SANTRENA WHITFIELD

Houston, TX 469-***-**** adwiof@r.postjobfree.com www.linkedin.com/in/ santrena-whitfield-a635a5a1/

Cash Applications Specialist/ Cash Poster/ Payment Poster

PROFESSIONAL SUMMARY

A dedicated, competitive, results-driven professional with 22+ years of dynamic experience in patient account representation, medical claims researching, accounts receivable and accounts payable management, billing, and client services supervision. Proficient in accounts reconciliation and analysis, customer service management, medical terminologies, and medical claims processes. Adept in directing and implementing practical techniques and strategies to provide excellent healthcare management in compliance with company policies and procedures. Consistent in reaching goals and identifying opportunities while cultivating a positive and productive environment to foster healthy relationships in the workplace.

CORE EXPERTISE & COMPETENCIES

Process Improvement Accounts Receivable (AR) Accounts Payable Account Reconciliation Accounting External Audit

Internal Audit Invoicing Data Entry General Ledger Bank Reconciliations Cash Management Cash Receipts Medical Billing

Billing Process Journal Entries Payments Healthcare Management Medical Terminologies Electronic Medical Record (EMR)

Medical Coding Healthcare Information Technology (HIT) Current Procedural Terminology (CPT) Sarbanes-Oxley Act (SOX)

Standard Operating Procedures (SOPs) Revenue Cycle Management Revenue Analysis Commercial Operations Collaborative

Leadership Good Decision-Making Skills Problem-Solving Skills Strategic Planning Analytical Strong Attention to Detail

Excellent Organization Skills Time Management Skills Fine Interpersonal Skills Stellar Written and Verbal Communication Skills

PROFESSIONAL EXPERIENCE

Senior Cash Specialist- Revenue Cycle Operations

AmerisourceBergen/ CVS Health Initiative Carrollton, TX

Sep 2018 – Oct 2022

Lead the development and execution of revenue cycle operations through innovative and strategic thinking while supporting continuous organizational growth, partnering with vendors and internal business partners to increase efficiency and accuracy.

•Ensure compliance with established laws, regulations, policies, and procedures, protecting clients and employees, creating a better working environment, increasing worker productivity, and strengthening and safeguarding company operations.

•Drive operational requirements to support billing and collections, supporting strategic partnerships with health plans, and bringing market knowledge and expertise combined with data insights to develop new strategies and drive negotiations.

•Facilitate and foster teamwork within the operations team, continually evaluating procedures to streamline operations through improved processes and advanced technology and improve the overall services provided.

•Implement knowledge in revenue cycle management (RCM) by tracking, identifying, collecting, and managing incoming payments, helping the company foster financial transparency, and exercising judgment within standard operating procedures.

•Manage database accounts, maintain client customer confidentiality and HIPAA regulations with all data handling and transfers, including pharmacy financial affairs, perform customer verification, and process applications, orders, requests, and payments.

•Post daily payments, including adjustments, zero remits, payment corrections checks, wires, and credit transfers to customer accounts.

•Identify, reconcile, and post-forwarding balances received from payers while reviewing and negotiating unapplied payments.

•Perform billing and coding duties, assisting Team Lead in identifying and troubleshooting cash posting discrepancies to improve processes while providing training and support to inter-departmental associates.

•Provide documentation for incoming cash payments against receivables and ensure proper application of cash, wire, and other charges, independently and effectively resolving advanced accounts with minimal supervision.

Patient Account Representative

Fresenius Medical Care Plano, TX

Jun 2017 – Apr 2018

Thoroughly and proficiently entered remittance information and posted routine electronic, lockbox, and manual cash receipts, adjustments, and denials from insurance companies, governmental agencies, self-pay, and government payers.

•Liaised with insurance representatives and communicated with payers to interpret benefits, resolve any problems that may arise, verify patients’ insurance coverage, and seek pre-approval for necessary treatments.

•Refined and analyzed balancing reports to ensure accurate posting and adeptly balanced receipts through the generation and analysis of necessary information, resolving outstanding variances, errors, and issues before they escalated.

•Displayed a strong understanding of the medical billing process and the ability to coordinate and communicate with insurance companies and patients while performing all responsibilities in compliance with company policies and procedures.

•Disclosed and explained to payers’ insurance benefits while carefully reviewing medical records for accuracy and completion as required by insurance companies. Strictly followed all federal and state guidelines for the release of information.

PROFESSIONAL EXPERIENCE (continued)

Examiner

Shield Healthcare Carrollton, TX

Sep 2016 – May 2017

Researched, reviewed, and finalized provider claims within established regulatory requirements and insurance guidelines for accuracy and completeness, providing follow-up and intervention for provider claim inquiries.

•Documented all provider contacts and verified commercial and government payer accounts such as BCBS, UHC, Aetna, Cigna, Humana, self-pay, Medicare, and Medicaid to provide proper coverages, capabilities, and price fit for clients.

•Maintained and filed all required documents, ensuring accuracy and correctness before releasing the order for billing.

•Worked and functioned with internal teams and departments to review and follow carrier billing instructions, ensure application processing, contract execution, credentialing providers, and insurance verification and eligibility.

•Performed other duties and special projects as the manager assigned and directed while working on various monthly reports.

Billing Specialist Aug 2015 – Aug 2016

Summit Medical Center Edmond, OK

Sent invoices and account updates to clients, received, sorted, and tracked incoming payments with precision, and professionally addressed client questions and queries while providing accurate reports of billing data.

•Reviewed and ensured all commercial and government claims such as BCBS, UHC, Aetna, Cigna, Humana, Medicare, and Medicaid were ready for transmittal and made any corrections to claims before the submission.

•Processed billings for ICD-9 and ICD-10, managing the status of accounts and balances while identifying inconsistencies.

•Adhered to laws and best practices with regard to protecting client’s data and information, on top of performing other duties assigned and requested. Collaborated with coworkers and other departments regarding concerns with accounts.

•Refined and worked on aged accounts payable, estimating the number of uncollectible accounts receivable into time buckets.

•Confirmed the accuracy of demographic and insurance information of clients to run an efficient medical center and conducted follow-ups on rejected or denied claims in clearinghouse Greenway and by duty re-filed claims.

Cash Poster

Oklahoma Heart Hospital Oklahoma, OK

Apr 2014 – Feb 2015

Posted and received checks, processed payments from insurance companies and patients, and maintained a detailed recording of all accounts, including adjustments, and denials from patients, commercial insurance companies, and governmental agencies.

•Primed finance-related tasks, including assembling supporting information for payment processing, checking figures, postings, and documents for correct entry, mathematical accuracy, and proper code application.

•Recorded, balanced, debited, credited, and totaled accounts with dates and initials on the payment receipt spreadsheet and database to efficiently and accurately run transaction reports and enter invoices into the computer system.

•Ensured strict compliance with federal, state, and company policies, procedures, and regulations to streamline internal processes.

Accounts Receivable Representative

Concentra Urgent Care Billing Office Addison, TX

Oct 2013 – Dec 2013

Prepared, posted, verified, and recorded customer payments and transactions by reconciling clients’ check and credit card transactions. Maintained and updated client files, including name and address changes, mergers, including mailing attentions.

•Drafted correspondence for past due accounts and collections, collecting revenue by contacting and notifying customers of insufficient and delinquent payments. Furnished reports on the current status of client accounts as requested.

•Dexterously maintained an accounting ledger, researching and resolving client account discrepancies and past-due amounts by collaborating with other staff, personally investigating documents, and conducting insurance verification.

•Performed administrative duties such as answering queries, receiving incoming calls, and routing them to the appropriate department.

Patient Account Representative

HCFS Inc./ Methodist Richardson Frisco, TX

Jan 2009 – Mar 2013

Handled all matters concerning patient billing and medical insurance claims, correctly matching self-pay patients to federal, state, county, or third-party payer programs. Collected payments and created suitable payment plans for patients.

•Established a patient recording system that detailed patient treatment, managing cases for a patient regarding Social Security, Medicaid, Medicare, workers' compensation, and third-party coverage, including the appeal process.

•Communicated with medical insurance providers, instructing and assisting patients with eligibility processes while in a hospital setting, including processing eligibility forms, applications, and methods from computer-generated reports and referrals.

•Updated and completed proper forms and documentation according to standard operating procedures (SOPs) for the coding and closing of all accounts; also reviewed statements at a resolution to ensure guidelines have been complied with.

PROFESSIONAL EXPERIENCE (continued)

Account Receivables (AR) & Account Payables (AP) Representative

Credit Solutions of America Addison, TX

Jun 2006 - Jun 2008

Assisted with the general operations of the finance department by maintaining financial records, screening documentation, resolving discrepancies and disputes, and ensuring all payments made were in accordance with company policies.

•Posted payments to customer accounts and contacted creditors to set up payments for the customer’s settled accounts.

•Organized and filed deposit receipts, reconciling cash and deposits while analyzing financial records for accuracy.

•Accurately recorded, computed, classified, and entered complete financial data in a specialized computer processing system.

Client Services Supervisor

Credit Solutions of America Addison, TX

Jun 2006 - Jun 2008

Managed and supervised a department of 40+ customer service representatives to drive quality performance of duties such as responding to customer queries, resolving complaints, and addressing issues before escalation.

•Organized, oversaw, and delegated tasks, provided coaching to representatives, and scheduled work to appropriate departments.

•Conducted and completed constructive regular performance evaluations to track progress and determine areas of improvement, creating and summarizing reports to show the team's daily, weekly and monthly gain.

•Assembled new hire workstations by submitting IT tickets promptly, answering questions regarding call procedures, and providing departmental documents, identifying opportunities to update and improve customer service procedures.

Inpatient Hospital Medical Claim Researcher

Concentra Preferred Systems Carrollton, TX

Jan 2000 – Dec 2005

Maintained records, files, and documentation, providing detailed reporting on data such as claims, savings, and billed charges. Determined medical claims' status and researched United Healthcare's shares to ensure accurate payments.

•Organized claims within guidelines and standards against overbilling, coding errors, and contract mistakes to prevent fraud and abuse.

•Provided excellent customer service by resolving claim issues, such as assisting in identifying refunds received by the client.

•Conducted customer service calls to hospitals to verify patient information and money due to the insurance carrier for clearance.

TECHNICAL SKILLS

Alpha Numeric Data Entry Spreadsheets HCX/ Meridian

Healthcare Software: Meditech, Stockell, Soarian, MedAssets, Greenway Clearing House

Software: 10 Key, Windows, Citrix, Centricity, AS400

Social Media: Facebook, Instagram, Twitter, TikTok, LinkedIn

Google Suite: Docs, Drive, Sheets, Presentations

Microsoft Office Suite: Word, Excel, PowerPoint, SharePoint, Outlook

Contact this candidate