to learn and effectively apply new skills/techniques as customer expectations change. Complete projects in established timeframes, as deemed necessary. Other tasks as assigned.

(August 2018-November 2020) Nuance/ Mychart technical support team (remote): Direct and assist patients through the EPIC EMR system. Help accomplish activation of new accounts increasing access to medical records information. Provide username and password to log into the MyChart System. Direct patients in the location and retrieval of medical records and test results, assisting patients with accomplishing messaging providers and scheduling appointments. Enter patient data into the system and document up to 70 calls per day.

(November 2017-August 2018) Inova Healthcare Services. Patient accounts Follow up team: Full cycle of the medical billing process from date entry, to insurance verification, to claims submission, to follow up for reimbursement and posting of the payments. High volume billing cycle for timely and accurate editing of 75-100 assigned claims daily in the EPIC system. Able to process claims for multiple payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.). Assure all assigned claims meet clearinghouse and/or payer processing criteria. Assure appropriate follow-up on assigned work lists. All work meets departmental productivity and quality review standards. Provide updates to Team Management with issues regarding claims follow-up process. Provide Team Supervisor or Manager with issues and potential resolutions regarding problems with the claims process. Payer response reports and rejection reports are worked timely and meet Departmental Productivity and Quality Review standards. Provide support, education, and guidance to the team. Perform duties as assigned, in the absence of the Supervisor or Manager. Assure appropriate and timely documentation of all account activity. Correspondence is handled appropriately. WIP counts completed timely. All required reports are filed timely and accurately.

(February 2017-November 2017) Capital Area Pediatrics Call Center Representative.

(Consultant) :Short term consultant position to assist with the creation and launch for a new call center phone system. Answer inbound calls for five pediatric facilities average 150-200 calls per day. Entering data into the Athena system. Schedule appointments for all sites. Assist with obtaining immunization and medical records. Assist with medical forms required for school and sports participation. Provide reminder calls for appointments and testing. Review and document medical information via EMR. Take and forward phone notes and messages through the EMR system to all providers and staff. Created and managed team schedules ensuring coverage for all shifts.

(August 2013- November 2016) Grubbs Pharmacy DME Medical billing and Coding Representative: Full cycle of the medical billing process from date entry, obtaining and verifying referral and authorization, to insurance verification, to claims submission including updating CPT, HCPCS and ICD 9-10, to follow up for reimbursement and posting of the payments. High volume billing cycle for timely and accurate editing of 50-75 assigned claims daily in the Brightree system for commercial, government and managed care plans, attach appropriate Modifiers and revenue codes. Run daily reports for rejected and processed claims. Create invoices for medical supplies and retail services and scheduled deliveries. Close out the cash drawer. Collect copay and deductible amounts. In and outbound calls for assistance with medication and medical equipment. Scan electronic records and prescriptions attached to the correct account.

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