Sharon Moses

Medical Billing Specialist/ Customer Service Rep

ad4i70@r.postjobfree.com

Northridge, CA 91324

818-***-****

Made outbound calls, took payments, documented each account, cash posting. resolved issues. Prioritize my workload. Superior Customer Service and Team Player. Microsoft Access, Windows computer programs, Power Point. Data Analysis.

Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Client Financial Service Specialist

Robert R Half/Heartland Dental

June 2021 - Jan 2024

Post payments to patients accounts. Made adjustments, discounts, handled disputes. Data Entry, provide Customer Service. Resolved issues. Maintain files on individual appeals and grievances May coordinate the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mail.

Covid Investigator

Barren River District Health Dept

Bowling Green

Dec2020- March 2021

Contacting Covid 19 Patients

Following up on their symptoms, educating them on the disease. How to properly isolate themselves from others. Following up with Patients, Companies, Schools, Hospitals, Clinics to make sure they were educated as well on the disease.

Receptionist/Administrative Assistant

Stifel Nicolaus -

Bowling Green, KY

April 2020 to August 2020

Answered multi line phone, updated clients records, data entry, metered mail, fedex labels, filing, copying, scanning and faxing. Customer Service. Set up appointments.

A/R Specialist/Administration

Comprehensive Pain and Neurology -

Murfreesboro, TN

March 2019 to June 2019

·Billing and Collections of Medical claims. Following up on denied claims with insurance companies. Ran reports, Data entry, CSR, Electronic Records, Resolving issues. Prior Auth, Self-pay, Collections, Set up payment plans. Documentation Specialist. EDI Specialist. Summarizes current financial status by collecting information; and preparing balance sheets, profit and loss statements, and other reports.

·Substantiates financial transactions by auditing documents.

·Maintains accounting controls by preparing and recommending policies and procedures.

·Guides accounting clerical staff by coordinating activities and answering questions.

·Reconciles financial discrepancies by collecting and analyzing account information.

·Secures financial information by Business Use completing database backups.

·Maintains financial security by following internal controls.

Medical Billing/ Collections Representative

Parallon Healthcare

January 2018 to June 2019

·Worked old A/R to account resolution. Working denials, Contractual adjustment issues, took payments, Updated patients info, CSR. Documented accounts.Prior Authorization, Documentation Specialist, A/R, A/P, Data Entry, Denials, Appeals, Reimbursements, Summarizes current financial status by collecting information; and preparing balance sheets, profit and loss statements, and other reports.

·Substantiates financial transactions by auditing documents.

·Maintains accounting controls by preparing and recommending policies and procedures.

·Guides accounting clerical staff by coordinating activities and answering questions.

·Reconciles financial discrepancies by collecting and analyzing account information.

·Secures financial information by Business Use completing database backups.

·Maintains financial security by following internal controls.

Medical Collections Specialist

Healthcare Provider Solutions -

Nashville, TN

January 2017 to January 2019

·Medical Collections, high dollar, mid dollar. Collecting on past due payments from payers, resolving billing and collection issues.Prior Auth, Working denials, Appeals, coding issues. Commercial and Government. Resolving issues for payment. Auth and Referrals, payment postings, refunds. Insurance Verification. EDI Specialist. Summarizes current financial status by collecting information; and preparing balance sheets, profit and loss statements, and other reports.

·Substantiates financial transactions by auditing documents.

·Maintains accounting controls by preparing and recommending policies and procedures.

·Guides accounting clerical staff by coordinating activities and answering questions.

·Reconciles financial discrepancies by collecting and analyzing account information.

·Secures financial information by Business Use completing database backups.

·Maintains financial security by following internal controls.

Medical Billing and Collections /CSR

Centerstone Behavioral Health -

Antioch, TN

April 2016 to February 2017

Verify insurance updating demographics., providing Superior Customer Service, faxing, scanning, copying. Ran outstanding A/R reports, follow up on claims, calling government and Commercial insurance. Work denied claims, contractual adjustments issues, appeals. Data entry, documenting each account, taking payments, posting cash. Working with dual screens. Prioritizing workloads. Resolving issues. Working on various billing systems. Star, Barr, McKesson.Pulled electronic documents, medical records, visits, consent forms, doctors notes, etc. EDI Specialist.

Patient Account Representative/CSR

United Surgical Partners Group -

Brentwood, TN

June 2014 to April 2016

Responsibilities

Medical Billing and Collections, Worked Denials and Appeals, Contractual Adjustments, Reimbursements, Checked

claim status, contacted insurance companies, both government and commercial. document each account. Insurance Verification. EDI Specialist

Accomplishments

Trainer for new billing system that was implemented.

Skills Used

Accounts receivable, data entry, computer skills, Microsoft word, excel, excel. Ran reports, written and oral

communication skills, customer service, 100 calls per day.

Patient Account Billing Rep. and Electronic Claims Specialist

Community Health Systems -

Brentwood, TN

April 2011 to June 2014

Superior Customer Service, Promotability.

Contact third party regarding claim status.

Monitored aging accounts to ensure timely filing an appeal review to ensure correct pricing

Review payer contracts to ensure accurate payment is received

Pursues all collection limitations are met per payer guidelines

Follow-up with phone calls to insurance payers on a daily bases

Enter daily charges for each clinic worked by Rep for month end close.

Chart notes on accounts with appropriate action being taken on each claim. Insurance Verification.

Billing and Collection Specialist

Gresham and Associates Cardiology Group -

Murfreesboro, TN

May 2009 to May 2011

HDX -Insurance verification of benefits

Electronic and Manual Billing

Contract third party payers regarding claims

Set up payment plans, take credit card and check payments via phone

Follow-up with phone calls to insurance payers on daily basis

Review payer contracts to insure accurate payment is received

Set appointments for EKG's and Stress Test

Identify errors and trends on claims (correct coding)

Mass refills once errors identified

Chart notes on accounts with appropriate action being taken on each claim

Cash Posting Daily

Patient Account Representative

Saint Thomas Cardiology Consultants -

Nashville, TN

May 2008 to May 2009

Manual and Electronic Billing of cardiology claims

Correcting errors in Misys billing system and rebilling claim

Follow-up with third party payers on claim status, Insurance Verification.

Chart notes on accounts with appropriate action being taken on each claim

Access third party websites for claim status, authorization status

Review Electronic claim submission reports.

Review payer contracts to ensure accurate payment is received

Review all claims with payment errors, low reimbursement, appeals and denials. Take over 100 calls per day.

Education

Bachelor's in Business Management

Kee Business College -

Newport News, VA

June 1979 to September 1983

Skills

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claims

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Billing

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Accounts Receivable

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Filing

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Collections

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Office Experience

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Multilingual

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Hospitality Experience

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AR

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AP

Insurance Verification

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Medical Billing

Medical Collections

Contact this candidate