Medical Billing Collection Representative
Resume:
Marjorie Belizaire
**** ****** *** ******* *****, FL 33426 * 954-***-**** * **************@*****.***
Objective
A highly organized and hard-working individual looking for a responsible position to gain practical experience.
Key Skills
●Advanced knowledge of using Microsoft Word, Outlook, Excel, and PowerPoint
●Ability to exercise discretion and showcase professional judgment
●Excellent interpersonal
●Excellent phone edict
●Great at writing
●Leadership
●Time management
●Adaptability
●Self- motivation
●Speaks Creole fluently
●ICD-9/10, HCPC /CPT codes, & Medical terminology
●Management of Epic
●Claim entry
●Online claim submission
●Management of Brightree software
●Usage claim editor
●Usage of ACE program
●Usage of DDE
●Analyzing and reviewing Government and non- government remits
Professional Experience
Team Lead Payments & Credits Representative NYU Langone Health Boynton Beach, FL 11/2020- present
Responsibilities and Results:
●Prints ERAs daily for any funds received via EFT, from either clearinghouse or carrier sites
●Logs EFT payments on daily batch sheet
●Receives incoming mail, separates and distributes to appropriate personnel
●Totals payments received and balances
●Logs mail payments received daily
●Allocate payments, rejections and adjustments from complex payer sources subject to individual carrier guidelines, fee schedules, contracts and government regulations.
●Research and determine cause(s) for electronic files to be out of balance.
●Reconcile posted payments to batch control totals.
●Reviewed and revised payment pathways to be uploaded into Panviva
●Prepared some Payment Pathways such as; Morning Dashboard Report, Clarification Logs, Chargebacks and Returned Check NSF
●Ran WQ 158 meetings with Omega and discussed outstanding items from the clearing.
AR Management Representative Rehab Medical Billing Service, Inc., Fort Lauderdale, 6/2020 to 10/2020 Responsibilities and Results:
Handle billing (electronic and paper) for physical therapy clinics.
Collections and Appeals with various accounts.
Submitting monthly patient statements.
Posting insurance payments.
Posting adjustments.
Reviewing accounts with overpayments.
Point of contact for client.
Managed Care Account Collection Representative Broward Health, Fort Lauderdale, 7/19 to April 2020 Responsibilities and Results:
Followed up on Insurance and patient aging. Re-submitted insurance claims as necessary.
Knowledgeable in timely filing restrictions.
Creating credit and debit adjustments
Analyzing and reviewing credit balances
● Disputed denials with insurance companies.
● Analyze multiple sources of remittance to determine proper allocation of payments, rejections and adjustments subject to individual carrier(s) guidelines and government payers.
Government Credit Resolution Rep Conifer Health Solutions, Boca Raton, 11/2015 to 07/2019
Responsibilities and Results:
Analyzing and reviewing credit balances.
Processing insurance and patient refunds.
Analyzing and reviewing Government/ Non-Government EOBs.
Importing and scanning EOBs and patient checks.
Creating credit and debit adjustments.
Verifying patient eligibility through the CWF (DDE).
Working reports such as: Adjustments greater than total charges, N status, COB, patient payment, month- end Medicare/ Medicaid.
Working month end and identifying adjustments that needs to be reported to Medicare/Medicaid monthly.
Reporting Medicare/Medicaid refunds during the quarterly process.
Creating and submitting reports to the facility’s Director Revenue Analysis.
● Preparing and creating Medicare/Medicaid hardcopy refund packets.
NIC hospital billing Specialist Conifer Health Solutions, Boca Raton, 2/2012 to 11/2015
Responsibilities and Results:
Experienced in billing hospital claims.
Ensured claims are entered and submitted correctly in claim editor (Epremis).
Handled of some hardcopy billing.
Experienced in working control ID.
Reviewed and responded to email requests dealing with billing issues.
Resolved NDC rejections.
Processed implant cost claims.
Created and billed patient type change claims.
Submitted implant claims to the insurance companies
Created and submitted split claims to the payers.
Created and submitted reports to the facility’s Director Revenue Analysis
Medical billing/ Collections and Appeals Specialist Medical Billing Solutions, Coral Springs, 2/2009 to 1/2012
Responsibilities and Results:
●Experienced in billing in DME to Medicare, Medicaid and other private insurances
● Ensured claims are entered and submitted.
●Ensured accuracy of insurance claims.
●Set up new patient accounts.
●Worked with clearinghouse to resolve file compatibility issues.
●Sent secondary claims upon processing of primary insurance.
●Monthly processed of patient statements. Answered and resolved patient billing inquires
● Followed up on Insurance and patient aging and resubmitted insurance claims as necessary.
●Knowledgeable in timely filing restrictions.
●Ensured office practices are in compliance with HIPAA regulations
●Managed Brightree based client accounts
●Reviewed/submitted appeals and audit to Medicare and other private insurances.
●Wrote appeals, redeterminations and reconsiderations.
●Disputed denials with insurance companies.
Technology Summary
MS Office (Word, Excel, Outlook), Webscan, Brightree, ACE, Epremis, On Demand, VI Web, Medassets, Passport,
Medicare CWF program, Epic, Availity and selected states DRG calculator, WebPT and RevFlow
Education
Associates Degree in the Arts, Broward College Pompano, FL, G.P.A 3.2, Dean’s List 2008
Bachelor’s Degree in Health Administration with a minor in Health Information Systems, FAU Boca Raton, FL 33431 June 2018- December 2020
Marjorie Belizaire
1090 Audace Ave Boynton Beach, FL 33426 * 954-***-**** * **************@*****.***
References
Professional:
Isdianel Diaz Haldane
Director of Operations
Rehab Medical Billing Services
Pompano Beach, FL 33309
Katianna Mazard
Staff Attorney
Coast to Coast Legal Aid
Plantation, FL 33317
Tavares Deon Parker
Distribution Supervisor
Owens & Minor Inc.
Sunrise, FL 33325
Contact this candidate