Hazelle Simpson

*** *********** **** **********, ** 29605

Ph 864-***-****

adt140@r.postjobfree.com

To obtain a position using my qualified skills and responsibilities to further my professional growth.

QUALIFICATIONS _

•Excellent verbal and written communication skills, with ability to communicate with all levels of management.

•Ability to prioritize tasks and handle multiple high priority assignments with minimal supervision.

•Excellent relationships skills with both internal and external customers.

•Ability to handle confidential material in a professional and highly ethical manner.

•Ability to work efficiently in a high-paced environment characterized by rapid changes.

•Mastering knowledge of billing procedures, health plans and claims processing.

•Three to five years of experience in charge entry, registration, and customer service.

•Excellent knowledge of Accounts Receivable among different states policies and procedures.

WORK EXPERIENCE

Patient Account Specialist Revenue Cycle Ob Hospitalist Group Greenville, SC 03/2018-Present

Perform account research by contacting and responding to request from billing vendor and payers for verification of patient claim status and/or demographic information.

Prioritize workload based on aging reports, account balance, and priority accounts under the direction of management.

Investigative skills. Pursues non-payment form third party payors until resolved.

Resolve claim errors, demographic issues, duplicates, and no coverage errors in work queues.

Process government and commercial insurance claims. Resolve claim edits and rejections. Coordinate collections and delinquent unpaid accounts.

Claim processing which includes investigating billing problems and assists with error resolution.

Identifies account delays, and follow up on balances with the designated payor, utilizing websites when available.

Maintain a consistent processing and low error rate.

Responsible for collection process for outstanding insurance carrier claims in a timely manner.

Perform other duties as assigned.

Responsible for researching credit balances and processing refunds or other actions necessary to resolve credit balances or a patient balance and payer balances.

Prepare refund requests for all payers via credit balance report.

Process refunds with billing and reimbursement knowledge.

Solve and complete refund request form if necessary.

Eligibility& Verification Specialist Revenue Cycle Ob Hospitalist Group Greenville, SC 04/2016-03/2018

Ensured all insurance, demographic, and eligibility information is obtained and entered in an accurate manner.

Determined eligibility for Self-Pay accounts utilizing Datalinks, Availity, payer websites, contact with payers, hospitals EMR and and/or patients.

• Performed insurance verification process on all assigned Self Pay and uninsured patients.

Patient Account Representative I Revenue Cycle I Prisma Health System I Greenville, SC I 2012-2016

Processed insurance claims. Reviewed and worked claim edits and rejections. Coordinate collections and delinquent unpaid accounts.

Guided or supervised claim processing which includes investigating billing problems and assists with error resolution.

Identified account delays, and follows up on balances with the designated payor, utilizing websites when available.

Responsible for collection process for outstanding insurance carrier claims in a timely manner.

Investigated billing or collection problems and assists with resolution. Resolves account issues to the highest level.

Identified trends for management and escalates issues to the next step through the payor contacts or internally as the appropriate next step guided or supervised.

Responsible for the coordination and resolution of the administrative denials and appeals of the system-wide comprehensive denials and appeals management program.

Performs the necessary audits to evaluate the revenue cycle process and educates Management Staff on issues impacting reimbursement.

Exceeded standards and met goals of 90% daily.

Exceeded quality assurance accuracy reviews for Billing. Met and exceeded goals for Billing 80% and Collecting 75%.

Denials & Appeals Specialist I Patient Account Services I Prisma Health System Greenville, SC I 01/2011-09/2012

Reviewed opening and following up on appeals process due to a denial in order to receive payment.

Reviewed claim edits, correcting and resolving billing errors for the claim to be billed and processed in a timely manner.

Updated insurance information system-wide in correcting resolving future errors to reduce unclean claims in the beginning stages of processing.

Admissions Counselor I Patient Account Services I Prisma Health System I Greenville, SC I 04/2007-06/2008

Received and interviewed patients to collect and verify pertinent demographic and financial data.

Collected required payments or makes necessary financial arrangements.

Performed all assigned duties in a courteous and professional manner.

Certified Patient Access, Team Lead I St. Barnabas Medical Center I Livingston, NJ 11/1998-08/2006

Served as a team lead and liaison for support staff within the facility.

Supported management in the daily administrative operations of the practice.

Coordinated shift change and assigned daily duties in which were appropriate.

Registered patient demographics and insurance information.

Maintained an accuracy rate of 99% on all registrations.

Answered telephone calls, scheduled diagnostic testing, coordinated Primary Care Physician's to correspond with Emergency Department staff.

Currently enrolled in ICD-10/CPT coding course at Greenville Technical College

Drake College of Business I Elizabeth, NJ I 10/1996-08/1997

Major: Medical Assistant Certification

Elizabeth High School I Elizabeth, NJ I 06/1992

MISCELLANEOUS CREDENTIALS & BACKGROUND

Technical Skills: Microsoft Word, Excel, Outlook and PowerPoint Applications. Bipas, Aeos, EPIC.

Professional Skills: Customer Service, Good Human Relation Skills, Problem Solving, Teamwork, Analytical, Design, Project Management, Judgment, Motivation, Professionalism, Innovation, Attendance/Punctuality, Organization Skills, Communication Skills, Accounting, Human Resource Management.

Strong understanding of all HIPPA rules, regulations, hospital policies and procedures among multiple states.

Proficient at reading, writing, and speaking English.

Typing speed of 40 WPM.

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