Medical Transcriptionist Billing Specialist
Resume:
Resume
Shawn Renee McKinney
Email: adwkcs@r.postjobfree.com
Phone 512-***-****
MediRev/Tegria – 01/24/2022-10/26/2022
A/R Specialist
• Follow up on the A/R working providers claims where services were provided in a hospital inpatient and outpatient in multiple states for all insurance payers.
• Trained to learn the software and the FU protocols in place.
• Worked on a team covering various payers, provider types and clinics.
• Reviewed claims and made corrections and rebilled the claims.
• Worked in my que to complete 66 accounts a day.
• Reconciled patient accounts and fixed billing errors.
• Sent request to team responsible for passwords to various systems and payers.
• Completed notes in accounts according to protocol in place.
• Completed refund request according to the protocol in place.
• Worked on special projects with team as directed by supervisor.
• Followed protocol in place and sent claims to the credentialing department work que regarding providers claims that were rejected or denied due to the provider not being credentialed.
• Reviewed EOBs for missed payments and added the EOBs to the payment posters WQ for follow-up.
• Attended weekly and monthly meetings via google meetings. R3 Mobile Management/Insperity- 07/15/2020 – 12/17/2021 Medical Billing Specialist
• Follow up on the A/R for Rapid Radiology one of the clients contracted with R3 Mobile Mgmt.
• Worked with coders regarding coding issues on claims and denials.
• Worked with the payment posters on payment issues and and also trained the payment posters on posting the ERA’s. Worked with IT and our software vendor to set up the process to download ERA’s into OPS for processing and posting the ERA’s that were not coming thru the clearinghouse and causing a hold up with payments being posted.
• Posted ERA’s and manual payments for Rapid Radiology Inc.
• Set up insurances with payer ids in the insurance library in OPS.
• Reconciled patient accounts and fixed billing errors.
• Worked to set up logins for myself and other staff with various payers.
• Worked with OPS support the billing software vendor to fix issues on claims rejecting or missing information.
• Worked with the IT department regarding printing issues in the office along with computer issues.
• Scanned the correspondence received by mail to the drop box weekly.
• Worked on special projects with team and management.
• Fixed errors regarding the submission of claims to BCBS going out for providers providing services in states outside of Texas.
• Worked with the credentialing department regarding providers claims that were rejected or denied due to the provider not being credentialed. Comprehensive Healthcare Revenue Mgmt.- 07/23/2018 to 05/14/2020 Billing Specialist
• Accessed the database and billing software to review denials and unpaid claims daily.
• Contacted Insurance companies regarding unpaid claims, denials, and missing payments.
• Resubmitted claims to the insurance companies while working the A/R.
• Reviewed claims for prompt pay violations.
• Prepared and sent appeals to the insurance companies.
• Worked with the coders regarding denied charges, rejected claims, clearinghouse issues etc.
• Accessed the correspondence folders to work letters received from the insurance companies requesting additional information to process the claims and worked the EOB’s from insurance companies containing denials.
• Called insurance companies to obtain missing EOB’s.
• Submitted missing EOB’s to payment posting dept.
• Called patients to obtain updated insurance information.
• Called patients to collect past due balances.
Financial Investigation and Reimbursement Mgmt Lakeway, Texas 2012-2014 Office Manager/Medical Biller
• Managed the office located in Lakeway overseeing administrative functions.
• Supervised all staff.
• Worked with TWC to recruit staff. Handled all recruiting of staff.
• Prepared the staffs performance evaluations.
• Trained new staff.
• Monitored inventory and ordered supplies.
• Implemented an efficient follow-up system to expedite the recovery of 30-day outstanding payments from non-responsive insurance carriers.
• Responded to inquiries from providers on a broad scope of coverage issues pertaining to eligibility, explanation of benefits, and payment schedule.
• Responded to providers concerns regarding their monthly A/R and total payments received.
• Ensured claims were entered and submitted with 48 hours of receipt of charges.
• Posted and reconciled insurance and patient payments.
• Processed and mailed patient statements monthly.
• Answered and resolved patient billing issues and concerns.
• Set up new patient accounts.
• Verified correct ICD-9 and CPT codes for multiple specialties.
• Posted patient payments.
• Verified patient eligibility.
• Filed claims by way of the clearinghouse and by paper.
• Handled calls from the insurance payers.
• Provided end of month financial reports to our physicians.
• Managed time clock for all staff and submitted time sheets to payroll.
• Completed credentialing applications for providers.
• Placed cold calls to potential clients to establish new business. Central Park Imaging Center Austin,Texas- 2010-2012 Office Manager
• Managed front office and employees.
• Hired front office employees.
• Reviewed employee timesheets and submitted to payroll.
• Maintained a clean front office and waiting area.
• Maintained employees and physicians’ schedules.
• Processed statements for Group Bill Accounts.
• Pulled monthly reports from the billing software to provide to investors.
• Communicated with insurance companies and facilities regarding credentialing of the facilities physicians.
• Assisted patients with their accounts.
• Reviewed request for refunds to be forwarded to the accountant.
• Coordinated with the billing office to ensure all claim information needed had been received.
• Worked with the billing office to correct mistakes made by office staff.
• Worked with referring physicians and their staff to resolve issues and concerns.
• Ordered office supplies.
• Worked with the marketing manager to bring in new providers patients.
• Assisted in keeping all equipment working and repaired if needed.
• Received and distributed all mail.
• Reconciled group bill payments from providers.
Central Texas Kidney Associates Austin, Texas-2007-2009 Receptionist/Insurance Biller
• Checked patients in and collected co pays and balances.
• Entered all collections on a spreadsheet for each quarter.
• Ordered all office supplies.
• Received and distributed the mail for my location.
• Completed weekly bank deposit.
• Worked the A/R for all BCBS accounts.
• Rebilled claims.
• Responded to all correspondence from the insurance payers.
• Posted patient payments and insurance payments.
• Scheduled patient appointments.
Austin Psychotherapy Associates Austin, Texas-2004-2007 Administrative Assistant
• Checked patients in and out and scheduled follow up appointments.
• Took messages and screened calls for the physicians to ensure timely action was taken while also providing appropriate attention to the patients and their needs.
• Pulled and filed charts for two physicians daily.
• Processed prescription requests by phone and fax.
• Sorted mail for the 12 clinicians in the office daily.
• Processed co pays and posted payments to the patient's accounts.
• Followed up on past due balances.
• Entered patient data into Lytec.
Southwest Corporate Federal Credit Union Plano, Texas 1998-2003 EFT Representative
• Used Fed Plus to process incoming and outgoing wire transfers by daily cutoff time.
• Input international wires to US central by the 11:30 cutoff.
• Received and processed western unions daily by cutoff.
• Called member credit unions to notify of incoming wire transfers to insure timely posting to the customers’ accounts.
• Input of information on spreadsheet to be sent to accounting for posting to our member credit union accounts daily.
• Handled member credit union inquiries along with researching, tracing wire transfers and western unions.
Education- Moore High School- Moore, Oklahoma Diploma 1982 Software Experience-Word, Excel, Outlook, Lytec, Md Dictate, Amicas, Centricity,Medisoft, Nextgen, Clinical Works, Advanced MD
Clearinghouse- Availity, Relayhealth, Realmed, Gateway, Waystar KEY SKILLS
• ICD9, ICD10CPT & Medical Terminology
• Medical Insurance
• Excellent Interpersonal Skills
• Excellent Phone Skills
• Used multiple Billing Software Applications
• Used several clearinghouses for Medical Billing
• Claim Entry & Payment Posting
• Records Organization & Management
• Insurance & Patient Aging
• HIPAA Compliance
• Online Claim Submission & ERA Processing
• Transact and Western Union
• Fed Plus
• Payment posting
• Accounts receivable
REFERENCES
Tia Aspra
Owner/Operator
Financial Reimbursement and Management Services
1-830-***-**** or 830-***-****
adwkcs@r.postjobfree.com
Silvia Ciuffetelli
adwkcs@r.postjobfree.com
Previous Assistant Manager
The Firm
Sandra Davila
Accountant
adwkcs@r.postjobfree.com
Sherry Whispell
Medical Transcriptionist
adwkcs@r.postjobfree.com
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