Medical Billing Insurance Specialist

BRENDA MONTAGUE **************@*****.*** Cell: 516-***-****

OBJECTIVE: To obtain a challenging position that utilizes my experience in

Revenue Cycle

Haven Behavioral Healthcare 8/17/18 - Present

AR Collection Specialist

High dollar collections, meet goal of over $900,000.00 monthly.Work remote at home office since 3/2020, Monitor and maintain high dollar review to ensure timely resolution. Resolve complex claim issues, claim adjustments, claim denials and Appeals to payers. Excellent understanding of the Revenue Cycle process through billing and collections. Attentive to detail and accuracy. Exercise sound judgement and confidentiality in maintaining sensitive information. Knowledge of Fair Debt Collection Practices Act.

Healthcare Provider Solutions 8/1/17- 8/15/18

Homecare Insurance Specialist

Follow up with payors and other third parties for ensuring timely claims submission. Resolve accounts including secondary billing, appeals process and patient liability. Proficient in comprehending and applying payor contracts and reimbursement. Knowledge of healthcare claims processing UB-04 and 1500 claims. Excellent customer service skills, verbal, computer and multi- tasking skills.

Jacobus Consulting 2/15/16 – 1/30/17

Revenue Cycle Team

Member of A/R traveling resolution team, working onsite or remote. Working knowledge of Revenue Cycle. Identify payer trends or delays in payment and escalate to next step. Resolve complex claim issues, claim adjustments and solve issues. Appeal claim denials. Excellent understanding of the Revenue Cycle process through billing and collections. Assess and resolve credit balance report. Attentive to detail and accuracy. Exercise sound judgement and confidentiality in maintaining sensitive information. Demonstrated the ability to self-manage in a remote work environment and experience solving problems in a work from home environment.

Nearterm Corporation 3/5/15 – 9/11/15

Medicare Revenue Recovery Specialist

Travel onsite and work remote. Adjustments and rebill through Medicare DDE, Billing and follow-up of Medicare, Medicaid and Commercial Insurance, refunds and adjustments. Extensive use of Meditech, Epic, Medicare Fiss, Emdeon, Availity,

Expeditive, Inc 10/14 – 3/2/15

Independent A/R Medicare Specialist

Medicare audits on SNF accounts, Adjustments and rebill through Medicare DDE, Billing and follow-up of Medicare, Medicaid and Commercial Insurance, posting refunds and adjustments using IDX-Centricity. Extensive use of Meditech-Star, Availity, Accretive YBFU system.

Xtend Healthcare 2/4/13 – 7/25/14

A/R Specialist, Biller

Member of A/R traveling resolution team, traveling to facilities in every state. Identify payer trends or delays in payment and escalate to next step. Resolve complex claim issues, claim adjustments and solve issues. Excellent understanding of the Revenue Cycle process through billing and collections.Ability to read and evaluate healthcare receivables information. Knowledge of Medicare/Medicaid Guidelines and regulations. Working knowledge of Medicare Direct Entry System and FISS. Working knowledge of medical billing systems. Third party biller for commercial insurance, Medicare, Medicaid, and secondary insurance payers. Extensive use of Epic, Meditech, Eprimis, Emdeon, SSI and Cirrius software.

Dell Corporation 3/2010 -1/31/14

Senior Project Manager

Member of A/R traveling resolution team, traveling to facilities in every state. Possess the ability to learn and master multiple account systems. Identify and resolve complex claim issues, claim adjustments and solve issues. Ability to read and evaluate healthcare receivables information. Knowledge of Medicare/Medicaid Guidelines and regulations. Working knowledge of Medicare Direct Entry System and FISS. Working knowledge of medical billing systems Meditech, Medisoft, Source, MedBos and Epremis.

PerotSystems Healthcare 12/2000 – 6/2005

Project Manager

Member of A/R traveling resolution team, traveling to facilities in every state. Knowledge of Fair Debt Collection Practices Act. Monitor and maintain large dollar review to ensure timely resolution. Claim adjustments, track payments, appeals, payment variance reports and contact management issues.

TRAINING: American Health Information Management course included JCHO Standards, OSHA Standards, ICD-9 and CPT coding, state bylaws, Medicare/Medicaid regulations, Medicare University 101, Critical Access Hospitals, HIPAA Compliance

SKILLS: Medicare, Medicaid and Commercial Payer billing and follow up regulations, excellent customer service, Revenue Payment cycle management.

Medical terminology, transcription, accounting, typing 65wpm, Microsoft Office, Windows, MS Word, Excel. Medical billing software Meditech, Sorian, Epremis, Cirrius, and SSI,

References available upon request

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