Third Party Account Representative
Resume:
Anita Chapel
Indianapolis, IN, *****, US
**************@*********.***
Work Experience
Nov, 2014 - Mar, 2023
Patient Account Representative, Accredo Health Group, Inc. Escalate delinquent and/or complex claims
Pursue collection activities to obtain reimbursement from payers and/or patients
Follow up with payers and/or patients on outstanding accounts Obtain prior authorizations as required, statements of medical necessity, assignment of benefits and submit claims documentation to third party payers and manufacturer's support programs
Report any issues that prevent claims from being billed to supervisor and review unbilled claims reports
Obtained prior authorizations as required, statements of medical necessity, assignment of benefits and submitted claims documentation to third party payers and
manufacturer's support programs
Coordinated the shipment of specialty pharmaceuticals Responsible for cash application
Account daily to ensure accurate financial data and system documentation
Managed and sent eligibility notifications to patients and Doctors Skills
Handled insurance billing, collections, and clearing shipments of medications to the pharmacy for patient accounts Processed multiple insurance claims on a daily basis Analyze complex financial forms and collections of numerous accounts
Coordinated the reimbursement process of receiving referrals, analyzing financial forms and account collections
Submitted claims to third party payors, and directly to contracted payors
Detailed the benefits of utilizing the company's pharmacy services to patients
Work and maintain detailed spreadsheets and collection current and outstanding balances (insurance and patient) Identify problem account with payors; investigate and correct errors, follows-up on missing account information, and resolve past-due accounts
Verify insurance benefits, obtain authorizations,work with manufacturers and doctor's offices to get new patients on service
Worked to file pharmacy claims for Humana Military benefits Nov, 2009 - Nov, 2014
Insurance Claims Specialist, Kelly Services, Inc.
Demonstrate the financial and statistical accuracy of claims Develop open lines of communication with other departments to reduce processing errors
Utilising over 15 years personal insurance experience Calling other insurance companies for information
Worked multiple screens while utilizing several databases Assist patient in resolving insurance related questions, billing problems, coverage issues and so forth via contracts and CRT Monitor work queue on a daily basis to properly manage transactions
Temporary to Hire position
Mar, 1998 - Nov, 2012
Billing Representative, Wishard Health Services
Type billing documents, shipping labels, credit memorandums, or credit forms, using typewriters or computers.
Verify accuracy of billing data and revise any errors. Keep records of invoices and support documents.
Prepare itemized statements, bills, or invoices and record amounts due for items purchased or services rendered. Answer mail or telephone inquiries regarding rates, routing, or procedures.
Resolve discrepancies in accounting records.
Compute credit terms, discounts, shipment charges, or rates for goods or services to complete billing documents. Compile reports of cost factors, such as labor, production, storage, or equipment.
Operate typing, adding, calculating, or billing machines. Contact customers to obtain or relay account information. Medicare and Medicaid Patients hospital billing
Commercial patients Hospital billing
Education
2007
American InterContinental University-Online, Master's Degree in Business Administration and Management
2005
Indiana Wesleyan University, Bachelor's Degree in
Information Technology
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