Medical Billing Customer Service
Resume:
Alnita L. Saucer
************@*****.***
OBJECTIVE:
To obtain a position with a reputable firm where I can make a contribution to the team efforts as I continue to expand my business management skills. PROFESSIONAL EXPERIENCE:
Patient Access Representative/ Authorizations
Hollis Cobb & Associates - Duluth, GA August 2019 to Present Performs clerical and customer service functions required to service the needs of the patients, providers and organization
Maintains a high volume of inbound calls, researching and responding to billing questions and inquiries
Negotiates payment on patient account balances
Communicates hospital financial policies to patients and identifies patients who need financial help
Retains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up to secure reimbursement of claims Contacting and communicating with patients who have procedures scheduled, but have not had those procedures yet
Verifying if self-pay patients have any insurance not documented in client system Verifying that insurance information in the client system is accurate Determining the patient liability estimate
Communicates hospital financial policies to all patients Collects on self-pay accounts, co-pay, deductibles and co-insurance Update the patient accounts in multiple client systems Responsible to meet production targets for collections, pre-registrations and phone calls Deliver employee workplace skills training
Complex Authorizations Specialist
Triwest Healthcare Alliance, New Orleans, LA 2017-2019 Assist Veterans with the coordination of healthcare in the community Process authorizations for specialty health services Verification of Veteran Benefits
Proper Coding for processing authorizations
Interaction, corresponding and coordination with Veteran Affairs Intake Coordinator/Reimbursement Specialist
Infusion Partners/ Carepoint Partners/ Bioscrip, New Orleans, LA 2009-2013 Generate and track forms (CMN, AOB, Consent to Treatment, etc.) Insurance verification and case management negotiations for patient setup Communicate with referral sources and insurance case managers to obtain authorizations Coordinate and set up Home Health, ordering and processing prescriptions for pharmacy to home delivery for patients discharging from the hospital on Home IV services Verify accuracy of billing data and revise any errors Compute credit terms, discounts, shipment charges and rates for goods and services Answer and solve insurance company and patient inquiries about balances and charges Claim processing, resubmissions, appeals, prior authorizations, maintain EMR and assist patients in enrolling in copay assistance or financial hardship programs Practice Manager
Crescent City Physicians (Touro), New Orleans, LA 2007-2009 Assist in the development and delivery of reimbursement updates and training materials Physician credentialing
ICD-9, ICD-10, CPT-4, HCPCS coding
Responsible for compiling policies and procedure manual and training of office staff Processing claims on HCFA and UB92 claim forms and electronic filing HIPAA compliance
Patient balance resolution
Collections, pre-certification, bookkeeping, typing, patient charting Posting of payments and charges
EDUCATION:
B.A., BUSINESS MANAGEMENT, DILLARD UNIVERSITY, NEW ORLEANS, LA 1996
MEDICAL ASSISTING, BRYMAN COLLEGE, NEW ORLEANS, LA 1995-1996
MEDICAL BILLING AND CODING, NEW ORLEANS, LA
2015-2016
CPAR Certification
2021
SKILLS:
Medical: Venipuncture, Injections, First Aid, CPR, Medical Terminology, Urinalysis, Specimen Collection, Differential and Blood Analysis, Instrument Preparation and Sterile Techniques. Clerical: Insurance Billing (ICD-9, ICD-10 and CPT-4 Medical Coding Systems, Medicare, Medicaid, Skilled Nursing Facility, Workman's Compensation, Automobile Insurance, Commercial and Managed Care) Filing, Accounting, Payment Postings, Bookkeeping, Typing, Customer Service, Appointment Scheduling, Insurance Verification, Pre-Certification, Patient Charting, WordPerfect, Lotus, QuickBooks, Excel, ElComp, Medisoft, CareRevolution, EPIC, CareTend, Microsoft OfficeSuite, Medical Manager, BaseMed, Tiger/Misys, ProComm, IDX, Protomed, PPM, CPR+, MRO,STAR, PREMIS, CUBS, Louisiana Medicaid, GAMMIS, Availity and Carecentrix Web Portal, Medic.
REFERENCES AVAILABLE UPON REQUEST
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