Medical Records Project Management

VANESSA BAKER

**** *. ***** • Chicago, IL ***** • ****************@*****.*** • 773-***-****

Medical Services Professional with exceptional achievement record in securing resolutions to billing and accounts receivables issues. Strong negotiation skills. Able to sell solutions to outside parties. Noted for astute problem solving capabilities. Train staff in job skills with emphasis on developing initiative, energy, loyalty, dedication and high quality performance. Seek a position in a progressive environment where her medical, financial, negotiation and leadership skills will be maximized. Proficient in MGM, N-DAS, EnCare, EPIC, PCon, HBO Medical Pathway, MedAsset, Microsoft Office and all Medical Billing and Collection proprietary software and all script system

CORE COMPETENCIES:

•Prioritize work • Maximize reimbursements • Effective communicator

•Conflict resolution • Staff training • Research discrepancies

•Team leadership • Close receivables • Project management

Usa Vein Clinic

A/R Medical Collections Specialist

October 2021 to Still Present

Submitting Medical Claims to insurance company for payment

Contracting insurance regarding claim status, and denials

Outstanding payments, authorization explain benefits to patients

Contact patient regarding outstanding co -payments and deductibles

Submit appeals and medical records timely filing for denied claims

and other documentations request to insurance company as needed

Review eob and payment check benefits through navinet mass health

or any other websites prepare medical records if required. Perform

high clerical duties including copying, faxing, and filing

Takes parts in chat with email communication other guidelines related

to the company. Demonstrates knowledge of services

Professionalism and outstanding customer services. Handle multi-line

language telephone calls on daily basic research resolved outstanding

claim issus work with report management system

WORK EXPERIENCE:

Healthcare Information Service

November 2020-July 2021

Reimbursement Specialist

Specialist is to Analyze the billing process to determine

appropriateness in payment responsible for handling

all components of claims processing including coordination

of disputed reject

ed and delay claims and to review returned

disputed or rejected claims from commercial medicare medicaid

and w/c claims and other third party payers and problem solve

Responsible for communication with all type of insurance coding

processes to prevent future denials. Work with spreadsheet and

top priority accounts on a daily basis.

Incart Shopper

February 2018-October 2020

Buying grocery at different stores location through the city area

there are local stores that the company has partnered with and

delivering those item’s to the customer’s home. Also intercart

partnered with binny’s stores as well for the customers.

Wolcott, Wood, & Taylor

January 2018- May 2018

A/R Representative

Resolve outstanding receivables with 3rd party payors or patients.

Identifies denial trends and works to correct issues or errors.

Works with a high volume of claims.

Work off multiple ques to manage open A/R.

Resolve claim form edits, rejected claims and patient or insurance correspondence.

Exhibited superior organization skills to maintain high levels of productivity.

RUSH UNIVERSITY MEDICAL CENTER

June 2011-August 2017

Financial Representative I

Manage Blue Cross/Blue Shield (BC/BS) accounts receivables to maximize reimbursements on outstanding, denied or disputed claims. Research thoroughly all documentation relevant to each case and analyze discrepancies. Prepare information for resolution. Contact BC/BS and negotiate due reimbursements. Monitor contractually agreed upon payments schedule. Create a permanent record of outcomes.

•Avoid lost payments through account management and fiscal analysis.

•Take ownership of special projects as assigned by senior management.

•Prepare volume, productivity and management reports.

•Establish collaborative working relationships with all internal departments.

NORTH SHORE UNIVERSITY HEALTH CARE SYSTEM

March 2005- June 2011

Insurance Follow-up Representative

Prepared documentation regarding follow-up and collection activities and created files in the Patient Accounting System. Monitored and reported discrepancies, errors or denials. Contacted payee to resolve unpaid accounts. Keep records current to ensure outstanding payments submitted on time. Determine all data required, recorded and available. When necessary, resubmitted claims via Ecare System. Partnered with managers and other departments to complete tasks. Utilized Epic System to make records accessible for future reference.

•Advised senior management of problem accounts when intervention required.

•Verified patient information was current and updated when necessary.

•In cases of denied claims appeals, forwarded all information to the appropriate department.

•Ensured all Federal and State billing/collections regulations were in compliance.

EDUCATION:

AT HOME PROFESSION

Fort Collins, CO

Studies in Medical Claims and Billing Specialist

WILBUR WRIGHT COLLEGE

Chicago, IL

Studies in Data Processing

Professional References

Available Upon Request

Contact this candidate