Medical Billing
Resume:
SUZANNE CUEN
Tolleson, AZ ***53
OBJECTIVE
To obtain a position in a medical environment that offers challenging responsibilities, will effectively utilize my healthcare related experiences, creative abilities and provide continued professional growth within any organization.
EXPERIENCE
10/2008–7/2009
A/R Account Representative AHCCCS, Paloverde Hematology & Oncology
Glendale, AZ
Responsible for analyzing and collecting outstanding account balances for all AHCCCS Plans, assessing aged accounts cash flow potential and ensure the timely collection for accounts receivable.
Ensured accounts over 30, 60, 90 & 120 (aging) were reviewed for end of the month reports and were handled professionally as well as accurately.
Perform claim status and follow up activity for outstanding balances. Document all information in memo notes of the A/R system.
Reviewed explanation of benefits (EOB) and remittance advises within the corporate time requirements and take action as required for full payment.
Send secondary claims with required supporting documentation in a timely manner.
Called all necessary plans for denials on claims for AHCCCS Plans. Documented all information required when speaking to other insurance plans for future documentation in A/R system.
Performed necessary steps to clear denials and/or rebill within timely requirements.
Payment posting to accounts in the billing system ensuring contractual adjustments and write offs are accurately inputted into system.
Maintained and met productivity log standards required by A/R business office.
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3/2008 - 10/2008
Patient Relations/Business Office, Integrated Medical Services
Goodyear, AZ
Responsible for analyzing and collecting outstanding account balances for all insurance types/patient accounts assessing aged accounts cash flow potential and ensure the timely collection for accounts receivable.
Responsible for A/R follow-up on patients with outstanding balances, sending 1st, 2nd, 3rd and final request prior to sending to collections.
Worked with Emerald Collection Agency to solve any discrepancies on patient’s accounts.
Responsible for audits of accounts that have incorrectly had money posted to and/or adjustment incorrectly applied, reviewing Explanation of Benefits (EOB) and remittance advises to validate any errors and took action as required.
Reviewed all correspondence/return mail on a daily basis, utilized WHIN-OneSource to verify correct address for patients and resent patient mail.
9/2006–3/2008
Self-Pay Patient Relations, Paloverde Hematology & Oncology
Glendale, AZ
Responsible for analyzing and collecting outstanding account balances for all insurance types/patient accounts, assessing aged accounts cash flow potential and ensure the timely collection for accounts receivable.
Responsible for A/R follow-up on patients with outstanding balances, sending 1st, 2nd, 3rd and final request prior to sending to collections.
Coordinated meetings with patients that have questions on statements and/or make payment arrangements based on company policy Responsible for audits of accounts that have incorrectly had money posted to and/or adjustment incorrectly applied, reviewing Explanation of Benefits (EOB) and remittance advises to validate any errors and took action as required.
Reviewed all correspondence/return mail on a daily basis, utilized WHIN OneSource to verify correct address for patients and resend patient mail.
Reviewed accounts in which patients have expired and have a balance, utilized resources, rootsweb, Maricopa.gov, WHIN, and verified if patients had estates.
Responsible for End of Month reports on patient balances and collection status.
Processed Statements on a weekly basis uploading on Express Bill via electronic processing. Sent monthly statements in a timely manner.
Trained all new hires on self-pay procedures as needed and provided training manuals.
Maintained productivity standards and cash goals as established.
Assist in troubleshooting A/R Patient Accounts problems with appropriate internal employees to improve quality of information on accounts to decrease turnaround time for full payments. Follow HIPPA regulations and meet every effort to exceed the A/R indices.
2/2005 - 12/2005
A/R Supervisor, NO APPT MD Glendale, AZ
Responsible for overseeing the Billing Department.
Perform billing and collection functions as assigned.
Assured all claims for services rendered are processed according to the billing guidelines and timeframes established by contract and corporate procedures.
Responsible for maintaining Fee Schedules for all Health Insurances utilized by No APPT MD.
Scheduled hours of time off for employees, assured full staff for department.
Responsible for coding all charge tickets on a daily basis & up-coding as necessary.
Implemented training courses for new recruits — speeding profitability.
Maintained the flow of department, making sure all demographics and Insurance information was added to the system so that charges could be entered appropriately.
Ensured that charges were entered accurately at the end of each day, maintaining the Electronic reports generated.
Responsible for Reports (Billing Summary Report) distributed on a daily basis to keep track of average per patient a day that is seen.
Responsible for maintaining the Application (Medisoft) and its functions.
Received incoming calls on a daily basis and multitasked between patient account balances and Insurance balances.
Maintained a working knowledge of Insurance rules and regulations as it relates to Federal, State and managed care payers.
2003–2005
A/R Billing/Collections/Cash Poster, Los Nino’s Hospital Phoenix, AZ
Maintain a data collection system that assures claims for all services rendered are prepared correctly and timely to avoid delays in payments.
Perform claim status and follow up activity for outstanding balances, document memo notes of the A/R system for supporting documentation.
Payment posting to the correct accounts in the billing system ensuring contractual adjustments and write offs are accurately inputted into system. Call on a daily basis to Insurance plans for follow up on member accounts.
Perform necessary steps to clear denials and rebill within timely requirements.
Assist with trouble shooting on system issues on a daily basis as needed.
Responsible for DDD billing for Home Health, Early Intervention and Therapies.
Responsible for filing, mailing claims, problem solving all billing/collection issues to support the A/R department as needed.
Attend any training provided by the company to be compliant with billing/collection updates.
Responsible for all month end reports in a timely manner, maintenance of billing software annually or when needed for updated programming and/or electronic billing.
11/2001–9/2002
Quality Trainer Prior Authorization, Schaller Anderson of Arizona Tempe, AZ
7/1998 – 11/2001
Prior Authorization, Nurse line, Information Tech & Credentialing, Phoenix Health Plan Phoenix, AZ
10/1994 -7/1998
Medical Records Tech & Center Cashier, Cigna Health Plan Phoenix, AZ
EDUCATION
AT-Home Professionals
Medical Billing and Claims Specialist – Complete
Medical Coding Specialist- Current
ADP Payroll Systems 2002
CPR-Certified 2002
Hirsch Electronics System 2002
Phoenix Health Plan
Microsoft Applications 1999
Crystal Reports 1999
Computer Classes/Frame Reader 1999
Information Systems Class 1999
Cigna Health Care
Computer Class-Windows-95-1997
Franklin Planner 1997
Safety Class 1997
Arizona Institute of Business and Technology, Phoenix, AZ.
Medical Records Specialist- May 1994-Diploma
GED-1994
References: Provided upon request
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