Office Assistant Medical Manager
Resume:
Nicole DeBoard
Clarksville Tn. 37043
*************@*****.***
North Clarksville Medical Center Feb 2017 – Current Clarksville, TN 2nd Time
Administrative Assistant / Billing / Front Office / Prior Authorizations /
* Trained new office staff their positions, front office, billing, referrals, prior auths
* Handle all complaints from patients to make sure there is a positive outcome
* Very compassionate patient advocator. Meaning I will not stop until I can get what that patient needs outside of our office as far as getting medical supplies DME approved, home health set up and approved, or any RX they may need approved
* Contacted payers regarding payment of outstanding claims
* Corrected and resubmitted denied claims
* Verified that payments/adjustments were posted correctly per the EOB's
* Contacted patients to relay information regarding insurance denials
* Followed up with various payers: Commercial, HMO, PPO, BCBS, Government, Workers
Comp, Tricare, Auto and some Medicaid
* Handled claims rejected electronically due to registration errors
* Contacted patients to relay insurance denials and to obtain correct insurance information and
demographics
* Scheduled and obtained authorizations for patients to go to specialist visits
* Entered patient demographics when they arrived for their appointments.
* Verified insurance benefits, copay and deductible amounts
Nashville General Hospital May. 2008 – Feb 2016 Nashville, TN
Patient Accounts Representative / Financial Counselor / Collector
* Receives cash posting sheets from the Admitting and Outpatient departments, and ensures posting and reconciliation is complete
* Prepare daily deposits for accounting department
* Open and close batches daily
* Correct room and board charges on patient accounts
* Collector for prisoner accounts to various payers to obtain payment
* Educate patient’s inpatient and outpatient with our financial counseling program and help get
them certified for charity program
* Data entry of patient demographics for financial counseling data base and calculate income to
see what they qualify for
* Submit billing for SAFE accounts to the State of Tennessee
* Work VA accounts that we haven’t received payment on in a timely manner
* Take payments from patients
* Set up patient payment plans
* Give estimates to patients for outpatient and inpatient facility services
* Run all credit card transactions for patient accounting
Clarksville Gastroenterologist and Endoscopy Center Jan. 2008 -March
2008 Clarksville, TN
Front Office Assistant / Patient Account Representative / Billing Specialist
* Checked patients into our facility for office visits and procedures
* Checked patients out and rescheduled them for their next appointment or procedure
* Collected all copays and deductibles from patients for office visits and procedures
* Explained colonoscopy and endoscopy preps to patients for procedures
* Verified all insurance benefits for office visits and outpatient facility procedures
* Contacted patients before their procedures to let them know what their patient responsibility is
* Verified that payments/adjustments were posted correctly per the EOB's
* Contacted payers regarding payment of outstanding claims
* Handled denials for facility and professional claims
* Corrected and resubmitted denied claims
* Contacted patients to relay information regarding insurance denials
* Followed up with various payers: Commercial, HMO, PPO, BCBS of all states, TennCare,
Amerigroup, AmeriChoice, Government, Workers Comp and Tricare
North Clarksville Medical Center Jan. 2006 -Oct. 2007 Clarksville, TN
Billing Specialist / Front Office Assistant
* Contacted payers regarding payment of outstanding claims
* Corrected and resubmitted denied claims
* Verified that payments/adjustments were posted correctly per the EOB's
* Contacted patients to relay information regarding insurance denials
* Followed up with various payers: Commercial, HMO, PPO, BCBS, Government, Workers
Comp, Tricare, Auto and some Medicaid
* Handled claims rejected electronically due to registration errors
* Contacted patients to relay insurance denials and to obtain correct insurance information and
demographics
* Scheduled and obtained authorizations for patients to go to specialist visits
* Entered patient demographics when they arrived for their appointments.
* Verified insurance benefits, copay and deductible amounts
Dameron Hospital Aug. 2004 -Sept. 2005 Stockton, CA
Account Clerk/ Admitting
* Data entry of patient demographics, insurance information for pre-operative department, regular
admitting and emergency room
* Interpreted legal papers to patients such as HIPPA, patient financial responsibilities and made sure
their surgery packets were correct and ready to go
* Answered phones at the multiline
switchboard and directed incoming and outgoing calls to
where they needed
* Verified insurances for inpatient and outpatient procedures
Blue Shield of California Aug. 2002 -Aug. 2004 Lodi, Ca
Customer Service Representative
* Answered incoming calls to assist subscribers and providers with claims and benefits questions
* Processed professional and facility claims for denial or payment
* Worked on appeals from subscribers and providers checking to see if they denied correctly
* Reprocessed claims that denied incorrectly for payment
Dr. Weldon D. Schumacher, M.D. Sept. 2000 - Aug. 2002 Lodi, CA
Billing/ Office Manager
* Entered all patient demographics and charges from super bills into our system
* Billed various insurance companies primary and secondary: Commercial, HMO, PPO, BCBS,
Government and Medi Cal
* Verified that payments/adjustments were posted correctly per the EOB's
* Corrected and resubmitted denied claims
* Contacted patients to relay information regarding insurance denials
* Followed up with various payers regarding payment of outstanding claims
* Verified all insurances for eligibility and primary care physician information
EDUCATION
Andon College Medical Office Specialist Aug. 2000 Diploma Stockton, CA
COMPUTER SKILLS / OPERATING SYSTEMS USED
Medisoft, Medical Manager, DOS AS400, Medisoft, Cyramed, STARR, McKesson
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