Assistant Classes Collections Specialist
Resume:
NELSON RAY B. DAOEY
Mundelein, Illinois 60060
847-***-**** / **********@*****.***
SUMMARY
Highly experienced and results-driven Medical Billing and Collections Specialist. Outstanding account analysis, cash application management, and collections planning skills. Successful track record of immediately determining account collectability, collecting aged accounts, and consistently exceeding monthly cash goals.
PROFESSIONAL EXPERIENCE
MINDLANCE (Staffing Agency)
AbbVie Insurance Specialist (IS1) 05/09/2022 – 05/26/2022
ALLIANCE RX (ARxWP) 10/2019 - 04/2022
Insurance Verification Specialist.
Maintains patient demographic information and data collection systems.
Verify insurance eligibility for both medical and vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
Review patient deductibles and/or copays and enter into the billing system and spreadsheets provided to the front end department at all locations.
Coordinate with front end regarding scheduling errors.
Assist front end staff and call center staff in understanding carrier websites and verification of eligibility. •
Enter insurance referrals as needed.
Participates in development of organization procedures and update of forms and manuals.
Answers questions from patients, clerical staff and insurance companies.
Works in conjunction with the reception to ensure clean billing. • Performs miscellaneous job-related duties as assigned.
Participates in educational activities and attends monthly staff meetings.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.
OPTION CARE, 10/2016 - 02/2019
Collections Specialist
Follows up on invoices submitted to ensure prompt and timely payment and escalates issues as necessary.
Evaluates payments/denials received for correctness and ensures that they are applied appropriately.
Identifies bad debt write-offs and A/R adjustments. Initiates write-off and adjustments in accordance with policies and procedures.
Identifies any overpayments and/or duplicate payments, and investigates and resolves. Processes refund requests, in accordance with policies and procedures.
Ensures that secondary bills and patient invoices are accurately generated and submitted on a timely basis.
ADVOCATE CONDELL MEDICAL CENTER, 09/2014 - 10/2016
Pre Access – Central Scheduling
Monitored inbound calls for appointments.
Scheduled proper procedures as stated on the order.
Worked closely with the various departments to ensure proper diagnosis to the order stated.
Worked closely with doctors offices to obtain proper orders for the patients.
Monitored the process in verifying that the insurances were within hospital network to avoid patient responsibility.
Worked with patients to insure accurate appointments when scheduling multiple procedures.
CVS CAREMARK, 05/2013 – 06/2014
Sr. A/R Management Collections Specialist
Successfully managed the timely collection of monies due to company.
Monitored, reported and analyzed accounts for timely and accurate invoicing.
Reported weekly invoicing totals and aging totals.
Worked closely with the Billing Department to implement processes and policies that contribute to accurate invoicing.
Currently working with Medicare Part B regarding appeals of unpaid Therapies.
ORSINI PHARMACEUTICAL 2012-2013
Benefits Verification
Responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by an individual’s provider.
Responsible for entering data in an accurate manner, as it is his job to update patient benefit information in the organization’s insurance system and verify that existing information is accurate.
Spends extensive amounts of time on the phone with insurance companies.
CVS CAREMARK, 2008-2012
A/R Management Collections Specialist
Successfully managed the timely collection of monies due to company.
Monitored, reported and analyzed accounts for timely and accurate invoicing.
Managed cash application making sure that all cash was applied properly.
Reported weekly invoicing totals and aging totals.
Worked closely with the Billing Department to implement processes and policies that contribute to accurate invoicing.
Read and interpreted EOB’s and insurance contractual adjustments.
Created and executed a collection plan.
EDUCATION/CERTIFICATION
Bergen Community College, Paramus, New Jersey
Medical Coding/Billing, 2004
Certified Nursing Assistant Classes
Meadow brook Manor, Naperville, Illinois, 2002
Associates Degree
AMA Computer College, Baguio, Philippines, 1994
Computer Programming
HONORS & ACHIEVEMENTS
International Baccalaureate Certificate holder
Honors Society, Brent International School
SKILLS
Language/Communication: Proficient in English – Verbal and Written
Proficient in conversational Filipino
Enthusiastic and able to partner effectively with patients, payors and colleagues.
Computer Knowledge of MS Office Suite and the ability to navigate several on-line insurance web sites.
Adequately trained in Graphical Designs using Corel Draw and Adobe Photoshop.
Organization: Comfortable with tight deadlines and be able to multi-task in working for aggressive growth goals.
Contact this candidate