Carol Baker

Phoenix, AZ 602-***-**** adre4i@r.postjobfree.com

SUMMARY

Highly analytical and process oriented accounts receivable analyst. Strongly driven with exceptional attention to detail. Proven experience serving as a single point of contact to meet customer needs. Skilled in Health Care Medical Claims, State Medicaid Encounters, Home infusion and DME billing. Experienced in electronic file transmissions, billing and collections.

SKILLS

Team Leadership Information Technology Revenue Cycle

Interpersonal Communication Customer Service Problem solving

Accounts Receivable Records Management Continuous Process Improvement

Technical Skills: Google products (Gmail, Google Drive) and Microsoft Office (Word, Excel, PowerPoint), Windows (7/8/10).

WORK EXPERIENCE

Home Infusion Biller CVS-Coram Phoenix, AZ 2021 - Present

●Price pharmacy claims before transmission using contracts and pricing tools.

●Review submissions in ePremis and track trending rejections.

●Make corrections as necessary after verifying information.

●Suggest process improvement and/or contract reviews.

Senior Assistant, Accounts Receivable CVS - RCI Tempe, AZ 2017 -2021

●Provided intermediary collections for Healthcare providers.

●Worked on special projects for skilled nursing facilities and DME providers.

Collections Specialist Phoenix Children’s Hospital Phoenix, AZ 2009 - 2014

●Review claims that were denied, rejected or partially paid.

●Then resubmit the claims for the correct and maximum reimbursement using research and analytical skills.

●Responsible for AHCCCS reimbursement of medical claims.

●Maintained professional contacts to resolve high dollar encounters.

Collections Specialist St. Luke’s Behavioral Health Phoenix, AZ 2003-2007

●Audit claims before billing them to the insurance company.

●Review audits with director and manager for registration/prior authorization process improvement.

●Responsible for high volume AHCCCS behavioral encounters.

●Researched claims/encounter denials extensively using the AHCCCS web site, Provider Manuals and Reimbursement tables/matrixes.

EDUCATION & CERTIFICATIONS

Accounting Certificate Maricopa Skills Center 1998.

Arizona State University B.S. Women and Gender Studies 2024 (in progress).

CompTia ITF 2022 (in progress).

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