Insurance Specialist Administrative Assistant
Resume:
Teresa Silva
*************@*****.***
SUMMARY OF QUALIFICATIONS
With more than 20 years of professional administrative, billing skills, I am eager to bring my experience, education, training and skills to a new position matching your current hiring needs. Throughout my career, I have been exposed to a wide variety of billing and insurance situations in a comprehensive range of health care settings, including extensive exposures to Medicare and Arizona Health Care Cost Containment Systems (AHCCCS). I am dedicated to delivering accurate and complete patient insurance and financial information and I possess the ability to easily establish positive, professional working relationships.
Accounting Business Finance & Communication Management
Customer Service Concepts Critical Thinking & Decision Making Business Law Marketing Quality Management Human Resource Management Business Principles A highly structured individual, I can work with the independence as required, or to work effectively in a team setting.
Medicare and AHCCCS billing and reimbursement
Prepare billings; prepare spreadsheets for revenue estimates and forecasts for management evaluation.
Possess knowledge of ICD-10, CPT codes and hundreds of medications and their approved uses.
Prepare documentation for insurance companies to acquire pre-approval/prior authorization when medical practitioner chooses to us "off-label" medication in patients’ treatments.
Oversee follow up, procurement and allocation of payments.
Carry out billing, collection and reporting activities according to the specific deadlines.
Manage reconciliation of all accounts.
Monitor patient account details for non-payment, delayed payments and other irregularities.
Accurately maintain accounts receivable patient files; make required corrections /changes.
Carefully investigate and resolve various patient inquiries; working with insurance companies on denials; process adjustments as necessary
Organize debt recovery system and initiate collection efforts.
Professionally communicate with patients via phone, email, mail or in person
Adhere to all HIPPAA and practice patient confidentiality requirements. EMPLOYMENT
CARBON HEALTH (SOUTHERN ARIZONA URGENT CARE) 09/02/2019-01/06/2023 REVENUE CYCLE SUPERVISOR – Oversee the day-to-day work functions of the billing department, provide support to staff and exercise cost control in order to accurately and timely process medical claims. Hire, inspire, motivate, coach counsel and supervise staff and front office. Monitor employee performance. Assess and allocate work, daily and special projects that may occur. Create Pivot tables for AR review and creating spreadsheets for team to work. Payroll approval, timecards, productivity audits, training, 1:1 team TUCSON MEDICAL CENTER-
09/01/2017-09/01/2018
Insurance specialist/ biller – submitted claims for processing –revenue cycle, follow up, billing, appeals. Day to day billing activities, reaching out to payers for updated claim information as applicable.
BANNER UNIVERSITY MEDICAL CENTER
08/18/2015-09/15/2016 (Cancer Center) - also 02/01/2019- 07/20/2019 as Temp thru Acclivity PATEINT FINANCE; Pre visit, secure Authorizations for Chemotherapy office visits, labs, in office procedures. Verify insurance eligibility, contact patients with estimated liability for treatments. Received authorization for cancer treatments, dealt with physicians on experimental case studies, Patient advocate, ensuring that patient was afforded cancer treatment, Follow up on denials AZ ONCOLOGY
11/07/2013-07/2015
INSURANCE SPECIALIST: insurance follow up, rejections, self-pay accounts; taking payments over the phone from patients/ insurance companies; Writing appeal letters, rebilling corrected claims. EYE ASSOCIATES OF TUCSON
03/15/2003-10/15/2013
FRONT OFFICE LEAD/ BILLING; As lead, assigned duties to front office staff, ensured that patient appointments and insurance information was correctly entered into system; answered multiline phone system; billing, entered charges; insurance follow up; processed statements; handled patient calls regarding billing issue; worked closely with the office staff as needed. Trained all front office staff. EDUCATION
PIMA MEDICAL INSTITUTE 2001-2002 MEDICAL ADMINISTRATIVE ASSISTANT Graduated with Honors.
Brookline College- Associates in Business applied Science Sept 2019 LS Coding – Professional Medical coding CPC -ICD-10 coding estimated graduation date TBD due to school issue with their system, currently in online class. Letters of recommendations available upon request
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