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Customer Service Medical Billing

Location:
Baltimore, MD
Posted:
October 07, 2019

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Resume:

EVELYN M. WARD

**** *. **** ****** *********, MD 21218 Phone: 410-***-**** email:adajbd@r.postjobfree.com

Professional Summary

, MD 21218 (H) 410-***-**** adajbd@r.postjobfree.com

Manage and supervise a staff of 25 employees or more within the Healthcare industry for technical and professional accounts receivable, Medical Billing and Customer Service, extensive experience as a Consultant Administrator, I have over twenty years of comprehensive medical revenue cycle experience. as well as a Financial Accountant. I have also traveled as a consultant within the United States assisting clients collections, accounts payable and receivable, overseeing and implementing the efficiency in order to reduce costs. Acquainted and utilize All-Scripts, AS400, Passport One Source, Click on Demand (SSI), NextGen, Navinet, One Health Port, Availity and Gateway Clearinghouse, McKesson Star & Horizon, (East Coast -CMS Secure Net Access Portal for Medicare WPS) EPIC, and (SMS) Invision, GE Centricity, Power Chat, Revenue Cycle and Advanced MD.

Accomplishments

Ensuring compliance with Federal and State regulations and company policies that govern Medicare and state payment systems as well as identifying fraudulent non-plan billing practices and assisting the legal department with litigation preparation.

Establishing and maintaining required billing records and patient insurance information according to Medicare, HIPAA and other department guidelines.

Improving total company performance and lead multiple engagements for the client over time.

Planning, managing and executing major tasks for consulting projects, company-wide activities and business development.

Customer Service

Management/Supervisor

Credentialing Specialist

Accounts Payable/Accounts Receivable

Reimbursement Specialist

Medical Secretary

Professional Experiences

Practice Dynamics INC March 2019 May 2019

Medical Collections Analyst

Follow up claims on payer rejections to ensure the timely filing.

Verify, analyzed and interpreted patient medical coverage for inpatient and outpatient services.

Utilized online websites to check eligibility on patient insurance coverage

Credentialing in the Billing Department

Medstar Health July 2018 November 2018 Collections Analyst

Escalate provider Credentialing issues, Coding, Payment posting, Accounts Receivable/Accounts Payable, Reconciling payments and adjustments

Collections follow up

Reimbursement Specialist

Resolution with all insurance companies including Medicare/Medicaid

Insurance verifications

UPMC Pinnacle Lancaster Regional Hospital October 2015/ December 2017

PBX Operator

Answering and completing telephone, pager and other communications efficiently adhering to hospital and departmental policies and procedures

Greeted customers and visitors in person and via telephone calls, physician and other hospital personnel with excellent customer service skills.

Demonstrated skillful multi phone lines abilities

Interacted with all vendors, contractors and professional service personnel to receive orders, direct activities and communication management instructions.

Carried out other secretarial and or receptionist duties as required; i.e. data entry, filing, help with medical billing when needed and doing insurance verification.

Frasier Healthcare Service June 2012 / October 2015

Interim Traveling Analyst Consultant

Assisting the clients with their needs as to traveling consultant Analyst throughout the US.

Telecommunication PBX Operator with UPMC Pinnacle Lancaster Regional Hospital assisting managers and director with administrative duties as well as maintaining appropriate communication links with the department manager, co-workers, physicians, and other hospital personnel with excellent customer service skills.

Account Representative with WY-West Park Hospital Organizing inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Identifying problem accounts with payers; investigating and correcting errors, follow-up on missing account information, and resolves past-due accounts.

Team Lead at Mercy Hospital Planning, managing and executing major tasks for consulting projects, company-wide activities and business development.

Conducting quantitative and qualitative analyses as well as supporting performance improvement efforts, including process assessment, data collection and reporting, and development of dashboards and scorecards.

Overseeing billing, payroll, AP, and AR and verified that proper procedures were followed as well as establishing implementation of an effective budgeting and accounting system that improve efficiency and reduce costs.

Expeditative Healthcare Consultant at Carroll Health Group as Insurance Follow Up (Medicare, Medicaid and Commercial plans), A/R clean-up, claims resolution, work denials, researching, appeals, customer service, phones, resolving insurance discrepancies. Processing medical records request, preparing documents for scanning, adjustments, verify coverage, data entry, setting up payment plans and posting payment.

Joseph Eisenberg, PhD Baltimore, MD November 2007- December 2012

Office Manager/ Medical Billing Specialist

Mental Health Claims-Insurance Follow Up, (Medicare, Medicaid and Commercial plans) referral coordinator (obtaining pre-cert/authorizations), A/R clean-up, claims resolution, work denials, research, appeals, customer service, phones, resolve insurance discrepancies.

Processing medical records request, preparing documents for scanning, adjustments, verify coverage, data entry, setting up payment plans and posting payment.

Coordinating billing and collecting/posting payments for 2-provider offices, Insurance Follow Up (Medicare, Medicaid and Commercial, Workman Comp plans), A/R clean-up, claims resolution, work denials, research, appeals, customer service, phones, resolve insurance discrepancies.

Processing medical records request, preparing documents for scanning, prepping court documents for attorneys, adjustments, verify coverage, data entry, setting up payment plans and posting payment.

Sinai Hospital Baltimore, MD May 2005 – November 2007

A/ R Representative/ Medical Billing Specialist

Coordinating billing and collections follow up

Accounts Receivable claims resolution

Reimbursement Specialist

Appeals

Resolutions with insurances in which included Medicare and Medicaid

Insurance verification

Customer Service

Education

Business Administration

Bay College of Maryland - Baltimore, Maryland



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