Nancy Travis

**** ***** ****, **** ***

Sacramento, CA 95842

916-***-****

OBJECTIVE:

To maintain and manage patient accounts accurately by working with a team. By utilizing the systems, software, tool’s function to resolve and resolute variances. I will acquire the knowledge and skill to contribute to the overall success of the organization. I am bilingual and a team player and customer service skills.

EMPLOYMENT HISTORY:

Adventist Health One Adventist Health Way, Roseville, CA 95661. 03/20/2019 – current.

Contact: Olivia Allbee Supervisor 916-***-****

Title: Senior Billing Associate:

Follow up on claims variances, bringing them to closure by providing contract information, medical records, authorizations or by using the skills and tools required to complete the appeals in a timely manner. Analyze payer issues, trends while communicating with providers regarding the status of accounts. I possess strong oral/ written communication skills required for expedition of accounts. Recall of contracts, timing, organizational skills are used weekly to meet, exceed and ensure payments; the follow up on reports, ensure quotas are met regularly and inventory does not fall into untimely status. Collaboration with peers, and management is necessary for all job-related duties.

Adventist Health One Adventist Health Way, Roseville, CA 95661. 03/05/2018- 03/20/2019.

Contact: Lynn Ayubi Supervisor 816-***-****

Title: Reimbursement Refund Specialist:

Reconciles balance sheets assigned. Assist in maintenance of credit balance services for the organization. Assist with the preparation of audit variance assigned. Maintained account receivables of payment to patient accounts. Management of outstanding patient and insurance accounts, unpaid claims, denial tracers, credit balances. Provided support for accounts payment as needed, including filing and mitch match reports. Documented checks, copies of explanation of benefits or other system entries. Preformed other job-related duties as assigned.

Molina Healthcare 2180 Harvard St. Suite 500, Sacramento CA 95815 02/29/2016- 02/28/2018

Contact: Amy Dowd 585-***-****

Title: Appeals & Grievance Specialist

Manage, intervene, submit, or resolve patient appeals/grievances, complaints from Molina Members and related outside agencies as part of the Marketplace Government Contracts Team. Conduct pertinent research and other inquires accurately, promptly and in accordance with all regulatory guidelines. Prepared case summaries, correspondence and/or document for tracking and trending data. Collaborate with other departments responsible for daily case work regarding resolutions for HICS or state-based grievances. Enters case specific information into data system, while assuring timeliness according to state, federal and Molina Healthcare guidelines. Acts a liaison between members request’s and Health Department actions.

Sutter Healthcare 100 Howe Ave, Suite 120, Sacramento, CA 95825, 02/15/2013 -10/02/2015

Contact: Emily Stiles: 916-***-****

Title: Non-Government Account Representative SHHR PAFS:

Provides timely and effective follow-up of claim or balances related the PPO Claims. Acts effectively as a resource person with regards to claims including BMT, Transplants, Global type contracts, NICU, from the acute facilities and clinic with respect to payer or services, relating to hospital billing. Provide timely and effective collection and expected reimbursement, COB, and secondary payers. Help with training account representatives. Answer phones.

Other related title: Refund Representative: Credit Rep

Provides effective and efficient patient accounting services on credit balance patient accounts. Responsibilities include accurate and timely auditing; patient account follow up and patient account maintenance functions in accordance with over 180 established Managed Care Contracts. The incumbent acts independently to perform all activities related to adjudication and resolution of credit balance accounts for PPO/Blue Shield and Blue Cross Out of State claims for SHSSR, EMC and all their associated clinics. Various duties may include research and analysis, contract interpretation, monitoring of expected reimbursement system, accounting transactions and maintenance functions to ensure optimal, accurate and compliant reimbursement is collected for services provided.

Saint Thomas Physician Services 501 Great Circle Rd, Suite 200, Nashville, TN 37228, 7/2006- 6/2012 Contact: Brenda Holsker HR 615-***-****

Title: Billing Follow up Specialist

Billed Appeals, Corrected Claims. Self-Pay. Maintain Accounts Receivable report. Coding Support-Add diagnosis code to EKG by verifying Physician’s Report in Cerner Data base. Bill EKG according to inpatient, outpatient ER status. Correct patient demographics, load insurance, added Encounter for patient DOS. Corrected billing for each Physician. Refund Specialist-Review and research patient accounts for insurance refunds to all credited accounts. Pull EOB and match accounts with credit balances. Verify correct insurance for billing or refund purposes. Verify patient and insurance addresses. Other Title: Cash Applications-Apply Co-pay’s and patient payments to correct accounts. Transfer incorrect applied payments to correct accounts. Maintain patient payments and refund patient credit balances. Insurance Account Representative-Resolve and analyze patient accounts, claims, and payer issues, follow up, verify insurance, correct patient demographics, bill corrected claims, appeal claims, resolve patient issues. Responsible for ensuring the timely collections of AR from self-pay accounts as well as insurance payers including Medicare, Medicaid, Workers Comp, Blue Cross, Blue Shield, HMO/PPO’s. Collections-Resolve and bring all patient accounts to current payment status. Call patient and arrange easy payment options. Bring down company outstanding balances. Correct patient address and insurance plans.

Perot HealthCare System 101 Cumberland, Madison, TN 37115, 03/2004-7/2006

Contact: Shanta Vaugh 615-***-****

Title: Project Manager:

Responsible for resolution of accounts by correctly, effectively, analyzing accounts to resolution. Ensure compliance regarding billing and follow-up on all accounts. Ensure timely billing, meet or exceed the daily production goal as defined by the Director. Identify possible areas of concern by resolving real time issues on first time resolution. Assist with the training of new employees.

Non-Related Essential Jobs:

The Sport's Authority 2305 Gallatin Pike, Madison, TN 37115, 10/1998-12/2003

Contact: HR 407-***-****

Title: Merchandise Team Lead:

Managed 2170 square feet of apparel. Processed and merchandised apparel according to T.S.A standards and guidelines. Maintained, merchandized weekly sales ads and floor plan, aided escalated customer call issues. Supervised employee training for apparel associates.

Title: Cashier verified closing deposits balanced cash drawers and sales transactions for the next day business.

Marshalls 2113 Gallatin Pike, Madison, TN 37115, 11/1996- 10/1998

Contact Pat Powell 615-***-**** Merchandise

Title: Coordinator:

Created daily computerized task cards for the scheduled employees and managed the completion of daily task. Merchandized the apparel floor according to Marshal's standards, ran the customer service desk. Help resolve customer issues on sales floor and phone. Cashiered and maintained the Layaway Department, received shipment of trucks, processed and merchandised onto the Sales floor within 24 hours.

Color-Vision, Bally’s Park Place, Atlantic City, NJ, 08215, 4/10/1992-4/1996

Contact H.R. 1-800-***-****

Title: Store Manager:

Managed two store locations, supervised and trained all associates. Maintained quarterly progress reports on all employees. Recorded and reported the transactions of daily sales. Provided weekly inventory of two stores, made daily store deposits, cashiered, updated and maintained all operational disk equipment and maintained a pleasant environment for employees and customers

EDUCATION:

Riverside Community College Riverside, California Office technology

Atlantic Cape Community College

Volunteer State Community College Years Attended

Currently in process Spring 2022

Systems/Programs/Software used: Smarts,

Perse, Gateway, RealMed, NexGen, MediTech, Touch Chart, Cerner, Microsoft Windows and Outlook. MS4, MS8. Siemens DI, RCI, PMMC

References:

Dorthea Smith 615-***-****

Lorraine Shurley 916-***-****

Contact this candidate