Medical Collector Billing
Resume:
Talaya V. Harris
********@*****.***
PROFESSIONAL SUMMARY
Medical Office Professional that is self-motivated, learns quickly, works well without supervision, detail-oriented, deadline driven with ability to prioritize work to meet goals and objectives within acceptable time frames. Excellent customer service skills as well as strong records maintenance skills.
COMPUTER SKILLS
●Created, edited, and formatted business with Microsoft Office Suite of programs-Word, Access, Excel, and PowerPoint
●Medical Terminology,Anatomy and Physiology
●Properly use and apply CPT-4, ICD-9, ICD-10, HCPCS and Medisoft
●Misys, Misys Tiger,NextGen, Navicure, Instamed, EclinicalWorks, Availity 10-key, Typing 40 WPM
●Properly processing electronic Medical Records
PROFESSIONAL EXPERIENCE
Stericycle, Garland, TX 11/2020-12/2021
Plant Associate
● Responsible for unloading all waste from vehicles the vehicles are decontaminated and waste is properly
staged for scanning and processing
● Stage waste on conveyor system or properly stack waste for scanning in the Biotrack system
● Responsible for sterilizing containers for needles placing reusable containers on tub wash for decontamination
● Supplying orders for hospitals and doctors’ offices scanning and processing items for correct shipping
Stewart Healthcare, Richardson, TX 3/2019-9/2019
Hospital Medical Collector
●Responsible for the timely submission of institutional or professional medical claims to insurance companies including physician offices, hospitals, nursing homes, or other health care facilities.
●Follow up on unpaid claims within the standard billing cycle timeframe of days via phone or online.
●Check each insurance payment for accuracy and compliance with contractual discounts.
●Call insurance companies regarding any discrepancy in payments if necessary.
●Identify and bill secondary or tertiary insurances for each claim where required.
●All accounts are to be followed up on at least once every 30-day period until paid in full.
●Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
Urology Clinics of North Texas, Dallas, TX 05/2016-01/2019
Medical Collector/Billing Specialist
●Responsible for accurate and timely submissions of insurance claims to Medicaid, Medicare,
●Managed Care, and patients
●Made outbound collection calls to patients and insurance companies to obtain claim and payment status
●Relentlessly submitted written appeals to payers, on denied claims for adjudication and resolution
●Successfully overturning numerous insurance decisions
●Reduced aged account receivable by 75 percent
●Completed a total of 100 calls/contacts or more per day to successfully meet and/or exceed established quotas
●Answered patients questions regarding problems with their accounts
●Negotiated payments plans and made inquiries to insurance companies
●Applied provider payments on accounts applying contractual managed care reimbursement rates
●Provided excellent customer service to patients an co-workers
Cigna HealthSpring, Philadelphia, PA 03/2014-11/2015
Precertification Specialist
●Receive request for authorization from hospitals, providers, members and vendors.
●Determine authorization requirements based on company policy, member benefit grid and provider status.
●Review authorization requests and make determinations on the correct authorization process (i.e. auto approve, refer to Pre-cert Nurse or Medical Director).
●Process extensions of authorizations as appropriate.
●Processes denials including correspondence sent to families, members, facilities and applicable contracted providers.
●Notifies responsible parties prior to initiation of denial letter and ensures that member and responsible party understand details of the letter and the appeals processes to follow.
Main Line Health, Broomall, PA 11/2011-09/2012
Electronic Medical Records Clerk
●Receives inbound phone inquiries from requester clients regarding patient medical records
●Manage client concerns and questions regarding status of requests, invoice/fee issues
●Ensure that calls are answered promptly and courteously within prescribed standards and metrics
●Works with Supervisor and Team Lead to escalate complex elevated issues
●Maintain and ensure positive relationships with clients (hospitals) and release of information (ROI) requestors (attorneys, insurance companies, state disability offices, record copy services, doctor’s offices, and others).
Lazerspot, Chester, PA 05/2011-12/2011
Yard Check Processor
●Responsible for entering all incoming cargo truck scan numbers into system
●Responsible for documenting all cargo truck as empty or loaded, Fax daily log to Supervisor
Maxa Internal Medicine, Duluth, GA 04/2006-02/2011
Medical Billing/Accounts Receivable Clerk
●Responsible for accurately entering office visit charges into Misys Tiger billing system
●Responsible for follow-up on all insurance claim denials from electronic accept/reject report
●Responsible for entering demographic, insurance information, claim correction, and resubmission of claims
●Document all collection activity into billing system to ensure continuity in communication handling of account
●Scan patient’s medical record information in Electronic Medical Report system
●Provide timely and efficient claim follow-up to maximize cash collections through telephone, electronic billing, hard copy billing, third party billing, and written correspondence to process claim quickly
Snellville Clinic, Snellville, GA 01/2005-03/2006
Medical Receptionist
●Responsible for answering telephone providing excellent customer service
●Responsible for insurance verification, patient demographic, collect co-pays, schedule appointments, obtain referrals, authorizations, and balance daily deposits
●Pull medical records for patient appointments
●Process request for Release of Information
●Scan patient’s diagnostic test, procedures, and consult reports into EMR system
●Released medical record information to patients, agencies, and healthcare providers in compliance with appropriate regulations
●Protected the security of medical records to ensure confidentiality
●Maintain medical records including generating chart numbers, filing, and copying
Cardiology Consultants, P.A Newark, DE 11/2002-08/2004
Hospital Medical Billing/Precertification Specialist
●Responsible for entering hospital inpatient and outpatient charges into Misys billing system for 29- physician practice
●Process claims accurately and in a timely manner to minimize denials
●Process claims for Medicare, Medicaid, HMO’s, PPO’s, Managed Care, Blue Cross, and all other private insurance carriers
●Verified insurance eligibility and benefits with the appropriate carrier via on-line, insurance verification system, or telephone inquiries
●Maintained confidentiality of all information received
●Obtain authorizations, precertification, and referrals for inpatient hospitalizations & outpatient procedures
●Provided superior customer service on all incoming/out coming calls
●Performed other duties related to job as assigned
EDUCATION
Christiana High School, Newark, DE 1990-1994
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