Amber M. Thomas

E: adntcz@r.postjobfree.com ● M: 281-***-**** ●Houston, Tx 77573

Linkedin.com/in/amber-thomas-62813260

Healthcare Billing & Collections

Meticulous Medical Biller who undertakes complex assignments, meets tight deadlines, and delivers superior performance. Posses practical knowledge within the Revenue cycle. Applies strong planning and analytical skills to establish and maintain proper billing and collections procedures. Assigning accountability to key staff to help meet critical functions. Meeting and exceeding assigned collections efforts helping to reduce company collections through multiple facilities by meeting monthly collections efforts. Operates with a strong sense of urgency and thrives in a fast past setting. Very knowledgeable in Out of Network/In Network billing and collections process. Core competencies include:

●Customer Service● Financial Reporting ● Financial Analysis ● Analytical & Reasoning Skills ●Medical Terminology ●ICD 9/10 ● HCPCS ●CPT ● UB-4/CMS Billing ● Insurance Verification ●Insurance Carriers for both IN/Out of Network Plans ●Texas Department of Insurance ●Affordable Healthcare Act ●Emergency/Facility Billing

Professional Experience

05/2017-01/2018 Texas Children’s Hospital

Ranked #4 Best Children’s Hospital Nationally out of nearly 200 pediatric institutions. The leader in cutting edge use of technology for critical care procedures for children across the world.

Payment Operations Representative Team Lead

Team lead of financial services within payment posting dept. Secured position by exceeding dept goals in posting accuracy, meeting deadlines and collections follow up with insurance carriers for IN/Out of network claims helped to decrease company deficits.

Heavy data entry into Epic billing system

Responsible for pulling EOB’s and entering billing Claims paid for Physician/ Hospital

Responsible for posting $0 EOB for collection follow up

Responsible for researching and resolving overpayments

Responsible for pulling and reviewing EOB’s thru Navinet, Optum, Availity ect.

Daily contact with Aetna, BCBS, Cigna, MCR/MCD plans (various others)

Negotiate Contracts for reimbursement

Research and resolved over/under payments

Responsible for reconciling daily spreadsheets on all money received daily thru mail and wire.

Responsible for preparing checks for daily bank deposits

Collections follow up on unpaid accounts for patient payment

Responsible for follow up on Unidentified accounts in a timely manner.

Mail Opening/Sorting for both Hospital and Physician

Contacting insurance carriers to reconcile billing issues

Responsible for initiation of patient/insurance refunds

Extensive knowledge of reading and understanding EOB’s

Other duties as assigned

01/2013 – 05/2017 Bay Area Houston Endoscopy

As a subsidiary of HCA system’s, this facility was one of the largest in the area that implemented extensive care for patients needing Colonoscopy and EGD procedures.

Billing Supervisor

As a billing supervisor lead a team of employees overseeing the day to day efforts of collections, verification of insurance, coding and tending to month in closing and insuring all goals for collections efforts are made for the month and which monthly goals were met or exceeded under my direction.

Verification of insurances

Responsible for initiation of insurance authorizations/referrals

Heavy data entry into Advantax

Responsible for pulling and reviewing EOB’s thru Navinet, Optum, Availity ect.

Calling patients to go over benefits/financial responsibility

Answering phones

Checking ICD 10 codes for payable MCR services

Responsible for researching and resolving overpayments

Daily contact with Aetna, BCBS, Cigna, MCR/MCD plans (various others)

Assessed Contracts for reimbursement

Research and resolved over/under payments

Charge Entry

Payment Posting

Collections

Oversee day to day team operations

Assisted in interviewing perspective employees

Trained new hires

Assisted in month end closings

Conducted employee yearly reviews

Processing patient and insurance refunds

Contacting insurance carriers to reconcile billing issue

05/2011 - 01/2013 Thera Care Home Health

Providing exceptional Home Care in the Houston Metro Area for patients needing skilled nursing, and home care after being released form hospitals and facilities.

Intake Coordinator

Ensured accurate and timely process off patient referrals with regards to contacting case managers, scheduling and contacting patients regarding services.

Responsible for the intake of new referrals

Insurance verifications

Contact with case managers, and medical offices to confirm services being rendered

Verification of patient demographics.

Responsible for initiation of insurance authorizations

Responsible for ordering DME

Responsible for scheduling Nursing Visits for patients

Heavy Data entry, Scanning, and Faxing

Answering phones and problem solving of patient issues.

Other duties as assigned

12/2009 - 05/2011 Associated Credit Union of Texas

Community Credit Union highly noted for exceptional Customer Care in personal/business accounts, Mortgage lending, and Loans for various services.

Senior Member Services Representative

Provided exceptional customer service, exceeding company goals with opening accounts and offering company products such as credit cards with as many as 10 a day.

Providing member with fast and accurate transactions.

Cash Handling high delivery of money transported by Brinks.

Opening, and closing checking, savings, and CD accounts.

Responsible for counting money stored in the vault.

Data entry for credit card and loan applications.

Meeting goals and exceeding member’s expectations.

08/2006 - 08/2009 Beloved Home Health Services

Home Care business highly noted for exceptional patient care in the Houston Metro area. This company provides services to patients needing skilled nursing, and home care treatment following discharge from a hospital or facility.

Payroll and Billing Assistant

Under direction of supervisor conducted superior service exceeding company expectations in the handling timekeeping and payroll. Billing accuracy at 95% percent, and insurance collections that helped company regain over $50,000 due to prior billing and posting errors from past employees.

Responsible for entering employee’s hours and issuing checks using Intuit

Making sure checks were created and issued properly

Billing insurance companies for Medicare/Medicaid using Medisoft

Follow up on Collections for IN/Out of network accounts

Rebilling unpaid claims in timely manner to recoup payments

ICD 9 Coding for services rendered

Responsible for calling and reconciling payments from insurance companies.

Calling insurance companies daily to verify payments and amounts

Other duties include filing and answering phones.

08/2003 - 06/2006 Bank of America

One of the Nations most recognized financial institution’s providing personal/business accounts, Mortgage lending, Loans for various services.

Senior Teller

Provided Superior customer service and lead a team of tellers for both Lobby and drive thru duties. Under my supervision I helped to maintain accurate daily balancing of drawers and decision making regarding override of checks that may have cost the company thousands in kickbacks and charges if not help according to company and government guidelines.

Team Lead over Teller duties

Providing customers with fast and accurate transactions.

Heavy Cash handling

Opening/ Closing of accounts

Data entry

Customer Service

Education

Diploma

Clear Creek High School 2002

Bachelor of Science in HealthCare Administration w/ Concentration in Long-Term Care

University of Phoenix 2013

Technical Skills

Microsoft Word ●Excel ●Outlook ●PowerPoint ●Epic ●Vesta ●Medisoft● ADP● Intuit ●Kinsser ●Advantex.

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