Medical Billing Insurance

Tina C. Scrivner Crump

***** ********* *****

Woodbridge, VA 22193

Cellphone Phone 571-***-****)

Home; 703-***-****

E-Mail: ********.****@*******.***

Objective: To obtain a challenging position that offers opportunities for professional growth.

Experience

2010-Present Prince Georges Hospital Center, Insurance Specialist

My occupational duties may include: Obtaining referrals and pre-authorizations as required for procedures.

Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.

Reviewing patient bills for accuracy and completeness, and obtaining any missing information.

Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.

Following up on unpaid claims within standard billing cycle timeframe.

Checking each insurance payment for accuracy and compliance with contract discount.

Calling insurance companies regarding any discrepancy in payments if necessary

Identifying and billing secondary or tertiary insurances.

Reviewing accounts for insurance of patient follow-up.

Researching and appealing denied claims.

Answering all patient or insurance telephone inquiries pertaining to assigned accounts.

Performs insurance and patient refunds on both account receivable and bad debt accounts

Treat all patrons in a caring and professional manner to foster a positive image of PGHC and instill confidence in the care received

Demonstrates a commitment to professional, departmental, and organizational core values by incorporation into daily work

Prepares and issues all refunds for accounting office

2008-2010 K-Force/Planned Parenthood, Medical Billing Specialist

Submitted electronic billing

Account receivable/ posting payments

Work Denial claims

Corrected all allocation payments for refund purpose

Call insurance company/mail bills to patients Submits insurance claims to first, second, and third party payers

Applies payments to accounts/correct fund or revenue source

Process, Review and analyze Blue Cross, Commercial, HMO, PPO, Medicare (Parts A and B), Medicaid, Secondary, and Third party claims Discuses

Billing and accounting operations with other financial service colleagues

Identifies, research, analyze, and correct problems with overdue and unpaid patient accounts

Epermis Track (Stock Camp)

Microsoft Office XP (Word/Excel)

Provides guidance and training to lesser-skilled Account Representatives in all aspects of Patient Accounting

Answers questions concerning patient accounts and/or division/unit operations record data for patient billing purposes

Compiles data for reports, cost estimates, etc. and produces audit reports for electronic filing

Corresponds with insurance companies, hospitals, city/state agencies, and clinical physician offices

Drafts routine correspondence, memos, etc.

Skilled in Medical terminology, ICD and CPT-4 coding

Possess superior Customer Service skills

Serves as lead on special projects

2002-2004 Billing Specialist, Virginia Hospital Center-Arlington

Sort and organize work load on a daily basis

Adjust accounts for Commercial Blue Cross Blue Shield (Care First), some Medicare and Medicaid.

Electronically input data on patient’s accounts as needed

Perform various duties as assigned Anthem and CareFirst Point of Care and Epermis

Education:

2010- Present Strayer University College

2004- Certification Revenue Management of Patient Account

Contact this candidate