Bersetta Maria Kirby

Cell. 720-***-****

Professional Summary

● Medical field for over 20 years.

● Experience in billing Medicaid, Medicare, Commercial Insurance, Customer Service and Medical Collections.

● Strong attention to detail, excellent multi-tasking and team player with a positive attitude.

● Efficient courteous service, answering inbound/outbound calls, answering general correspondence about patients billing and E.O.B's.

● Provide account research for patients, setting up a payment plans, discussing patient balance on their account and doing follow-up with them and the insurance company.

● Updating patients accounts with insurance information/addresses and all vital information, while following HIPAA laws and guidelines.

● Reconciliation of account analysis, credit balances while explaining to patients about their insurance deductibles and co-insurance.

● Maintains strict confidentiality.

● Knowledge of HMOs, Medicare Medicaid.

● Electronic Medical Record (EMR) software.

● Medical billing software.

● Patient-focused care.

● Team player with positive attitude.

● Deadline-driven.

● Good written communication.

Education

● High School Diploma Richwood High School - Peoria, ILL, U.S.A Kaiser Permanente

8/2019 - 2/22

Call Center Rep

● Customer Service

● Handled approximately 60 - 70 inbound calls a day.

● Schedule pt appointments and answer their questions.

● Setting up appointments for the Covid testing and for the Covid Vaccine.

● Taking verbal orders from the provider line for the Dr.s

● Scheduling for other departments.

● Taking patients request to change to a different Dr. or Clinics

● Answering questions about the Covid Vaccine.

Experience

10/2018 - 06/2019

US Oncology

Medical Records/Insurance Specialist

● Customer Service.

● HIPPA laws.

● Handled approximately 50 – 60 inbound and outbound calls per day.

● A/R Report.

● Pulling Medical Records.

● Sending thru web portal or certified mail.

● Appeals and reconsideration.

● Follow up with Insurance on claims.

● Electronic Billing.

Eating Recovery Center

4/2016 - 8/2018

Claims Specialist

● Made approximately 50 - 60 outbound calls to payers to follow up on submitted claims.

● Prepares claims for re-bill by pulling up accounts from the system.

● Calling insurance company about claims and taking payments from patients.

● Follows up claims through resolution /collection.

● Post EOB’s, payments, A/R follow-up, patient eligibility, authorizations, and resubmitted appealed/denied claims.

● Pulls up EOBs /ERAs to research reasons for denials.

● Verifies eligibilities through web portals or through phone calls to insurance companies.

● Appeals and researches denied claims.

● Used Microsoft Excel daily for reports.

● Adjustments on patients’ accounts.

● Explaining to patient their out of pocket network their deductible and co-insurance. 06/2011 - 11/2015

Revenue Enterprises

Customer Service / Collections

● Handled approximately 50 – 60 inbound/outbound calls daily, arranging payment plans on accounts into centricity the software system used.

● Analyze and research patient accounts, problem solve discrepancies within patients’ accounts, detail oriented and meet deadlines.

● Confidentiality regarding patient information, release of information followed by federal/state regulations and guidelines.

● Resolving billing and reimbursement issues while enter up-date changes into billing software. 02/2009 - 05/2011

Favorite Staffing Services – University Hospital

Medical Billing / Customer Service

● Handled between 40 and 50 calls per day.

● Doctors office meeting and greeting patients.

● Carefully reviewed medical record for accuracy and completion as required by insurance companies.

● Recorded and filed patient data and medical records.

● Wrote clear and detailed clinical phone messages for physicians.

● Acquired insurance authorizations for procedures and tests ordered by the attending physician.

● Scheduled patient appointments.

● Completed registration quickly and cordially for all new patients.

● Confirm patient information collected co-pays and verified insurance billing claims. 08/2003 - 11/2008

Senior Care of Colorado

Medical Billing

● Medical billing, 50 – 60 inbound/outbound calls per day, carefully reviewed medical records accuracy and

● completion as required by insurance companies.

● Coded outpatient encounters, accurately entered procedure codes, diagnosis codes and patient information into billing software.

● Appropriately and correctly identified error and re-filed denials /rejected claim as they were received from the patient account representative.

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