Medical Billing Receivable Specialist
Resume:
Karol King
Accounts Receivable Specialist - McKesson Technologies
Riverdale, GA 30296
**.*****.****@*****.***
Over 20 years of experience in a healthcare setting. Skilled AR Specialist with excellent bookkeeping and accounts receivable management skills. Strong interpersonal and social communication allows me to successfully assist clients with locating invoices and payments. Exercise good collaboration with site managers and doctors regarding accounts.
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Patient Account Specialist/Admissions
Talbott Recovery - Atlanta, GA
May 2018 to Present
Acts as liaison between corporate office, facility where treatment is taking place and the patients
• Supervised Collection, posting and billing teams
• Handle claim negotiations within 24 hours of receipt
• Determine the necessity of patient refunds
• At times call potential patients and discuss benefits and collect payment due to begin treatment
• Handle single case agreements with insurance companies for patients with no out of network benefits
• Create all appeals for all facilities
• Supervised Collection, posting and billing teams
• Handle claim negotiations within 24 hours of receipt
• Determine the necessity of patient refunds
• At times call potential patients and discuss benefits and collect payment due to begin treatment
• Handle single case agreements with insurance companies for patients with no out of network benefits
• Create all appeals for all facilities
• Complete Admission paperwork with incoming patients Patient Account Representative
RiverMend Health LLC - Atlanta, GA
May 2018 to May 2019
Acts as liaison between corporate office, facility where treatment is taking place and the patients
• Supervised Collection, posting and billing teams
• Handle claim negotiations within 24 hours of receipt
• Determine the necessity of patient refunds
• At times call potential patients and discuss benefits and collect payment due to begin treatment
• Handle single case agreements with insurance companies for patients with no out of network benefits
• Create all appeals for all facilities
Accounts Receivable Specialist
McKesson Technologies - Norcross, GA
May 2012 to May 2018
• Acts as a liaison between McKesson and the staff at the place of service where procedures are performed
• Handle claims, correspondence and patient accounts on a daily basis in an effectively and efficient manner that results in quick-claim resolution and positive payment generation results
• Create and send appeals as needed to ensure prompt claim resolution
• Handle ACD inbound and outbound calls from insurance agencies, and internal and external customers
• Professionally communicate with patients to sufficiently respond to their questions, issues and needs
• Obtains all data under strict confidentiality in compliance with HIPAA regulations
• Collects and processes payments from patients and payers
• Handle daily claim negotiations within 48hrs of receipt
• Retrieve and respond to voicemail and email messages in a timely manner Cash Application Representative
Grady Healthcare System - Atlanta, GA
2009 to 2011
• Processed and accurately applied all incoming payments for all customer accounts from various sources to include commercial payers, Medicare and self-payments
• Identified and communicates discrepancies in payments received with the department credit analysts
• Performed reconciliation of daily deposits to the cash postings
• Researched unidentified payments for proper posting and or refunded the payer as applicable
• Processed credit card payments
• Calculated all contractual allowances to be posted in conjunction with the cash posting
• Maintained the responsibility for unapplied payments and lockbox bookkeeping accounts
• Downloaded, reviewed, reconciled and posted all lockbox and ERA payments on a current and daily basis.
• Quoted benefits and eligibility to various United Healthcare members in need of healthcare services
• Analyzed the coordination of benefits in relation to claim processing with the primary payer, commercial insurance and Medicare
• Verified insurance coverage of members to other insurance companies
• Provided members with assistance obtaining information concerning in network and out of network providers
Account Manager
Carolina Family Eye Care - Charlotte, NC
2006 to 2009
• Processed and filed healthcare claims to government and commercial payers
• Reviewed, processed and sent out accurate patient statements
• Manually posted all government, commercial and self-pay payments on a daily basis
• Ensured that payments were posted correctly by the employees at the sister office
• Analyzed accounts to ensure that the proper credit was applied for various diagnostic tests before the patient received an eye exam.
• Instructed patients on the proper procedures for insertion and removal of contact lenses. Ordered all office supplies and was responsible for all accounts receivable and accounts payable. Patient Account Representative
Reliant Care - Charlotte, NC
2002 to 2006
• Processed and filed healthcare claims to government and commercial payers
• Entered charges in the system to be filed
• Resolved coding and claims adjudication issues by recoding and/or writing appeal letters
• Manually posted insurance payments and denials
• Set up payment plans for customers with past due balances
• Set up Web MD and Blue-E for various clients that utilized electronic internet Education
Bachelor of Science degree
Johnson C. Smith University - Charlotte, NC
May 1988
Skills
• EMR (10+ years)
• EPIC (1 year)
• Excel (Less than 1 year)
• Microsoft Office (10+ years)
• MS OFFICE (10+ years)
• Outlook (10+ years)
• PowerPoint (2 years)
• SMS (10+ years)
• Word (10+ years)
• Time management (10+ years)
• Microsoft Excel (10+ years)
• Medical billing (10+ years)
• CPT coding (10+ years)
• Account Analysis (10+ years)
• Accounts Receivable (10+ years)
• ICD-10 (4 years)
• Account Reconciliation (10+ years)
• Accounts Payable (5 years)
• ICD-9 (7 years)
• General Ledger Accounting (10+ years)
• Communication skills
• Customer service
• Windows
• Salesforce
Languages
• Spanish - Beginner
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