Service Representative Medical Billing
Resume:
PATRICIA MARIE WILSON
Farmington Hills, Michigan 48336
248-***-**** // ***********@*****.***
Efficient, organized and detail oriented with proven success in problem solving and relationship building skills. Demonstrated success in developing target solutions that save time and money on projects and programs. Proven ability to coordinate projects in an ever-changing environment. Versatile and creative leader who possesses a strong work ethic and passion for achieving win/win scenarios for both customer / patient and organization.
Professional Experience
Brookdale Senior Living, Inc. Farmington Hills, MI
Director, Resident Programs & Transportation Services January 2022 – Current
Oversee the quality of life for resident engagement
Hires, Trains and Manages Associates
Leadership decision making to have a positive impact on community business operations including management of department budget and staff
Negotiates and manages community contracts in significant matters such as staffing, contract labor, vendors and entertainers
Participates in review of individual residents service plans and regulary documents progress. Participate in discharge planning with other members of the management team
Responds appropriately to resident emergencies, using independent judgment for in the moment decisions, calling or contacting appropriate internal and external parties according to protocol.
Ensures daily, weekly and monthly calendar of events requirements are met
Coordinates the transportation of residents to and from events outside of the community, which may include driving a community motor vehicle
Directly supervises Resident Program Assistants/Coordinators and Transportation driver as needed. May act in supervisory capacity as manager on duty or in the absence of the Execvutive Director, if assigned
NovaCare / Select Medical Livonia, MI / Pontiac, MI
Patient Service Specialist / Clinic Manger
August 2016 – January 2022
Hiring and training administrative staff
Evaluating staff performance
Scheduling staff for their work
Establishing office policies and procedures
Working with vendors to get needed equipment for the practice
supervising office staff, monitoring budgets and billings, ordering supplies, maintaining records, and ensuring that the day-to-day operations of our office run smoothly.
Patient appointment / schedulingObtain patient, billing and insurance information in order to maintain current and accurate information in patient files,TherapySource and RT Billing system. Also, prepare and work forms or reports and conduct billing or collection activities.
Insurance coverage and benefit levels with various third party payers and analyzes authorization and referrals, calculate patient liability.
Reporting Key center statistics to market management for sales, revenues, cash and patient flow.
Obtain and collect referrals and authorizations.
Verifies insurance coverage and benefits.
Reviews, monitors and reconciles patient accounts to ensure accurate bill productions along with third payer requirements.
Run and complete all front desk duties.
Ensure timely billing and coding of patients charts.
Dorsey schools Waterford, MI
Teaching Instructor for Medial Billing Feburary 2016 – March 2020
Teaching students – Supervisor for classes
Best practices in medical billing and practice managementIndustry-current electronic health records (EHR) software programs used in today’s physician’s practices, hospitals, and other medical facilities
Medical coding systems using CPT, ICD-9-CM, ICD-10-CM, and HCFA terminology, as well as hospital and institutional medical billing and coding. Coverage of medical terminology, anatomy, and physiology
The principles of accounting and business communication. Drafting reports, scheduling appointments, mangaging databases, filing insurance claims, and more.
Advantage First Aid August 2016 – August 2017
Customer Service Representative Manager / CPR trainer
Manage large amounts of incoming calls
Generate sales leads
Identify and assess customers’ needs to achieve satisfaction
Build sustainable relationships and trust with customer accounts through open and interactive communication
Provide accurate, valid and complete information by using the right methods/tools
Meet personal/customer service team sales targets and call handling quotads
Handle customer complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolutionKeep records of customer interactions, process customer accounts and file documents
Follow communication procedures, guidelines and policies
Customer Service, Product Knowledge, Quality Focus, Problem Solving, Market Knowledge, Documentation Skills, Listening, Phone Skills, Resolving Conflict, Analyzing Information,
Multi-tasking
Huron Valley-Sinai Hospital Commerce Twp, MI
Patient Access Rep II Coordnator
September 2010 – September 2016
Supervise Billing/intake operations, charge entry, payment posting, reimbursement mangament, referral intake and insureance verification, claim submissions, and accounts receivable follow up
Carry out audits
Train, allocate work and resolve probles amoug billing office personel
Provide motivation to employees to achieve their best performance and high degree of productivity
Register and schedule patients for health services
Explain appropriate forms to patient and family and ensures that necessary consent regulatory forms and MSP questionnaire are completed and that patient signatures are obtained.
Insurance coverage and benefit levels with various third party payers and analyzes authorization and referrals, calculates estimated patient liability.
Determines patient co-pay/deductibles and collects payment as outlined in hospital policies.
Assists patients in completing necessary forms and obtains patient signature as needed.
Collects referrals and authorizations as appropriate.
Attempts to secure telephone referral if necessary.
Resolves bill holds in a timely manner to ensure completion with 5 day bill hold reconciles and corrects any rejected transactions on user specific transmission.
Verifies insurance coverage and benefits.
Reviews, monitors and reconciles patient accounts to ensure accurate bill productions along with third payer requirements
COMPUTER AND TECHNICAL SKILLS
Microsoft Word, Excel, Power Point, Outlook, SharePoint, Microsoft Access and various proprietary software. Passport, Vision Share, Citrix, Impoc/Mosiaq,
First Net, Link, All insurance websites, Idoc, Workforce now, Apd, Portal Office,
Skill Port, Evolve, Engrade, Stericycle, SuperSaas, RT medical billing, Therapy Source, BCE reporting, DCRR and DPRL medical billing. Phreesia, AthenaNet, Powerchart, BSLNET, P.E.A.R, Coupa, UKG(Kronos).
Sound Solutions Farmington Hills, MI
Project/Office Manager 2001 – 2010
Prepared reports, summaries, and replies to inquiries by collecting, interpreting/calculating relevant information for various sources such as documentation, files and direct contact.
Responsible for daily operations of the office
Oversee patient care
Facilitate,evaluate and revise educational programming for all levels of nursing personnel as requestied
Support needs assigned units/clinics as needed
Implements Tenet programs for the nursing staff, with specific focus for units/clinics
Delivers/coordinates other programs as directed to support competence and professional growth of nursing staff
Organized materials for conferences, correspondence, appointments, meetings and interviews.
Worked closely with senior officers on scheduling as well as arranging appointments, interviews and business trips. Maintained schedule of commitments to avoid conflicts.
Facilitated a smooth-running, customer orientated operation which ensured staff worked together as a team.
Recruited, trained and monitored staff. Prepared work schedules. Assigns and reviews work performed by employees.
Maintains fiscal records by entering expenditures and income to unit accounts and prepares factual statements or reports
Creates, updates, revises, and retrieves files and records involving indexing and cross-filing requirements with responsibility for maintaining adequate, accurate, and accessible information, which may include confidential materials.
January 2012 Completed and passed the Certified Medical Assistant program with the American Red Cross
March 21 2011 Completed and passed the Nurse Assistant program with the American Red Cross -
Received Registry Document number in April 2011
BLS INSTRUCTOR CERTIFIED / AMERICAN HEART AND MEDIC FIRST AID
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