Account receivable
Resume:
**** *. ***** ******, ******, CO 80223 • 720-***-**** (Cell) • Email: ******.****@*******.*** INSURANCE SPECIALIST/PROJECTS COORDINATOR
HEALTHCARE/ADMINISTRATION
Revenue and Recovery Managed Care Providers Quality Assurance KEY PROFESSIONAL QUALIFICATIONS
Insurance Claims/Managed Care Providers Projects Coordination
Proofreading/Editing Billing/Auditing/Collections
Data Entry/10-Key by Touch Medical Records
Knowledgeable in Microsoft Word, Excel,
Outlook
Strong Analytical and Problem-Solving
Skills
Efficient/Well-organized/Able to prioritize Self-Motivated/Eager to Learn New Skills
Detail-Oriented/Goal-Oriented Commitment to Excellence PROFESSIONAL EXPERIENCE
ENCOMPASS HALTHCARE BILLING, Lakewood, Co 2020-February 2023 Account AR Billing Representative
-Responsible for working assigned accounts by insurance and/o r patients.
-Follow up with the insurance companies for s t a tus on c l a ims/appeals.
-Contact patients for p ayments o r o ther b i l l ing information.
-Correct and/o r appeals d enied or rejected claims.
-Resolve incorrectly paid claims.
-Work o ther shared duties a s required.
-Ensure s econdary carrier i s appropriately b i l l ed or s elf pay portion i s pursued.
-Basic knowledge o f CPT and ICD-10 s ervice skills.-Detailed oriented with an ability to work in a fast p aced and busy environment, organizational s i l l s . HealthOne-Data Entry 2013 to 2019
-Payment poster
-Account Receivable
KAISER PERMANENTE,Denver,CO 2012 to June 2013
Quality Assurance Analyst (April 2012 to June 2013)**This was a Temp Position only***
-Perform claims payment audits on Xcel based data extracts to ensure benefits paid according to Provider Contract.
-Analyze data on completed audits to compile results by error type and give recommendations for continued audit and potential analyst.
-Prepare audit results reports for senior management to provide quantitative results of Provider Contract audits
ROCKY MOUNTAIN POISON DRUG CENTER, Denver, CO 2011 to September 2011 Clerical Support Specialist V, Drug Administration (January 2011 to September, 2011) - Worked as a Call Center-Handled and document all calls.
-At the end of each day it is my responsibility of the PM Team call Center Specialist to ensure all Cases created are closed and pulled a reconciliation report for each appropriate department from Database. A copy of the report is sent to each department for the cases generated that day. THE CHILDREN'S HOSPITAL, Denver, CO 2004 to August, 2010 Revenue and Recovery Analyst (December, 2009 to August 2010)
Worked directly with Contract Manager to problem-solve and resolve pay issues
Liaison between all parties to correct errors as necessary including all involved departments within the hospital as well as the managed care providers with continual communication and follow-up
Responsible for analysis of denied reimbursement claims by compiling, researching, analyzing and resolving medical insurance code issues (Revenue Codes, CPT Codes, ICD-9 Codes) for pay problems
Ensured appropriate insurance coverage for compliance standards and revenue generation
Reviewed, created and entered ledger data on Excel spreadsheets for review by the providers Selected Accomplishments:
Researched incoming revenue and payments not previously collected/Discovered over $900K in lost revenues and recovered over $500K of that revenue
Created a package for the providers to obtain all documents necessary and, therefore, decreasing payment time by the provider
Insurance Representative-Payment Review (2006 to December, 2009)
Used assertive follow-up techniques with commercial and managed care payers
Provided additional information, corrections and problem-resolution as needed to ensure prompt and accurate payment
• Used correct matrices to ensure accurate payment and calculate/adjust accounts according to individual agreements
Followed-up with payers to resolve payment discrepancies
Processed denials to meet payer timely guidelines M 0 NA KASSAB Page 2 of 3
2692 S. Acoma Street, Denver, CO 80223 • 720-***-**** (Cell) • Email: ******.****@*******.*** Patient Services Coordinator (2004 to 2006)
(Front Office Assistant Duties)
Checked patients in and out
Scheduled appointments
Answered heavy volume of telephone calls
Maintained medical records
COLORADO ANESTHESIA CONSULTANTS, Denver, CO 2002 to 2004
(Large practice of 47 Anesthesiologists as a billing service for 15 additional Anesthesiologists that practiced at The Children's Hospital)
Researcher/Billing Coordinator
Audited all incoming charges prior to being billed
Verified all federal payers accounts
Performed billing and collections for non-contracted commercial insurance audit accounts prior to being sent to the collection agency
In charge of all pre-auditing of employee timecards RADIOLOGY IMAGING ASSOCIATES, Denver, CO 1997 to 2002 Insurance Editor Specialist
• Prepared correspondences, editing, and returned insurance claims for Swedish and Craig Hospitals
Maintained daily contact with patients and insurance companies regarding claims that had been returned and then resubmitted the claims to the insurance companies
Posted payments both manually and electronically for Medicare, private pay and other miscellaneous accounts
Provided quality customer service to insurance companies, private parties and co-workers SOUTH FAMILY PHYSICIAN, Denver, CO
Front Office Assistant
Scheduled appointments
• Answering heavy volume of telephone calls
Made referrals
Processed insurance claims
1994 to 1997
TELECHECK, Denver, CO 1992 to 1994
Senior Check Analyst (Responsible for leading and assisting Profile Clerks)
Monitored and scheduled work tlow and made sure department standards and procedures were met
Performed bank verifications as needed
• Edited and followed up on profile records to ensure accuracy
Conducted quality review and prepared production sheets
Maintained bank phone database
Established and administered programs to better track and utilize data reports
Received the "You Made It Happen" Award for going "above and beyond" the day-to-day job responsibilities
CADE CLINIQUE, Denver, CO 1990 to 1992
Electrolysis Technician
Removed unwanted hair from customers
In addition, performed general office duties which included scheduling appointments, recorded daily sales records, billing and processed mail
MONA KASSAB Page 3 of 3
2692 S. Acoma Street, Denver, CO 80223 • 720-***-**** (Cell) • Email: ******.****@*******.*** EDUCATION
IN MEDICAL ASSISTING AND EKG
DENVER TECHNICAL COLLEGE, Denver, CO
ADDITIONAL SKILLS: Payroll/Cashier/Lab Assistant/Night Auditor EXCELLENT REFERENCES AVAILABLE UPON REQUEST
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