Billing Specialist Accounts Receivable

Kimberly Goguen

Haverhill, Ma ***** (Cell) 781-***-****

*********@*****.***

Experienced in Word, Outlook, Excel, Epic, Athena, EMR. With a clear understanding of time management, communication and the ability to work independently or part of a team, I am motivated by new learning opportunities and challenges.

Northeast Arc-Danvers, Ma August 2023 to present

Senior billing specialist

Verify insurance coverage, insured accuracy of insurance claims, reviewed and resolved denied claims. Resolved incorrect insurance payment and issues with outstanding accounts. Obtain and enter prior authorizations, maintain the accounts receivable and patient eligibility report, post payments.

Robert Half/Murphy and Riley P.C November 2022 to January 2023 BILH/Billing Specialist

Transmit billing invoices, review for accuracy prior to submission, post payment, created deposits, research aged accounts.

BILH/Beverly Hospital August 2021 to November 2022 Patient Access/Emergency Dept

Greeting patients and their families, registration, insurance verification, copay collection, exceptional customer service, coordinate/facilitate daily administrative departmental activity. March 2020 to Aug 2021

Laid off from previous employer (Essex County OB/GYN Assoc) due to Covid-19 during which time I continued my job search while working on the start of my own business of Home Organizing. Essex County OB/GYN Assoc-Danvers, MA November 2019 to March 2020 Medical Billing Specialist

Prepare, review, and transmit electronic claims for processing via Epic. Analyze insurance payment for accuracy and compliance with contracted rates. Determine and bill secondary and tertiary insurances. Follow up with all accounts to assure payments. Answer patient and insurance company inquiries. Resolve insurance denials, resubmit claims (as needed), verify insurance eligibility, claim status, referral management. Winchester Hospital-Woburn Ma March 2019 to October 2019 Patient Access HB/PB Billing specialist

Identified, researched and resolved unpaid or rejected claims. Obtain prior authorizations and referrals prior to billing. Verify and correct billing information to assure proper processing and payment. Compile information to prepare and file appeals with insurance companies when not in agreement with their decision and file within a timely manner. Microsurgical Eye Consultants, PC-Peabody, Ma August 2007 to February 2019 Medical Billing Specialist

Verify patient’s insurance coverage, deductibles, insurance payments, and remaining balances not covered under policies to insure payment and correct patient balances. Balance daily deposits, research unpaid claims, obtain prior authorizations and referrals. Submit secondary and tertiary claims with primary insurance explanation of benefits. Manage daily electronic billing, analyze daily discrepancies and correct all errors prior to submitting. Identify trends impacting charges, coding, collection and accounts receivables. Processes accounts receivable reports, coordinate month end close, review credit balances, process refunds, interact with patients resolving billing questions and concerns. North Shore Physicians Group-Lynn, Ma February 2000 to August 2007 Medical administrative assistant

Maintain database of all new patient referrals, prior authorizations, scheduling, follow-up appointments, medical records, and other pertinent information. Assist manager, clinical and surgical coordinator. Created purchase orders of office inventory. Obtain and verify patient and insurance information. Reconciled accounts receivable ledger to verify payments and resolve variances. Record cash and check deposits and generate cash receipts and accounts receivable. Act as receptionist for incoming patients, answering questions or concerns in an efficient and courteous manner.

Direct calls, take messages, assist with projects, maintain and reconcile office petty cash. Maintain and update records of employee sick leave bank attendance records and prepare annual statement of benefits.

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