Willette Rose

Collection Specialist

Temecula, CA 92592

adxot9@r.postjobfree.com

619-***-****

Work Experience

Medical biller, Collections Rep, Payment Poster, Patient Rep

Chrysalis Psychiatry

August 2022 – February 2023

Billed claims to Commercial, Medicare and Tricare Insurance.

Worked for 1 Psychiatrist and 2 PA.

Posted all payments received and sent statements to patients on all patient responsibility due

Followed up with Insurance to verify claims was received and is in processing or get payment information.

Worked on unpaid

Claim and authorizations

Cleaned up old AR to bring it up to 60 days or less

Software: Kareo

Billing /Credentialing Assistant

Bridges Community Services LLC

July 2022- August 2022

Reviewed Referrals and verified Insurance and enter info in to the System

Created Follow up Spreadsheet for Medicaid Plan in MO.

Created Insurance phone and contact list

Worked Denied claims to verify reason for denial

Worked on Credentialing issue with Payers on claims that were incorrectly denying as Non Par provider.

Called Insurances for Authorizations

Posted payments

Billed Secondary Claims

Rebilled claims that were rejected.

Authorizations Rep

Palomar Health Medical Group

August 2021-December 2021

Submitted Authorization request to Insurance Companies Via Online portal or Phone call

Submitted all documentation to include test results and Medical records

Verify CPT code and DX code were correct for requested authorization

Worked with all Insurance companies to include Commercial HMO, PPO, Tricare, Medi-cal HMO Plans

Phone calls with rendering providers and Patient calls

Insurance Verification

System Used: Next-Gen

Collections and Billing Support Specialist for Substance Abuse Facility

Alpine Recovery Lodge

Sept 2020 – June 2021

Collection calls to All Insurances for follow up on claim status and payments

Patient calls for share of cost due per there Insurance payment

Maintained Spreadsheet on all outstanding Accounts Payable

Verify Eligibility and Coordination of Benefits with Insurance Via Online Portal or Phone Call

Updated Credentials for Physicians under Facility Tax ID number

Assisted with Billing issues via the payer code and or Clearinghouse

Worked all Correspondence

Identified Payer issues

System Used: Avea, Kipu

Collections Representative

EA Health Solutions

October 2019-January 2020

Follow up on all Medicare claims on Noridian Portal

Sent claims back to coding department of coding errors

Verified Eligibility an Coordination of Benefits

Identified incorrect denials and submitted Medical records

Verified Discrepancies with Insurance information provided

System Used: Patient Fusion

Temporary Employment Agencies

Collections Representative

Temp Unlimited

August 2019-September 2019

Calling Insurance for claim status and payment

Submitting Medical Records

Working all Correspondence

Submitting Patient statements

Worked aging Accounts Payable Spreadsheet

Collections Representative

Manpower Murrieta

May 2019-July2019

Calling Insurance for claim status and payment

Submitting Medical Records

Working all Correspondence

Submitting Patient statements

Patient calls, taking Credit Card information for payments

Verified Eligibility and Coordination of Benefits

Submit Medical records

Submitted and worked appeal claims

Mailed out claims

Updated patient demographics and Insurance Billing information

Reimbursement Representative

CHMB/Allscripts

January 2018-March 2019c

(Corporate Lay Off)

Collections for 3rd Party Administrator

Identified and worked closely with Management to identify Credentialing and payer issue.

Submitted appeal for under payment and ICD, CPT denials

Submitted Corrected claims

Verified Eligibility and Coordination of Benefits

Patient call, taking Credit card information for payment

Reduced cost and increased revenue by identifying non payable codes and confirming correct billing information such as payer ID number and Billing addresses

Identified and corrected Credentialing issues

Mailed out claims

Worked Accounts Payable aging Spreadsheet

System Used : Allscripts

Collections Representative

Rancho Physical Therapy

March 2017 –January 2018

Worked with Medicare and Medicaid, Accounts Receivable

Verified Medicare Secondary Payer

Worked Account Receivables for Contacted Insurance Plans

Finding solutions for quicker reimbursement

Submitted requested information on Work Comp claims

Identified payer trends

Submitted and worked Appels

Performed all Compliance testing supporting HIPPA

Systems used: AMD, Ducs

Reimbursement Representative

Genoptix Clinical Laboratory

December 2009-January 2017

Collections for Cancer laboratory

Identified and worked closely with Management to identify Credentialing and payer issue.

Submitted appeal for under payment and ICD, CPT denials

Submitted Corrected claims

Verified Eligibility and Coordination of Benefits

Patient call, taking Credit card information for payment

Reduced cost and increased revenue by identifying non payable codes and confirming correct billing information such as payer ID number and Billing addresses

Identified and corrected Credentialing issues

Mailed out claims

Worked Accounts Payable aging Spreadsheet

System Used: Quadex

Palomar Pomerado Health Systems

September 2001-March 2009

Collections rep for 2 hospitals. Pomerado, Palomar Trauma Center

Worked with all Helath Insurance plans

Verified Insurance and Coordination of Benefits

Submitted Medical Records

Identified under payments and submitted appeals

Identified Payer trends

Managed aging accounts payable spreadsheet

Responsible for a muliti million dollar account and received payment

Managed timely billing and payment issues

System Used: Cerner

Contact this candidate