Data Entry Payment Poster
Resume:
Renea Hidaro-Duncan
North Las Vegas, NV 89031
************@****.***
To find long term employment in an established firm where my skills may be used to a mutual advantage.
Work Experience
Department of the Air Force - Las Vegas
May 2020 - December 2022
Medical Support Assistant/Medical Records Manager
Front office processes and procedures, scheduling, training, secure email, check in patients, check out procedures to include follow up appointments, ensure that third party insurance information was correct, updated patient demographics if needed. Maintain patient data and supervise the employees with the medical records within the Mental Health Clinic. Manage and secure all written and electronic data within the Mental Health Clinic, and ensure that information contained in each record is complete, accurate, and secure. Scanned medical documentation to patients medical records. Worked closely with providers to ensure the daily process was completed in a timely manner. Created appointment slots for providers as needed.
Decypher Technologies - Las Vegas
March 2019 - January 2020
Medical Clerk
Front office processes and procedures, scheduling, training, secure email, check in patients, check out procedures to include follow up appointments, ensure that third party insurance information was correct, updated patient demographics if needed. Signature Performance/Health Management Partners - Las Vegas, NV March 2018 - February 2019
Medical BIlling Clerk
Prepares and transmits claims to third party payers using the UB-92, the HCFA 1500, Health Insurance Claim Form or other form required. Claims may also be processed electronically when available to the Government. Reviews Medical records for clarification of medical treatment history of illness medical tests, accident information or any other clarification for billing purposes. Use policies and procedures and processes or Third Party Collections, Medical Service Account and Medical Affirmative Claims IAW DoD 6010,15,M, Military Treatment Facility Uniformed Business Office Manual.
Department of Veterans Affair - Las Vegas, NV
May 2013 to February 2017
Financial Accounts Technician
Performed refund actions. Verified and confirmed all refunds were accurate and correct. Created refund vouchers through Access. Reviewed requests and compiled information necessary to complete refund requests from Third Party Payers. Performed aggressive follow-up actions based on outstanding third party receivables to determine the best course of action to affect maximum recovery. Analyzed, planned, initiated, coordinated and implemented actions required for collections of receivables. Responded to communications from third party payers. Contacted insurance companies and other third party payers to expedite collections. Determined when referral to Regional Counsel or other departments is appropriate for further progression of the collection. Analyzed and reviewed expected payments for consistency and were in accordance with the specific policy. Maintained and updated computerized records of debts to document collection efforts. Maintained working relationships with others throughout the organization as well as externally. Remained flexible to help out with other assignments as asked. Verified Veterans' insurance coverage for inpatient and outpatient services using insurance websites and making phone calls. Entering updated information and maintaining the database, including verifying benefits, policy numbers, pre-certification requirements, insurance company contact information and effective dates of coverage. Documented pre-admission requirements. Assisted with the precertification process and reviewing and explaining insurance coverage with Veterans. Coordinated completion of forms with patients, providers and administrative staff.
ABQ Health Partners - Albuquerque, NM
June 2011 to February 2013
Claims Specialist
Performed customer functions for patients including problem solving account discrepancies, served as a department liaison and researched financial activity within the accounting system. Ensured accurate and timely follow up for resolution of Patient Claim denials that impacted the organization's revenue cycle by maintaining knowledge of policy and procedures, insurance coverage benefit levels, eligibility systems and verification processes. Ensure appeals are processed in compliance with regulatory and reimbursement agencies and requirements as defined by various government agencies within a timely manner. Demonstrated customer service and cross-functional coordination of account information to promote and maintain positive customer service. Conducted third party and insurance follow up activity for account management resolution. Performed patient billing on behalf of physicians for non-collected services. Charge corrections through verification from the coding department. Presbyterian Medical Services - Albuquerque, NM
June 2010 to April 2011
Account Specialist I
Posted payment from commercial insurance using Explanation of Benefits and posted Medicaid Explanation of Benefits from Gateway EDI. Submitted secondary claims with proper Explanation of Benefits from the primary insurance. Also posted patient payments. Accountemp - Albuquerque, NM
March 2010 to June 2010
Account Specialist I
Temporary position held at Presbyterian Medical Services. Posted payments from commercial insurance companies using Explanation of Benefits and Medicaid Explanation of Benefits from Gateway EDI. Submitted secondary claims with proper Explanation of Benefits from primary insurance companies. Posted patient payments.
Tricore Reference Laboratories - Albuquerque, NM
September 2009 to January 2010
Third Party Collection Specialist
Performed collection activities on commercial insurance accounts by working aging reports focusing on 90 days and over accounts. Assisted in other payer groups to bring monthly percentages down. Follow up on claim status through insurance websites and over the phone. Problem solved billing issues (i.e. coding/modifier/diagnosis code issues). Received and worked correspondence. Electronic billing, secondary billing. Reviewed medical records for proper documentation for appeals.
Tucson Surgery Center - Tucson, AZ
April 2008 to August 2009
Patient Account Representative/Payment Poster
Customer service, data entry, phones, insurance billing, patient correspondence, collections, posting payments, posting EOB's, insurance correspondence and insurance follow-up. Tucson Pathology Associates - Tucson, AZ
August 2006 to January 2007
Patient Account Representative/Payment Poster
Customer service, data entry, phones, insurance billing, patient correspondence, collections, posting payments, posting EOB's, insurance correspondence and insurance follow-up. Skills
COLLECTIONS (8 years), CREDIT (8 years), BILLING (6 years), DATA ENTRY (4 years), INSURANCE BILLING (4 years)
Knowledge
MHS Genesis
ALTHA
CHCS
Outlook
Excel
HIPAA Compliance
VISTA Data Entry
HCPCS Medical Terminology
TPOCS Insurance Verification
CPT/ICD-9 Coding Account Receivable/Payable
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