Claims Examiner Accounts Receivable
Resume:
Vickie Maddox
*** ********* ****** ******, ******* 35124 205-***-****
Objective
Professional Profile
To obtain the position that will allow me the opportunity to utilize my insurance claims examiner experience as well as my healthcare management skills.
An ambitious personality results driven and delivers on established commitments and goals.
Highly skilled in conducting research and problem solving.
Demonstrated effective communication and organizational skills.
Ability to learn and apply new information and to support new patient growth.
Knowledge of coding issues by using CPT/IICD-9 coding books and Encoder Pro.
Experience using Microsoft Office Suite (97, 2007); Excel, Word, Access, Outlook and Power Point.
Experience
2023- Present Surgery Partners Corporate, Shared Services Center, Remote
Revenue Cycle Shared Service Center Collection Specialist
Communicate with the insurance companies, patients and other third parties in reference to collection of he accounts, through the Advantix Billing and Desktop Collector’s modules.
Responsible for contacting insurance carrier to dispute incorrect payments.
Researching claims and accounts to make sure that benefits were verified properly.
Responsible for follow-up on unpaid claims and collections of unpaid balances
Great presentation and communication skills
Knowledge of CPT and ICD-10 coding and electronic billing information
Assists with admitting personnel in the areas of insurance verification.
2007- June 12th, 2023, Surgery Partners / Birmingham Surgery Center, Homewood AL,35209
Accounts Receivable Specialist/Collector
Responsible for all collection accounts 30-, 60-, & 90 and over 120-day bucket. Prioritizes per our monthly strategy, generally from largest to smallest.
Workers’ compensation specialist also, I ensure accurate and timely management of time lost.
Communicate with the insurance companies, patients and other third parties in reference to collection of he accounts, through the Advantix Billing and Desktop Collector’s modules.
Responsible for contacting insurance carrier to dispute incorrect payment or nonpayment daily.
Run monthly reports to review outstanding Workers Comps and patient account balances and verify that insurance companies are reimbursing accounts correctly. Are 60-90 days past due. Pulling EOB’s and operative notes and documents or inquires on patient account to provide detail of account activities.
Required submitting month end projections and reports to Business office manager regarding the A/R and responsible for handling any question that may arise.
2006-2007 Birmingham Surgery Center Homewood, AL
Insurance Verification/Payment Poster
Contacting all insurance carriers per patient to ensure proper coordination and reimbursement of benefit.
Obtaining and verifying patient insurance information for proper claims to process.
Verify patient eligibility, and benefits for outpatients’ surgery in a timely manner.
Verify patient’s deductible, co pays, co-insurance, out of pocket maximum and lifetime maximum benefits.
Posted patient and insurance payments on accounts.
2004 - 2006 Blue Cross Blue Shield of AL Birmingham, AL
Inquiry Analyst Trainee
Identify customer inquiries and resolve them in an accurate and timely manner.
Research and interpret benefits using DORS, MRO, BOL and GEMS, paying attention to details.
2000 - 2001 United States Postal Service Birmingham, AL
Postal Worker
Received incoming packages and freight from truckers and delivered mail and packages throughout the Birmingham assigned areas.
1991 - 1997 Brookwood Medical Center Birmingham, AL
Multiple Competency Clinical Technologist
Responsible for collecting, processing and analyzing biological specimens and other substances.
Performed analytical test of body fluids, cells and other substances.
Demonstrated professional conduct and interpersonal communication skills with patients, laboratory personnel, health care professionals and with the public.
Meeting needs of and with existing and prospective patients, as well as clinicians and staff and educates
1989 – 1991 Veterans Hospital Birmingham, AL
Medical Secretary
Provided direct case management services including service linkage, crisis intervention, advocacy, assessment and maintained existing relationships with major hospitals in the territory.
Responsible for interviewing patients to assess their needs and providing information and referrals to other agencies while monitoring service delivery.
Ability to easily multi-task, and Great presentation and communication skills
Education
Shelton State Community College Tuscaloosa, Alabama
Associate of Science
Major: Medical Technician
University of Alabama in Birmingham Birmingham, Alabama
Associate of Science
Major: Clinical Technician
Strayer University
Bachelor of Business Administration Currently Pursuing
Health Services Administration
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