Primary Care Follow Up
Resume:
Kabita Lama
Contact
***B Freemont St,
Arlington, MA 02474
************@*****.***
Experience
Cambridge Health Alliance
Account Receivable Follow up Biller July 2023
Successfully worked on the claim edit, follow up,denial, non government non response Workqueue.
● Verify claim status through payor website
● Sent claim to correct payor
● Verify payment information/ EOB and sent it to posting department
● Able to send corrected claim with (review form, claim and EOB)
● Prepare and submit claims for specified third parties/special billing exceptions
● Perform account adjustments and write-offs per hospital policy and payer guidelines
● Refer accounts requiring review or correction to HIM, Patient Access, Clinical Departments, or other areas as necessary Doctor Finder Services/Outreach-Practice Medical Receptionist Feb 2018 - June 2023
Successfully updates and registers electronic medical records for patients, schedules appointments and responds to new patient requests received. Averages 372 inbound and 215 outbound calls per month.
● Answer incoming calls from patients and hospital staff using Avaya Phone System
● Register/create electronic medical record for new patients in EPIC for 13 Primary Care Locations
● Schedule New Patient Appointments for 13 Primary Care Locations for non-CHA and CHA patients in EPIC while following Doctor Finder Services Booking guidelines
● Process Insurance Eligibility via Passport OneSource
● Explains to potential CHA New Patients insurance networks, benefits, plan types and payer specific insurance change processes
● Outreach Primary Care patients to assure BIDCO Care Gap metrics meet Health Insurance Requirements and improve retention
● Outreach ACPP Primary Care patients to engage patient into care and/or strengthen relationships within CHA
Key Skills
Fluent in NEPALI, HINDI,
and ENGLISH,
EPIC,
Passport OneSource,
Evolve by CiperHealth,
Avaya: Multiple-line Phone
System,
Google Sheets,
Google Drive
Education
Bachelor of Science,
Health Care Management
Bay State College, Boston,
MA
Job Readiness Course,
Career Collaborative,
Boston, MA
Bachelor of Science,
Social Work
Siddhartha Academy
College, Bafal, Nepal
● Document BIDCO/ACPP outreach efforts in Evolve by CipherHealth dashboard
● Outreach Primary Care patients that are due for renewal of MassHealth Benefits
● Document MassHealth outreach efforts in Google Sheets
● Reports patients with potential duplicate medical record numbers
● Train new employee
● Send staff message to CHA 13 primary location for ed and urgent care follow up
Mass Visions
Account Executive, July 2016
● Developed and maintained favorable relationships with new and existing clients in order to increase value
● Learned about the client’s products, marketing goals and needs
● Ensured clients had proper documentation to be eligible to receive certain services
● Promoted to Co- Operative trainer
● Outreach clients eligible for MassHealth benefits Danger Awesome
Development Research Intern June 2015
● Verify and update list of voters and/or donors to online registry
● Evaluate and resolve duplicate data discrepancies Additional Experience
● Cashier, Dunkin Donuts, Cambridge, MA July 2010 – March 2014
● Volunteer, Heartbeat Organization, Dallu, Nepal, January 2009
● Volunteer, Youth Leadership Camp, Kathmandu, Nagarkot, Nepal, June 2009
Relevant Coursework
● Human Resources Management: A comprehensive overview of recruiting, selection, hiring and onboarding, compensation and benefits, performance evaluation and supervision.
● Healthcare Delivery Systems: An analysis of the modes of healthcare delivery from hospitals and clinics to long-term care and government entities.
● Healthcare Regulation: A study of the nature, implications, laws and regulations governing the operation, liability, licensing and practice of healthcare organizations
Contact this candidate