Collections Specialist Authorization
Resume:
Christie Payne
**********@*****.***
Professional Experience:
Philips/ Connect America – Nashville, TN
Billing Specialist
Obtaining and entering Medicaid authorization accurately and timely to ensure clean claims are released
Reviewing claims for accuracy of procedures, diagnoses, demographic and insurance information
Obtaining equipment upgrades and correspondence from the payor agencies
Reviewing and correction all claims/charges denials and edits that are communicated via Explanation of Benefits (EOB) and other methods of communications
Monitoring days in Accounts Receivable and ensuring that they are maintained at the levels expected by management
Responding to inquires from agencies, case managers, insurance companies, and internal/external customers in a timely manner
Episode Solutions- Nashville, TN
01/2020- 2/2021
Billing/Collections Specialist
File claims to Medicare Using 1500 claim form
Send crossover claims to secondary insurance companies
Work Aging Review 60+ days
Send appeal and/or reconsiderations on all denied claims
Provide feedback to leadership on any denial trends
Read and interpret EOB
Ability to communicate and answer question regarding payment issues
Bundled coding
The Next Door- Nashville, TN
07/2018- 01/2020
Billing/Collections Specialist
Scrubbed claims for accuracy and completed chart audits
Send Claims to Medicare and Medicaid for processing
Provided status on unpaid claims current to 120 days old
Called insurance company on all unpaid claims beyond 30 days
Accurately posted ERA and EOB to patient accounts
Prepared excel spreadsheet for ELT as needed for weekly financial meetings
Sent appeal and reconsideration information on all denied claims
Soar coordinator
Orianna Health Systems- Nashville, TN
11/2016- 05/2018
Billing/Accounts Receivable Specialist
Billed SNF claims using UB04
Completed outbound calls to insurance companies
Billing Follow up, cash posting of EOB and cash collections for accounts >30
File appeal and reconsideration
Fresenius Pharmacy- Franklin, TN
08/2015- 11/2016
Prior Authorization Specialist/Insurance Specialist
Prepared Prior Authorizations and processed insurance claims
Act as liaison between insurance companies and patients
Conducted outbound calls to insurance companies and verified patient insurance coverage
Collected copay payments from patients
Bureau of TN, Care-Nashville, TN
01/2014- 07/2015
Program Coordinator
Determined eligibility for Skilled Nursing and Long-term Care
Led peers/subordinates in preparing provider rates for long term care
Followed up calls to patients as needed for additional information
Department of Human Services- Nashville, TN
08/2008- 01/2014
Eligibility Counselor
Determined Medicaid and Medicare eligibility
Determined Food stamp and Families First eligibility
Verified income as reported by clients
Filed Medicaid, SNAP and Families First appeals
Education & Certifications:
Tennessee State University, Nashville, TN- Bachelor of Science, Sociology
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