Account Representative Mental Health
Resume:
Kim Weaver
Conyers, Ga. 30013 678-***-****
*********@*****.***
Professional Summary:
Supervisor Billing/Collection and Patient Account Representative/Financial Coordinator with +4 years of experience in a sensitive corporate environment. Skilled and experienced in Revenue Cycle with a strong knowledge of medical insurance verification. Outgoing and detail-oriented, I am proficient at building and maintaining professional relationships. Proven ability and determination to manage multiple projects under tight deadlines. .
Education
South University-South Carolina August 2016 – September 2020
Degree: Master of Clinical Mental Health Counseling
With Distinction
Columbia Southern University, Orange Beach, AL. August 2014 - May 2015
Degree: Bachelors of Health Care Management
Honors: Alabama Life Scholarship Recipient
Together Sisters Scholarship Recipient
Dean’s Honor List
Work Experience
Schindler Elevator, Atlanta GA, Lead District Account Manager January 2023- Present
Communicate with customers with focus on reducing the overall accounts receivables for districts
Document all customer communication and prepare any necessary documents needed
Participate and lead monthly conference calls with the local districts to review the top account impacting the financial performance of the district
Responsible for resolving customer disputes through contract review or negotiation and escalating if necessary
Meet or exceed financial targets set by management
Tracking of and filing liens on properties and setting up legal/collection files
Review unapplied payments to help resolve all unclaimed property items for assigned districts.
Interdepartmental communication is a must to achieve financial results
Willing to assist and train new members within the are of activity
Working a flexible time schedule and some travel may be required in accordance with the assigned district
Manage service escalations
Manage book of business
Collaborate with stake holders to discuss contracts
Develop and implement annual plans to develop to meet goals for stakeholders
Develop and present Kep performance indicators that adhere to specific goals for stakeholders
Fresenius Medical Care, Kennesaw, GA, Supervisor Collections and Billing Representative August 2016 – December 2022
●Conduct training of current processes; ensuring activities are in compliance with company policies and procedures.
●Mentor other staff by providing guidance, leadership and support with the assigned function(s).
●Identify, research, and resolve complex errors, issues and discrepancies within the assigned function(s).
●Handled inbound and outbound calls with the objective of collecting delinquent account(s).
●Researched, analyzed, and settled all customer billing dispute(s).
●Classified overdue accounts for efficient collections.
●Worked to resolve claims by disputes
●Identify not only that a claim has been denied, but also the reason for the denial
●Assisted clinics with determining what requirements are needed to efficiently process claims
●Developed reports to assist with trending issues that prevent claims from billing
●Ensure that correct procedure, modification, and diagnosis codes were implemented on each claim
●Created and submitted 1st, 2nd, and 3rd level of appeals as documentation needed for specific payer
●Developed plan of action for trending payer denials
●Assisted and devised power points to assist with visual aids for trainings
●EPIC Credentials in ADT, CADENCE
●Monitor accounts receivables to ensure accuracy and performance
●Hire new partners for vacancies
●Monitor team through work flow through Key Performance Indicators
Ray of Hope, Conyers, Ga. Revenue Cycle Finance Lead Sept 2019-Present (Part-Time)
Bill Medicare Part A & B Claims Processing through CMS through SNF guidelines
Billing Insurer’s through consolidating Billing
Ensuring Occurrence coding is correct
Completing Claims with correct ICD-10 and Rev Codes
Completing billing with implementing guidelines for re-admissions, benefits exhausted, No-payment
Ensuring that Claims are billed in regards to coverage requirements.
Worked to resolve claims by disputes
Identify not only that a claim has been denied, but also the reason for the denial
Assisted clinics with determining what requirements are needed to efficiently process claims
Developed reports to assist with trending issues that prevent claims from billing
Sleepworks, Atlanta, GA, Benefits Specialist September 2014- August 2015
Maintains benefit records and prepares documents necessary for implementing benefit coverage. Communicates with plan service providers relative to claims issues
Facilitates new hire enrollment
Assist employees with administering benefits plan so that they are in compliance with governing regulations
Partner with the Communications and Training department to update internal communications including that include: benefits newsletters, wellness and retirement education sessions, benefit announcements for various events such as open enrollment, new hire enrollment, wellness events, wellness screenings, etc.
Continuing assistance in areas that are associated with Human resource and benefits needs
Georgia Cancer Specialist, Atlanta, GA, Financial Coordinator November 2012 – September 2014
●Worked in the oncology revenue department and held the responsibility of identifying coverage issues.
●Assisted patients who are under-insured with alternate resources
●Submitted financial assistance application and Medicaid/ Medicare application process
●Researched assistance options
●Follows up with agencies to provide monthly reports
Target Pharmacy, Conyers, GA. Lead Certified Pharmacy Technician July 2011-September 2014
●Worked as the lead technician as a trainer
●Assisted the pharmacy with filling, scripts, taking orders over the phone, scheduling pickups
●Demonstrated leadership abilities with assisting new Pharmacists with the process and procedures
●Schedules all new orders to replenish stock of over the counter meds as well as prescription meds
Affiliations/Skills
Proficient in Microsoft Office*Verbal Communication*Strong Work Ethic*Customer Service* Problem Solving*Medical Insurance Verification*Human Resources Management*Mentoring*Strong Leadership*Team Management*Experience with Sharepoint *Decision Making*Experience with Relay Health Clearance*Experience with Cerner Soarian Financials*Data Analysis*Research and Planning*Organizational Skills*Revenue Cycle*Document Imaging*Pre-Authorizations and Referrals
References
available upon request
Contact this candidate