Houston, Texas 77051
Successful in delivering excellent customer service in support of structural objectives in medical business office arenas; collect information and answer questions; resolve problems through research across all departments; proficient and professional telephone etiquette
Win&Associates February 2019 to present
Medical Collection Specialist
Checked claim status via web portal or over the phone on commercial claims, send appeals on denied claims with all suppporting documentation, sent corrected claims, worked eob's,made payment arrangements with patients, handled negotiations.
Medical Plus Supplies May 2018 to November 2018
Durable Medical Equipment Claims only. Check status on claims via websit or over phone with commercial insurance companies. Work eob's. Send out appeals on denied/underpaid claims as well as claims denied for timely filing. Experience with UB04 and HCFA claims. Sent out corrected claims on any that needed adjustments or anything changed. Did write off's on claims that's unable to collect on. Processed credit card payments online from patients. Processed refunds. Inbound/outbound calls from patients and insurance companies. Took credit card payments over the phone from patients who wanted to make payments on their accounts.
Nobilis Healthcare March2016 to November2017
Checks status on unpaid claims via online or over the phone with commercial insurance companies. Work eob’s. Send appeals on denied,under paid and timely filing claims. File claims manually and electronically. Experience with UB04 and HCFA's. Work special projects. Take credit card payments over the phone from patients who wanted to pay on their accounts.
HOUSTON HOSPICE October 2015 to January 2016
Follow up on unpaid and denied claims. File claims manually and electronically. Send appeals on denied, under paid and timely filing claims. Set up payment arrangements with patients. Check claims staus online and via phone with insurance companies.
Nova Medical Centers May2014 to June2015
Refer workers comp patients to various specialist depending on the injured body part and nature of the injury. Communicate with adjusters for approval before submitting out the orders. Send STAT patients out immediately upon order from the treating doctors. Inbound and outbound calls.
Referred patients out in a timely manner. Maintained a high volume of patients and calls.
MMP/MedicalManagement Professionals, Houston, Texas, June 2011 through April 2013
ACCOUNTS RECEIVABLE SPECIALIST
Notified patients of delinquent accounts by telephone and form letters to secure payments. Researched errors and resolved problems with accounts records and claims. Corrected claims through Zirmed and resubmitted corrected claims to Payors. Updated and provided reports on account status and collections efforts. Identified delinquent accounts, aging periods and payment origins. Carefully maintain sensitive information with HIPAA compliant standards with regards to patient information. Reliable and dedicated to company objectives. Researched, evaluated and submitted appeals to Payors for denied claims. Scanned Explanations of Benefit and Explanations of Payment documents to proper departments for workup and finalization.
Maintained a proven track record of high volume claims research meeting collections goals.
Southwest Radiology Association, Houston, Texas, February 1999 to October 2009
ACCOUNTS/COLLECTIONS SPECIALIST(February/1999 October/2009)
Resolved problems by telephone with Insurance Payors and Patients. Made collections calls on outstanding accounts. Investigated and corrected discrepancies. Resubmission of corrected claims manually and electronically to Payors in accordance with policies. Researched, evaluated and submitted appeals to Payors for denied claims. Documented trends for management. Ensured payments through proper use of codes. Identified delinquent accounts, aging periods and payment origins. Carefully maintain sensitive information with HIPAA compliant standards with regards to patient information. Reliable and dedicated to company objectives. Generated weekly follow-up report. Assisted supervisor for various tasks involving organization and distribution of workload. Performed all other duties as required.
Achieved top volume of production and continually met daily, weekly and monthly deadlines in a high volume environment. Reported trending patterns with certain large Payors and assisted with resolve through communication and establishing effective relationships with administrative contacts.
8300 Canyon St. Apt.324 Houston Tx 77051
South Houston High School 1994 – Diploma