SAVERIO THOMAS

ad43gv@r.postjobfree.com 352-***-**** Spring Hill, Florida 34608

Summary

A highly motivated employee with a desire to take on new challenges. Strong worth ethic, adaptability, exceptional interpersonal skills, and ready to apply them in a work environment. Adept at working effectively unsupervised and quickly mastering new skills. Successful health information professional accomplished in maintaining complex and comprehensive records systems.

Skills

Customer Service

Strong Technical Understanding

Strong People Skills

Quick Learner

Strong Speaking Skills

Work well in a team atmosphere

Computer Skills

Critical Thinking

Flexible Schedule

Good Work Ethic

Active Listening

Epic Trained

Friendly, Positive Attitude

Team Building

Problem Resolution

Conflict Resolution

People Skills

Data Management

Organizational Skills

Reliable & Trustworthy

Relationship Building

Microsoft Office

Planning & organizing

Artiva Trained

Experience

Medicare Collections Specialist- Community Health Systems/2023- Current

Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare billing process.

Resolve billing issues, ensure accuracy re: CPT, HCPCS, ICD-9 codes as applicable.

Expand knowledge with insurance EOB & Traditional Medicare (handle denials and some occurring problems )

Call Medicare to re-open claims due to date, CPT, units, or other changes.

Used CPT-4 coders/Modifiers, ICD-9 codes, HCPCS codes when applicable for the resolution of claim payments. Expertise in Medicare billing procedures and regulations

Proficiency in medical coding (ICD-10, CPT, HCPCS)

Experience with billing software and electronic health record systems

Knowledge of medical terminology and anatomy

Understanding of HIPAA regulations and patient privacy laws

Strong attention to detail and accuracy

Excellent communication and interpersonal skills

Ability to work independently and as part of a team

Time management skills and ability to meet deadlines

Flexibility and adaptability to changes in regulations and procedures

Epic Trained

Consumer Access/Collections- AdventHealth- Daytona Fl 12/2022-6/2023

Consumer Access

Ensured patients were appropriately registered for all service lines.

Performed eligibility verification, obtained pre-cert and/or authorizations, made financial arrangements, requested and received payments for services, performed cashiering functions, cleared registration errors and edited pre-bill, and other duties as required.

Maintained a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary and patient access departments.

Actively participated in extending exemplary service to both internal and external customers and accepts responsibility in maintaining relationships that are equally respectful to all.

Verified medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicated relevant coverage/eligibility information to the patient.

Obtained pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients.

Obtained PCP referrals when applicable.

Alerted physician offices to issues with obtaining pre-authorizations.

Conducted diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed.

Collections

Ensured accurate and complete account follow-up.

Resolved claim processing issues in a timely manner, evaluating problem claims to the appropriate managerial personnel with the insurance carrier's organization to quickly resolve delinquent claims. or contacting patient or third-party payers in compliance with established policies and procedures.

Reviewed assigned claims working within the established productivity standards, for timely follow-up maintaining and updating all patient accounts to reflect current information.

Assessed each account for balance accuracy, payer plan and financial class accuracy, billing accuracy, denials, insurance requests, making any necessary adjustments, documenting appropriately and submits corrections or request for processing in a timely manner.

Resolved claim processing issues on a timely basis by reviewing claim.

Chef Pizza Hut - Spring Hill, FL 01/2017 - 09/2017

Collaborated with restaurant management to align kitchen operations with the goals of the establishment.

Preparing pizza dough, sauces, and various toppings, such as tomatoes, peppers, mushrooms, onions, and meats.

Monitoring the temperature of the pizza ovens as well as cooking times.

Preparing high-quality pizzas according to company recipes.

Monitoring inventory and placing orders for more supplies as needed.

Cleaning workstations before pizza preparation.

Ensuring that all utensils and cooking equipment are sterilized before each use.

Plating or packaging pizzas accordingly.

Managing all food order slips and ensuring that customers’ orders are completed in a timely manner.

Disposing of expired or spoiled ingredients at the end of each shift.

Registrar Brooksville Regional Hospital - Spring Hill, Florida 01/2016 - 1/2017

Registered patients and performs all registration-related functions, including explaining and obtaining all necessary patient consents and authorizations in a complete and timely manner, collecting financial paperwork (e.g., patient responsibility statement, etc.), and co-payment as required.

Communicated effectively with patients to assist in access to care by answering the telephone and other incoming communications in a timely and customer-service-oriented manner; replying to inquiries, the patient needs for information, and other parties clearly and in a timely manner; and, if the information is not readily available, follows up with inquiries to the responsible party.

Resolves all non-clinical questions within the scope of knowledge while providing excellent customer service on the phone and/or in person.

Performs ongoing documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors, including Medicare, using a variety of computer-based systems.

Routinely schedules appointments for all procedures educating each patient with pre-exam and if necessary, post-exam requirements within scope. Organized, generated and distributed patient reminders, results, and recall letters.

Established files, maintained information, and scanned medical records in a timely and organized manner.

Managed, directed, and responded to incoming office correspondence as deemed appropriate, including mail, email, faxes, and telephone calls, and forwarded queries to the appropriate staff.

Organized monitors, and orders for front desk supply inventory to assure cost-effective departmental spending.

Attends and provides feedback for departmental staff meetings.

Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity and communicating relevant coverage/eligibility information to the patient. Identified patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EM.

Completed Medicare Secondary Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards.

Role Modeled the Principals of a Just Culture and Organizational Values.

Ensured compliance with all applicable HIPAA, EMTLA, and Joint Commission requirements, providing required associated literature to patients.

Performed other duties as assigned on the department and organizational level.

Electronics Sales Representative Target - Spring Hill, FL 04/2015 - 12/2015

Analyzed customer needs and interests and recommended specific company products and services to best meet unique customer needs.

Maintained current store, product, and promotional knowledge to drive consistent sales.

Welcomed customers, offered to help locate items, and suggested merchandise without being intrusive or pushy.

Engaged positively with each customer, providing professional and polite support for sales and service needs.

Processed payments and maintained accurate drawers to meet financial targets.

Worked with off-site locations to find desired items for customers.

Approached customers and engaged in conversation through the use of effective interpersonal and people skills.

Educated customers on various product offerings, including cell phone, PC, and video game products, enabling better buying decisions.

Kept calm and applied strong problem-solving and interpersonal skills to resolve conflicts.

Education and Training

First Coast Academy 2725 College St Jacksonville, FL

EPIC Trained

DAR/Pulse Trained

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