Billing Clerk Medical
Resume:
DAWNICA R. HICKS
Pearland, TX *****• adu71n@r.postjobfree.com• 713-***-****
SUMMARY
Detailed-oriented professional with over ten years of professional experience in facilitating purchasing inventory and various managerial functions. Highly adaptable in mastering new process functions and navigating complex protocols . Seeking to leverage and align professional experience to organize and streamline inventory optimization and supply chain management.
EDUCATION
National Institute of Technology, Medical Billing and Coding, May 2005 PROFESSIONAL EXPERIENCE
Altus Biologics, Pearland, TX Feb 2020 –Present
Procurement and Purchasing Supervisor
● Improve operational efficiency and process enhancement by triaging operational and compliance needs, tracking inventory, and monitoring error reduction, and certifying the timely processing of orders and requisitions.
● Implement inventory control functions as directed by departmental SOPs and ensure timely output schedule.
● Collaborate with vendors and partners to develop, apply, and monitor products and services availability against ongoing supply chain requirements.
● Review purchase order requests
● Build relationships with clients and vendors
● Collaborate with interdepartmental leadership to identify and develop requirements for equipment and medication
● Maintain purchasing record keeping systems
● Coordinates removal or disposal of surplus materials
● Assesses current material availability, predict future availability based on market, delivery systems and other variables.
Out of Network Supervisor, Pearland, TX Feb 2015-Feb 2020
● Design and test enhancements to company database
● Submit appeals and claim reconsiderations when applicable for denied claims
● Collaborate with management for policy updates for identified trends and clinical policy updates from various payers
● Initiate calls with patients and send correspondences in order to update policy information with payer
● Document work performed in billing management system
● Run A/R Aging reports for assigned clients and follow up on outstanding A/R accounts
● Review a minimum of 20 accounts daily as well as maintain 120+ A/R at or below 15%
● Independently decide steps in resolving claim issues; able to search and solve issues
● Train new hires as well as assist with re-training for established employees
● Review patient chart to determine medical necessity based on payer policy for patients whom meet OON criteria
● Compile necessary forms for OON patient in accordance to the Affordable Care Act
● Provide Self Pay Quotes for self pay patients utilizing dosage and fee schedule
● Provide guidance to team members on completion of various tasks while encouraging them to remain focused Universal Weather and Aviation, Houston, TX Apr 2013 –Jul 2014 Third Party Billing Clerk
● Analyze and address barriers to receiving and validating accurate billing and insurance information while ensuring data quality.
● Serve as a liaison for various constituents and consulted with third party payers to resolve billing and reimbursement accuracy.
Primary Services, Houston, TX Feb 2012 – Jan 2013
Claims Validation
● Execute root cause analysis to determine source of claim discrepancies. Review and verify contract terms to ensure accurate payment reconciliation.
● Manage client insurance guidelines and verify eligibility to reduce noncompliance and process inefficiencies. Houston Cardiac Association, Houston, TX Jan 2011 – Jan 2012 Billing Clerk
● Maintain proper reporting and communications to Director of Revenue Cycle & Credentialing and CFO.
● Coordinate PI billing accounts for accurate payment posting and collections processes. Aramat Billing Services, Houston, TX Apr 2008 – Dec 2010 Billing Specialist
● Manage client accounts and support software maintenance, procedural troubleshooting, and multi-project management.
● Executed auditing processes, including review, analysis, and monitoring of procedures, performance, and systems management for claims processing.
Contact this candidate