Reimbursement Specialists

Mary N. Leftridge

****************@*****.*** • Maple Heights, OH • 216-***-****

OBJECTIVE

Professional health care specialist, seeking a challenging career opportunity, particularly to work at Dialyze Direct as Administrator Assistant working collaboratively with all interdisciplinary care providers, Physicians, Nurses, and other pertinent team members involved in health care and well-being. With strong emphasis in, by assuring excellent customer, communication with both medical, clinical and clerical staff throughout the company .

Thus, ultimately providing quality care and service in reaching desired goals and outcomes.

•Office Management

•Patient Registration

•Radiology Technology

•Medical Terminology

•Manage daily claims billings

•Worker’s Compensation

•Medical Terminology

•Medical Data Entry

•CPT/HCPC Coding

•Medical Chart reviews

•Medical Claims and Appeals

•Phlebotomy Technology

•Patient Confidentiality

• examining medical claims

•Functioning as a liaison

Career Experience

Hospital Reimbursement Specialist;

Cleveland Clinic Foundation, Independence, OH 1/2004 to 10/7/2019

Functioned as a lead billing and reimbursement specialist, w[1]ith emphasis in hospice billing and administrative support. Examined medical billing, updated patient data, developed payment plans, prepared invoices in order to process claims and collect revenue appropriately for medical services and procedures. Assured that patients were billed quickly and accurately. Provided insurance verification, CPT, HCPC, and ICD-9 Coding for precertification and appeal denial support for hospice patients. Managed daily claims, billing accounts, resubmitted timely information, and corrected inaccuracies. Oversaw end-of-month reporting. Designed and implemented process improvements, increased incoming revenue and improved efficiencies. Coordinated with partners and other hospice agencies to meet and exceed goals within allotted time frame and budget restraints. Worked to provide excellent customer service and client support in a fast-paced clinical environment.

Provided administrative support, processed and managed other medical specially accounts as assigned. Successfully met and exceeded reimbursement goals within time and budget restraints while working in fast-paced, clinical environment. Provided excellent customer service to both patients and their family members displaying empathy and compassion in managing and explaining their financial obligations and responsibilities.

AWARDS

Was awarded multiple accommodations for exceeding collection revenue goals annually.

Recognized as being overly efficient in filing appeals and recognized as the trouble shooter in the collection department.

Awarded accommodations for always being ready and willing to assist fellow co-workers when needed.

Medical Billing Specialist, and Front Office Patient Support Representative; Spherion Corporation, Cleveland, OH 7/2003 to 5/2005

Worked providing patients with memorable outstanding care experiences; using exceptional communication and organizational skills. Functioned within the medical billing placement agency, providing excellent customer service, assisting with managing front office and overseeing administrative duties for Textile Department, including utilizing medical and data entry technologies (MDET). Worked to determine the nature of incoming calls, responding appropriately and directing inquiries to the appropriate specialty resource. Functioned as liaison between appropriate medical staff, internal and external customers while adhering to HIIPA privacy act. Scheduled beds for inpatient admissions, scheduled patients for appointments, pre-admission testing, pre-cert insurance authorizations, and worked to provide education to clients according to case-by-case needs. Provided assistance, support and coverage of other office duties as assigned to various departments and co-workers during high volume workload and/or during shortage of staff. Answered a high volume of incoming telephone calls, examined medical billing and provided excellent customer service to both patients, guardians and their families.

Customer Service Representative

Family Physicians Associates 7/2001 to 7/2003

Duties included functioning as a pertinent, supporting team player to schedule and re-schedule doctor appointments, exams and testing for patients such as CT Scans, MRI scans, Ultrasound and x-rays. Communicated with patients by way of telephone and/or face to face contact regarding appointments; directed telephone calls to proper staff members, performed data entry and general clerical duties as assigned. Collected payment and co-payments from patients in a pleasant, non-threatening manner and generated transactions by way of office electronic database program; Reviewed orders for patient’s tests and procedures prior to scheduling in order to assure accuracy. Gathered pertinent medical and insurance information; copied patients’ information and documented all notes in records with accuracy; Managed front desk operations and prioritized duties; performed other tasks and duties as assigned.

Emergency Room Registration Representative St. Luke’s Hospital 5/ 1986 to 6/2001

Functioned in the Emergency Room front registration desk, greeting patients face-to-face, collecting demographic information, collecting insurance information and making contact with private insurance companies for verification; filing, coding, preparing charts, ordering and obtaining previous medical records and histories, answered incoming telephone calls, assisted other office staff, Nursing and Physician personnel as needed. Assisting with transportation to other departments and to inpatient admission units in absence of appropriate personnel.

Additional experience as a Radiology Coder, Admission Access Clerk, and Medical Biller.

Education

Associates Degree

Cuyahoga Community College, Parma, OH

Professional Training

Secretarial Certificate, USA Training Academy, Columbus, OH

Certified Phlebotomist, ICD- 10 Certification, 2019

CPC Certification

[1]

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