Customer Service Medical Billing
Resume:
. Ashley N. Mallory
*************@*****.***
Summary
Outstanding customer service skills; diplomatic and patient with all types of individuals and organizational levels.
Education Armstrong High School-Richmond, VA (High School Diploma)
Richmond Technical Center-Cosmetology (Certificate)
J Sergeant Reynolds-Business Administration
Highlights
Insurance
Banking
Technology
Claims Questions
Policy/account changes
Service –oriented
Conflict resolution expert
Courteous demeanor
Sharp problem solver
Energetic work attitude
Manager
Trainer
EPIC Billing System
IDX Billing System
EIQ Billing System
CRC Certified
AR Follow Up Representative Revenue Cycle/Team Lead, Work from Home 01/2019-Current
VCU HEALTH SYSTEMS/ENSEMBLE HEALTH PARTNERS-Richmond, VA
Follow up on claims processes
Develop a schedule to assess training needs.
Conduct employee surveys and interviews.
Consult with other trainers, managers, and leadership.
Track and compile collected data.
Conceptualize training materials based on data and research.
Communicate training needs and online resources.
Responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies.
Responsible for collecting payments for a company using skills in project management, organization and communications to collect the payments from clients and customers.
Medical Biller and Coder, 02/2017-07/2018
Universal Health Services-Richmond,VA
Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management.
Examine patients encounter forms to verify diagnosis codes, and reconcile codes against services rendered.
Accurately input procedure and diagnosis codes into billing software to generate invoices.
Used electronic charge capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on time.
Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances.
Document patient data and medical records, and perform routine medical record audits to comply with insurance company requirements.
Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
Provide administrative support to physicians and interpret medical reports and data to assign ICD-9 and ICD-10 codes; enter diagnosis codes and patient information into billing software.
Update and manage diagnosis lists, coordinate routine documentation and coding audits, and execute qualitative analysis of discharged charges.
Follow and maintain currency on coding, sequencing, and procedures best practices and updates.
Review and validate accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature.
Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers.
Performed insurance verification, pre-certification, and pre-authorization.
Entered procedure and diagnosis codes, and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnosis, and coded narrative diagnosis.
Responded to staff and client inquiries regarding CPT and diagnosis codes.
Customer Service Advocate, 09/2014-02/2017
Anthem Blue Cross and Blue Shield - Richmond, VA
Answer customer telephone call regarding existing accounts.
Make requested policy and account changes.
Escalate accounts to questions and concerns about service, and escalate calls appropriately to management team of the department to assist in resolving issue.
Consult with customers to evaluate needs and determine best options.
Counsel customers on options for service and coverage.
Upgrade service and offer additional service packages or options.
Consistently improve customer satisfaction through expert resolution of conflicts, issues, and concerns.
Perform and determine Pre-certifications needed for medical services inpatient, outpatient, surgeries and procedures.
Changed policy information for medical, dental, and vision benefits.
Update all customer information in system with accuracy.
Evaluate and reviewed all appeals, complaints, and grievances.
Document all customer information with physicians and physician’s staff.
Properly documented all customer accounts on resolving all balances that were sent to collections agency.
Completed all follow up calls on customers claims through contact of payer.
Worked to have EOB’s corrected for customers with coding and billing errors.
Negotiate payments with insurance and billing office for customer claims.
Teller, 09/2012-06/2014
BB&T BANK-Richmond, VA
Explain to customers the different types of loans and credit options that are available, as well as the terms of those services.
Process mortgage loans
Obtain and compile copies of loan applicants' credit histories, corporate financial statements, and other financial information.
Processed cash withdrawals, deposits, and selected internal and external account payments.
Adhered to regulatory, security, and audit procedures.
Balanced daily cash deposits and bank vault inventory with zero error rate.
Monitor and respond in timely manner to telephone and electric massages.
Processed mortgage loans and payments
Provide customer with timely and periodic status updates of their loan application
Collect required documentation from applicants and follow up on missing items
Establish, maintain, and update files, databases, records, and/or other documents for recurring internal reports
Title 1 Tutor, 01/2008-03/2012
Richmond Public Schools-Richmond, VA
Assist students in development of appropriate study skills.
Screen and give assessment of students in the program.
Organize paperwork for auditor’s summer visit.
Supervise and train other workers in their work.
Maintain records and data for assigned students.
Set interview appointments for parent-training tools for home.
Communicate with teachers and keep written documentations.
Review and analyze test data from previous years.
Schedule students for tutoring and attend component meetings.
Perform other duties as assigned.
Customer Service Representative, 08/2009-10/2011
DTLR-Richmond, VA
Acknowledge, communicate and greet customers in timely manner.
Manage phone calls and assist customers with orders.
Manage stock control: storage, retrieval and timely delivery of goods.
Stock racks and shelves and maintain presentable sales environment.
Communicate with supervisor and purchasing department.
Handle money transactions and operate cash register.
Present professional image at all times to customers.
Maintain inventory and purchasing needed supplies.
Handle and perform other duties as needed
Campaign Participant, 05/2008-11/2008
Otis Mallory for School Board-Richmond, VA
Greet and communicate with potential voters
Assist with organizing fundraisers.
Canvas and distribute neighborhoods with literature.
Additional Skills
Microsoft Window XP
Word, Excel, Access, Power Point, Outlook (50+WPM) Multi-phone line Filing, Printing, and Fax, machines, Possess good interpersonal and organizational skills. Good leadership skills. Organize and Systematic.
Volunteer Work, 05/2008/11/2008
Mt. Calvary Int’l Church- Providence Forge, VA
Dance
Daycare
Kitchen
References Available as Needed
Contact this candidate