Claudia Neil

323-***-**** / 323-***-****-cell

CAREER OBJECTIVE: Seeking a challenging opportunity where I will be able to utilize my strong organization skills, educational background, and exceptional people skills, which will allow me to grow personally and professionally in the medical field.

Additional Skills: Microsoft Word, Excel, Power Point, Med soft Software 10 Key Medical Terminology Health Claims Examining Medical Billing/Coding, Data Entry

Systems Used: NextGen, GECB (General Electric Centricity Business), SMS, MCCS, and (IDX/PCS), RainTree, Onstaff, Epic, CPS-Centricity Practice Solutions

EXPERIENCE:

06/2022 – PRESENT - Robert Half Staffing Agency – USC

Position: Contract/Hospital Medical Collector and Patient Account Rep

Responsibility: As a medical collector I was responsible for the follow-up on insurance balances or self-pay accounts to ensure payment without delay is received from the insurance companies and patient due by patient. Processing high dollar amount claims, ensuring claim is netted down to the correct expected reimbursement amount and requesting related adjustments. Ascertaining the reason for underpayment or denial and writing effective appeal letters to procure additional amount owed to the hospital. Calling to obtain payment owed to the hospital or checking the insurance web portal for claims received and processed or denied. To ensure the maximum collection effects by organizing, and prioritizing daily workloads, providing required documentation and minimizing external delays. Identifying which payer or IPA is responsible for paying the hospital bill for each patient’s hospital account and make sure that they have received the claim for processing.

Systems used: VisiQuate, Assurance, MS4, and N-thrive

03/2021 – 10/2021 People Solution Staffing Agency- Torrance Memorial Physician Network

Position: Contract/Medical Collector & Biller and Patient Rep.

Responsibility: Follow-up with insurance companies regarding unpaid claims via phone, web portals or EOBs. Respond timely and accurately all incoming correspondence for all accounts and contact patient when necessary to obtain information for processing of claims (information needed by the insurance companies. Verify eligibility and review claim for possible refunds. Prepare and send appeal letter attached (including Medical Records) to all documents needed to have the claim review by the insurance companies for payment. Send Medial Records when requested by Attorney,

Systems used: CERNER

09/2016 – 11/2020

Position: Biller/Collector, Patient Account Rep and Credentialing

Responsibility: AHF - AHF specialize in medical treatment for patients with AIDS or HIV or have been exposed to it; within the US and other countries. I provided medical billing, collection, patient account services, verify eligibility, and process refund, for 15 clinics. As a Revenue Cycle Collector, I preformed necessary follow-up to obtain the appropriate reimbursement for the services that were rendered. This includes calling and sending appeals, for HMO/IPA, PPO, Medicare and Medi-cal. Possess and maintain governmental payer knowledgeable of all billing standards and collection requirement. Checking eligibility and adding the correct insurance information and other demographic information when necessary. Prepare doctors for credentialing and follow up for timely processing of documents. Investigate and resolve complaints/grievances/appeals/provider disputes within specific time frame.

Systems used: CPS Centricity Practice solutions

08/15 – 05/16 Navigant/Cymetric Gardena, CA

Position: Patient Account Representative

Responsibility: Navigant/Cymetric is a third party collecting companies for Peace Health Medical Group; located in WA State and Oregon. Collecting for both the facility and professional fees with a wide range of specialties: such as Internal Medicine to Imaging. Accessing the insurance company’s website or calling then directly to obtain status on the claims that have not been paid in a timely manner. Sending appeal letters and/or medical records when needed or requested. Billing patients for their responsibilities or contacting them if other information is needed to have the claim processed.

Systems used: Star and Metrix (Peace Health Systems).

11/13 – 08/15 LaPeer Surgery Center Los Angeles, CA

Position: Collector/Biller and Patient Account Rep

Responsibility: Priorities and complete assignment in a timely manner, maintain strong communication with our customer and focus to keep a sound and good relationship. Verification process for major medical insurance plan before the patient’s appointment to verify coverage and patients responsibility. Monitor and collect accounts to make sure they are paid in a timely manner. Independently motivated and driven to achieve high goals and seek continuous improvement in knowledge and skills. Appeal all account denied in error or paid incorrectly. Mail patients statements and/or call to collect on all past due balances. Work with Worker Compensation adjuster to get accounts paid and negotiate payments with attorneys on PI cases.

System used Experior

07/13 – 10/13 Molina Medical Group (Temp position) Long Beach, CA

Position: Medicare, Medicaid and Medi-cal and FPACT Collector

Responsibility: To monitor aging report and correspondence for Medicare, Medi-cal, Medicaid and FPACT and work accordingly. Appeal all claims denied in error or not paid correctly. Assist all clinics with any questions they may have pertaining to billing and collecting and assist patient with any question on their accounts. System used Centricity

04/13 – 05/13 Alls Well Staffing (Healthcare Partners/Talbert) Costa Mesa, CA

Position: Medicare Collector/Biller

Responsibilities: Run weekly report on all Medicare claims and work all claims 60 days and older. Check the electronic claims for all the ones rejected and work accordingly, receive all EOMBs and work them accordingly. Make sure that all providers NPI’s and PTAN stay current with Medicare. System used Epic

09/12 – 02/13 New Leaf Staffing (Planned Parenthood) Los Angeles, CA

Position: Medical Biller/Collector/Customer Service Representative

Responsibilities: Work with insurances like HMO, PPO, Medi/HMO’s. FPACT and others. Appeal incorrect payment and denials. Follow up on all assigned accounts. Research and analyzes on assigned accounts and make sure they are billed correctly. Verify authorization/certification, proper ICD-9 and CPT codes are used and insurance eligibility. Respond timely and accurately to all incoming correspondence from insurance companies, patients and other parties. When needed post payments, per EOB’s. Prepare refund request and response to all incoming phone calls. Maintaining patient’s demographics by keeping all medi-cal and FPACT information updated. System used NextGen

02/10 – 02/11 USC Care Medical Group Alhambra, CA

Position: Medical Biller/ Collector /Patient Account Coordinator

Responsibilities: Responds timely and accurately to all incoming calls and correspondence and inquiries from payers, patients and other appropriate parties. Submit claims to secondary insurances. Posting payments per EOB’s and appealing all incorrect payments or denials. Maintaining all patients’ files and answering financial and insurance questions from patients and other parties and verifying insurance. Run weekly reports on all assigned patient’s account to ensure accurate and timely billing of all dates of services and monitor all aging accounts and work accordingly. Make calls to patients and insurances companies to collect payments, when they are not paid in a timely manner. Send appeal letter when claims are not paid properly or denied incorrectly. Check status on claims by calling the insurance companies such as HMO, PPO, Medicare, and or Medi-cal. These insurance can also be checked by websites.

The system used was GECB (General Electric Centricity Business).

08/09 – 02/10 H.E.L.P. (Hospital Employee Labor Pool) – UCLA Healthcare

Position: Customer Service Representative

Responsibilities: Following up on all assigned accounts. Respond timely and accurately to all incoming calls and correspondence, inquiries from payer, patients and other appropriate parties. . Working correspondence from all insurance, HMO, PPO, and Medicare. Appealing all claims not paid correctly and auditing aging report. Prepare refund request. Submit claims to secondary insurance company.

System used was SMS, MCCS, and (IDX/PCS systems).

EDUCATION:

12/12 to 12/17 -- Kaplan University/Online

Associate Degree- Health Information Technician

02/10 – 04/11 --- University of Phoenix/Online

Course of Study -- Medical Management

10/03 – 06/04 California Healing Arts College L.A, CA Swedish massage, Deep Tissue Massage, Oscillation, and Shiatsu

02/96 – 09/96 Ladera Career Path Ladera Heights, CA Medical Billing, Medical Coding and Claims examining

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