INGRID HENDERSON

Richmond, CA 510-***-**** adwmio@r.postjobfree.com

Account Receivable Team Lead Managed Care/Health Plan

Collaborative and problem-solving customer service professional with 20+ years of experience in the healthcare field. Experience in call center support, claims, authorizations, call resolutions, grievance and appeals, Medi-Cal and Medicare claims. Well-versed with HIPAA to maintain confidentiality.

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TECHNOLOGY SKILLS

MISYS

ICD-10 AND ICD -9 CONVERSION

XIFIN

MICROSOFT SUITE / MICROSOFT WINDOWS (WORD AND EXCEL)

OUTLOOK

LOTUS NOTES

SALESFORCE (CRM)

LIMS

INCONTACT

MEDICAL TERMINOLOGY

HIPAA

CPT- CODING

MES V-TERMINAL

XIFIN- MARS

MEDICAL BILLING

KEYBOARDING SKILLS

PROFESSIONAL EXPERIENCE

Accounts Receivable Lead Billing Specialist 03/ 20/21 - present

I Rhythm Technologies Revenue Cycle Department (San Francisco, CA)

Resolve member concerns by providing them with detailed health plan information, Medicare Part D (pharmacy), and their benefits, resourcefully provide them with recommendations and alternative solutions

Accurately submits all claims and timely collections in accordance with third party contract terms including Medicare claims, Managed Care, and Private Pay

Examine and investigate denials and ensure that they are properly re-submitted with accurate information within the allowable time limit

Obtain, review and input insurance authorization and referrals prior to patient services.

Conduct insurance benefit investigations and appeal denied claims by communicating with clients and insurance agents

Prepare, review, and transmit claims using billing software, including electronic and paper claim processing

Communicate effectively via phone with patients, medical offices, and insurance companies.

Medical Benefits Specialist 06/01/19-03/20/21

Insurance Billing

Communicated the out-of-pocket expenses.

Assisted patients with navigating financial assistance program.

Secured and managed patients financial and medical records

Prior Authorization-Front End /Back-end Research and Appeals Specialist 11/16/2016 – 06/09/2019.

iRhythmtech.com (San Francisco, CA)

•Researched denial codes and compliance regulation by using sound judgment to solve problems for members who filed an appeal for a denied authorization or claim

•Interfaced with members, providers, physicians, clinical nurses, and medical providers to gather more information such as medical history, to resolve the appeal

•Obtained medical records for Medicare/Medical coverages, resulting in successful processing of 50 cases a day within the assigned authorization queue

•Tracked appeal cases on a weekly basis using Excel spreadsheets and inputted information into a database

•Synthesized information gathered from appeal cases to present to management, grievance & appeals, and regulatory agencies

•Communicated effectively through writing via email (Outlook) and on the phone with members and providers to follow-up and resolve complaints

•Documented calls, what was discussed, and steps taken towards resolution in an accurate, clear, and concise manner using Customer Relationship Management (CRM)

•Prepared and wrote resolution letters summarizing the grievance and mailed it to members

•Worked independently to perform quality checks of data entry by reviewing appeals and correcting claims processes to ensure timely delivery on billable claims

•Contacted 20+ insurance companies daily to confirm insurance coverage and eligibility of devices based on CPT codes Benefit investigation, out-pocket.

•Ability to analyze 35+ records and prior authorization requests to complete patient and insurance information with minimal supervision in a timely manner

Prior Authorization/ Research Reimbursement Specialist 03/25/2015 –11/01/2016

Natera Inc. (San Carlos, CA)

•Researches and corrects invalid or incorrect patient demographic information using a variety of patient registration/accounting systems to ensure proper billing transactions

•Work closely with lab information representatives to ensure CPT codes and ICD-10 codes are accurate.

•Assists patients by answering inbound calls and making outbound calls to answer inquiries regarding their accounts, payments, benefit plan options, and served as their point of contact for any verification issues

•Communicates and works with doctors’ offices or clinics, providers, and other staff to resolve accounts with patients who have outstanding balances and determined eligibility for financial assistance for patients who have financial difficulties.

•Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims through the end-to-end process of billing

•Liaison to billing team of changes in authorization process, insurance policies, billing requirements, rejection or denial codes as they pertain to claim processing and coding.

•Communicate effectively with clinic management and staff regarding department issues in order to promote continuous improvement, service delivery, and communications to meet company vision and goals

Pharmacy Technician 05/01/1998 – 03/25/2015.

Safeway’s Pharmacy

Receiving and confirming prescription orders

Preparing and filling prescriptions

Interacting with patients and answering questions.

Managing inventory.

Perform organization task.

EDUCATION

High School Diploma

Pentecostal Way of Truth School Academy Oakland, CA

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