Data Entry Reimbursement Specialist
Resume:
Kimberly R. Greene
Philadelphia, PA 19141
*********@*****.***
Technical Skills: Microsoft Word, Excel, Outlook, PowerPoint, Data Entry, Typing, Meditech, SMS, Facets, IDX, Diamond, Spectrum, and Care Planner System, NaviNet, Nextgen, Emdeon, PEMS, Web MD, Navicure, Promise, Athena, Pear Portal.
Martin Luther King High School, Philadelphia, PA
High School Diploma
Employment:
2021-Present A/R Rep Ophthalmic Partners Bala Cynwyd, PA
Responsibility includes addressing and sorting any incoming correspondence, initiating collections o any accounts that are past due. Resolve any billing issues denials, appeals, rebilling, coding. Answer client calls and process customer payments by recording checks, cash, and credit card transactions as well as posting insurance payments in billing system. Update customer demographic information and sort and distribute incoming mail.
2014-2020 A/R Rep Mercy Health System, Conshohocken, PA
Responsible for processing and responding to all correspondence and telephone billing related issues in a timely and effective manner. Reviewed and investigated all documentation for completeness. Updated patient/insurance information in Nextgen/Athena system. Reconciled account balances to insure receipt of accurate insurance and patient copays and or deductibles. Responsible for billing and collecting on insurance and patient balances on Medicare and Medicaid and Commercial insurances. Bill on primary and or any secondary insurance through Nextgen/Athena. Submit appeals for missing authorization and/or medical necessity. Reviewed EOB and COB issues. Met productivity goals. Followed up on accounts within a 30 day turn around. Documented all accounts with a complete response or follow up response.
2013-2013 Reimbursement Specialist Cardionet, Conshohocken, PA
Responsible for collecting and billing balances on over 200 commercial insurance accounts. Handled correspondence from insurance carriers. Resolved denials, filed appeals, contacted health insurance carriers for payment status as well as verifying missing insurance and demographic information from patient. Verified that claims were completed in a timely manner for payment. Worked with Excel spreadsheets daily while meeting monthly productivity. Coding and rebilling all claims that were incomplete or denied in Nextgen system. Answered phone calls from patients and insurance companies, as well as Provider offices and effectively notated all communication on accounts to resolve any problems.
2008-2012 Precert Associate Premier Prizm Solutions Marlton, NJ
Responsible for entering data for NJ PIP (Personal Injury Protection) claims in Spectrum system within an expected time frame and meeting or exceeding set benchmarks while maintaining quality of work. Performed special projects and checked for provider credentials.
2001-2007 Medical Claims Biller Select Financial Jenkintown, PA
Entered data from paper and electronic medical claims in IDX system. UB 92, HCFA 1500, 3rd party billing. Processed and sent the bills for Medicaid, Medicare, and Auto claims. Called and verified eligibility status with insurance companies as well as follow up calls for payment status.
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