Reimbursement Specialist Billing

Diana Broxton

Cell#267-***-****

Philadelphia, PA 19142

**************@*****.***

Training and Experience:

·Excellent Customer Service experience and support

·Enrollment insurance verification experience

·Knowledge of Medical Terminology

·Computers skills, Medic systems, SMS, Citrix, Nextgen, Centricity, Emdeon, Epic, Medent

·Experience in medical claims procedures and terminology, specialities, hospitals, skilled nursing facility claims, BH claims, Worker Compensation/MVA knowledge, A/R hospital billing, physician billing, ICD-10 CM, CPT knowledge,abilty to meet productivity goals,strong problem solving, and research skills. Excellent interpersonal skills both written and verbal.

·Experience with Manage Care, Commerical, Medicare and MA Billing/medical claims and Self pay

Work Experience:

Aerotek Inc,/PATHS LLC, CherryHill, NJ(Temp)

Accounts Respresentative-08/2021-present

·Contact insurance companies to resolve unpaid balances on accounts

·Review assigned accounts for missing insurance payments

·Assist with the resolution of credit balances in a timely manner

·Obtain information from insurance companies to foster claim adjudication

·Inform management of issues with accounts that require client intervention

Constellis Inc, Doylestown PA, Pittsburg PA, Bensalem PA,(Temp)

COVID-19 Patient Administrator -03/2021- 07/2021

·The Patient Administrator interacts with individuals interested in registering to receive a COVID

·ensures all of the relevant paperwork is completed in full.

·enter patient data into the provided vaccination information system in an accurate and expeditious manner.

·responsible for maintaining and tracking electronic records and logs.

Crozer Health Systems, Chester, PA

Reimbursement Specialist- 03/2020-08/2020

·Researched worker's comp/MVA claims for non payment or unprocessed claims

·Verified eligiblity for compensation of work injuries and MVA accidents

·Contacted Auto claims departments spoke with claim adjustors for verification of injuries

·Sent necessary documentation for clams processing.

Drexel University-Phila, PA (Contract Assigment)

Accounts Receivables Specialist- 04/2019- 01/2020

·Provided Accounts reveivables servies fo physician billing practice

·Worked with Family Medicine providers claims

·Identified the root cause of issues with claims denied

·Ensure accurate payments of claims are received

·Made claim adjustments and write-off

·Batched all services according to billing area

Cooper Health, Camden NJ

Collections Specialist II- 01/2018- 7/2018

·Edits claims for registration errors

·Producing accurate first steps to clean a claim

·Verifying eligibility capturing as much patient information to ensure claim is sent to correct insurance carrier

·Ensuring valid CPT and DX codes are being billed for each claim and group

·Validating physician information is correct using EPIC system

·Send Appeals for denied claims

SIRRUS Group

Accounts Receivable Specialist 11/2016 -03/30/2017-(Temp) Oreland, PA

·Specialized in Worker’s Comp and Motor Vehicle claims

·Investigate worker’s compensation incidents, validate insurance, collected pertinent information pertaining to processing a claim

·Cash posting

·Claims verificaton

Jefferson Hospital- Phila, PA

Accounts Receivables Specialist- 10/2015- 6/2016

·Responsible for collections,analysis, and overall management of Accounts Receivables as well as assisting with account payable process to ensure healthy cash flow of the company

·Answer A/R inquires from staff and clients

·Facilitate issue resolution with A/P invoices

·Third party verification

·Worked outpatient, inpatient and self-pay claims

·Updated patient demographics

Fresenius Medical Care, Malvern, PA

Billing Specialist- 6/2013- 10/2015

·Researched and resolved claim issues by contacting the pertinent parties by telephone or insurance website

·Met productivity goals by working 95% of accounts within 45 days from bill date

·Managed over 200-1500 accounts monthly

·Sent patient invoices for self payments

ARC Group- Hatboro, PA

Accounts Receivables Representative-01/2009- 6/2013

·Reviewed claim edited lists for missing or incorrect registration date and post patient third party payment to accounts in IDX Flow cast system

·Reviewed EOB received to ensure proper payment from the third party payors. Interact with clinical departments (internal) insurance carriers (external)

·Followed up on rejected or under paid outpatient facility claims. Re-submitted claims to third party carriers as necessar, ensuring all necessary paperwork was attached to claims

·Handled billing inquires from patients and insurance companies as well as from physicians concerning patient accounts.

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