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Medical Billing Authorization Specialist

Location:
Nampa, ID, 83651
Salary:
20.00 per hr.
Posted:
August 01, 2022

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Resume:

Judy Hanson

Nampa, ID *****

adrywc@r.postjobfree.com

208-***-****

Authorized to work in the US for any employer

Work Experience

Medical Orthopedic Account Receivable and Account Payable Direct Orthopedic Care September 2021 to Present

Working daily claims for local offices addressing billing issues for 5 clinics including A/R, claim submissions with insurances. Posting daily and weekly insurance payments including EFT and physical payments. collections, procedures, and patient accounts. Medical Account Receivable Specialist

Change Healthcare – Remote January 2021 to September 2021 Processing aged and daily claims for both clinical and hospitals, all medical services. Utilizing correct coding along with correct authorizations for timely payment and the ability for timely appeal and or redeterminations. Obtained and entered all authorization and correspondence for new patient referrals, gathered necessary information for proper billing. MEDICAL LIABILITY CLAIM Representative

St. Alphonsus Regional Medical Center - Boise, ID March 2017 to January 2020 I was a Medical Liability Claims Coordinator with an emphasis in Medical Payment and Bodily Injury claims. I worked with various hospitals liability claims in Idaho, California, and Oregon and five hospitals. Work including Claim processing, A/R Reports, A/P Reports, Lien Filing, and Attorney Settlement Agreements.

Configuration Analyst

MOLINA HEALTHCARE - Boise, ID February 2016 to March 2017 Configuration analyst for state policies in Idaho Medicaid. I worked with the Contract Department for hospital rates, fee for service contracts, capitation agreements and other contract issues for Idaho. ACCOUNT MANAGER

KAREO MEIDCAL BILLING SERVICES - Las Vegas, NV March 2014 to June 2016 Manager overseeing physician contracts for all billing services for both hospital and clinics including A/R, claim submissions with vendors, and various office needs. I met with Physicians on a semiannual basis for their Medicare and other medical insurance contracts as well as monthly to report any credentialing issues, collections, procedures, and patient accounts. I developed, monitored, and updated all billing rules for insurances, specialties, and patient accounts. Prepared and analyzed A/R reports, weekly and monthly financial reports, and insurance contracts in concert with the Practice Administrator. Collect and compiled accurate statistical reports. ADMINISTRATIVE ASSISTANT

IPC HOSPITALIST OF NEVADA - Las Vegas, NV March 2013 to March 2014 Providing reception and administrative support. I also updated and maintained all monthly reviews for their hospital credentialing. Managed multiple calendars: assisted with coordination of business meetings and notification of attendees as needed. Assisted with developing and maintaining contract databases and contact lists for the executive team. MEDICARE CUSTOMER SERVICE

UNITED HEALTHCARE - Las Vegas, NV October 2012 to February 2013 Provided excellent customer service for the Medicare members in Nevada. Responded to complex member inquiries. Resolved such inquires which may have included: Benefits and eligibility information, billing, and payment issues, claim issues with both members and providers. Obtained authorizations for both medical and pharmacy services. MICHAEL HORAN, M.D., NEUROLOGIST OFFICE MANAGER JANURARY - Las Vegas, NV January 2011 to September 2012 Worked all claim submissions daily and obtained necessary pre-certifications. In charge of new patient referrals, gathered necessary information, and assigned the patient accounts. Posted all EOB's collected co-payments, deductible and other out of pocket amounts consistently. I also managed his quarterly requirements for the State of Nevada Hospital privilege contracts. MEDICAL BILLING AND AUTHORIZATION SPECIALIST

KAISER PERMANENTE - Aurora, CO June 2006 to September 2010 Daily Prior Authorizations for both clinical and hospitals, Processed claims, and billing for both Inpatient and Outpatient all medical services - utilizing correct ICD-9 and CPT codes. I ran daily reports on queues, also charge entries. Obtained and entered all authorization and correspondence for new patient referrals, gathered necessary information for proper billing. Education

Associates in Medical Billing and Coding in Medical Billing and Coding PARKS COLLEGE - Aurora, CO

February 2002 to May 2002



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