Medical Billing Data Entry
Resume:
Devna Andrews
Dania Beach, FL 33004
************@*****.***
PROFESSION: CUSTOMER SUPPORT SERVICE REPRESENTIVE
SPECIALZNG IN MEDICAL ACCOUNT REIMBURSEMENT
Objective: To utilize my acquired specialty in a Position to benefit a progressive business with opportunities in professional and personal
Work Experience
Senior Travel Coordinator
Royal Seas Cruise Lines - Hallandale, Fl
From September 2020 to December 2021
Duties Include: Receiving inbound calls from prospective customers looking for a rewarding cruise line vacation package, booking confirmation email which Includes: travelers are placed on a phone dialer system with questions regarding available packages around the holidays, hotels booking if client decides to include round trip of a stay on the island with available hotel packages for a couple different vacation packages available and left of time a phone dialer system of (60-80 calls per day), relating to booking cruise line reservations for future travel dates, disclosing policy and procedures of their travel arrangements, along any extensive or discount packages on specific cruises lines, review accurate concerns on customers behalf arrangements, forward confirmation of detailed information to customer email along with confirmed details on clients cruise schedule==z and time through to booking department for date of departure
Medical Billing & Collection Specialist
Infinity Behavioral HealthCare
July 2018 to August 2020
Duties include: following up Insurance claims on all accounts to ensure prompt payment. Identify coding or billing issues and works to correct errors in a timely manner. Monitor insurance claims which include running reports and contacting insurance companies to resolve unpaid claims, prepare accounts for rebilling and for filing secondary insurance; send carrier info. with necessary documents, as needed. Completes the filing and follow-up on insurance denials to obtain reimbursement. Handles patient and insurance inquiries. Updates and re-files claims, as required. Acts as a liaison in collection of third-party accounts,
Administers contracts with third party payers including Medicare and Medicaid, through facility processes. Notifies Office Manager of contractual issues that are contrary or inconsistent with contract language. Negotiates payment plans on self-pay accounts regarding Settlement Discounts. Complete monthly & weekly tasks,
Responsible for reducing and achieving collection maintenance on accounts receivable calculated days along with bad debts write offs, Performs monthly reviews and turnovers of aged accounts. Cross train and perform other duties as assigned based on business operational needs. Adjust personal daily schedule to meet special project and monthly goal needs.
Medical Collection Representative.
Medivance HealthCare
July 2013 to June 2018
Duties Include: Prepares and submit clean claims to various insurance companies, obtained claim status, Performs various collection actions including contacting patients, correcting and resubmitting claims to third party payers, Identify and resolve patient billing complaints, review patient balances and sends all patient statement information. Review and report status of all delinquent accounts. Assist patients, clerical staff and insurance companies. Attend monthly staff meetings.
Pharmacy Representative Process
Express Plus Pharmacy
March 2009 to June 2013
Verification of Infusion special coverage for specialized medication throught infusion care therapy, confirmng authorizations and referrals for requred for speciality medications. Schedule and confirm delivery and maintence of all medications. Coordinate maintenance of pharmacy claim submission, Assist patients primary care physicans office with detailed information on infusion speciality care benefits for specialized pharmaceutial speciality medications requesting required medical documentation to authorized pharmacy specialized medications to obtain authorization speciality compound medication process. Strong interpersonal and Multi-tasking skills upon resolving claims reimbursement discrepancies and or medications ordered by physician. Ensure multiple carrier and Government policies on reimbursement policies, Limited Coverage Determinations, and coding guidelines, Knowledge of
ICD-9, ICD-10 CPT, and HCPCS codes.
Medical Billing & Collection Coordinator
Nationwide Laboratory
April 2005 to March 2009
Duties Include: Specializes in the processing Medicare, Medicaid, Commercial, PIP and multi-specialties claim Reimbursement & claim Refunds. Submit billing to appropriate Insurance carriers to include outpatient part B services. Review weekly census report to determine the appropriate billing carrier, verify medical insurance coverage & obtain authorization for services prior to services rendered.
Review patient responsibility & pays close attention to detail, with strong accuracy in data entry by reviewing front end edits for electronic claims submission. Process accounts in a timely manner prior to billing insurance.
Interpret explanation of benefit and reviewed obtained documentation on appealed claims for resubmission. Implement coding and modifier when required. Ability to multi-task and resolve disputed claims. Experience and knowledgeable of payment posting and contract adjustments. Meet monthly with Business Office Manager to explain any deficiencies and concerns associated with under paid claims.
Lead Patients Accounts Coordinator
Doctors Hospital of Hollywood
February 1998 to April 2005
Duties Include: Provides intake services and setup demographic information all new patients. Verify insurance benefits major medical plan & secondary plans. Review clinical documents for prior authorization & pre-certification submission.
Coordinates the patient's care with physician offices, nurses, pharmacists and patients. Performs accurate and timely insurance verification, both major medical and pharmacy benefits. Works with home health nursing visits and maintenance of a patient census throughout the course of their therapy if needed. Support other team members in the healthcare team. Ensure continuous customer service improvement quality approach. Maintain current documentation related to the patients care plan. Actively participates in discussions with Pharmacists, Medical
Nursing Services and Care Coordinators to review cases related to covered medical benefits. Flag issues that need to be addressed. Processing billing & collection of submitted claim follow-up within a timely. Submit medical documentation for claims appeal.
Certified accredited medical resolutions
Specializing reimbursement and problem solving
Certified member in American Guild in Patient Accounting
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