Eduarda (Edna) Concha Cell# 312-***-**** email: adzb02@r.postjobfree.com

Objective: To obtain a challenging position in which I can utilize my skills & experience to be able to learn & grow with the business.

Experience:

Community First Medical Center: 5645 W. Addison Chicago, IL. 60634

Revenue Cycle Dept. (Biller & Collector) 10/2022 to Current

• Run daily reports on claims that dropped for billing, A.R & the Medi-Medi accounts

• Complete, scan & upload in Medi System - HFS form(s) on Adjustments & Overrides

• Work on 835/vouchers received in OneSource on payments & denials

• Help peers with questions on portals, EOBs, Remittance etc.

• Work daily work-queues with the highest to lowest balances

• Send emails to Department Heads & Associates when correcting accounts with updated insurance(s), correct spelling of patient(s) name.

• Bring up issues to be resolved in our weekly meetings

• Request Medical Records for appeals & recons.

• Make calls to HFS on accounts that show the patient has a third-party liability that terminated or no longer had Medicare part A or B benefits, also to check on claim status or errors codes not listed on HFS’s denial code list.

Chicago Behavioral Hospital 847-***-**** 555 Wilson Lane, Des Plaines, Il. 60016

Biller – Government & Non-Government 05/10/21-08/12/22

• Download Reports, scan & email to Depts. Leads & Collectors.

• Bill all claims that dropped in the Clearinghouse, enter notes in accounts

• F/U on Medicare & Medicaid accounts, write up Medi-Medi adjustments

• Answer all emails & resolve issues, before the end of shift

• Complete work list in Comp Data on all four Hospitals

• Work Daily EOBs on Medicare & Medicaid, A/R & Rev Cycle end of the Month Closing

St. Anthony Hospital 773-***-****

Insurance Representative/Collector & Biller 12/07/15-10/16/20

Patient Financial Counselor/Public Aid Coordinator 06/25/07/12/06/15

• Run a report on all commercial ins., bill all claims, UB04, 1500, 2360s

• Run a second report on all HMO/IDPA & on all secondary claims, bill claims.

• Enter late charges which are given daily

• Bill Dialysis claims once a month & Do Import for a week once a month

• Continue to assist co-workers with questions in follow-up, recons, & appeals

• Change and update correct insurance when registered incorrect

• Submit claims electronic and hard copy claims in a timely manner

• Payments received that were underpaid are appealed.

• Changed, updated insur., review denials, resubmit a corrected claim, worked weekly mail.

• Review account for authorization for inpatient, observation, therapy & or infusion center.

• Work the daily EOBs and work the account in question.

• Call insur., for claim status, for elig., & have claim(s) reprocessed for re- considered for payment.

Volunteered: Scheduled & Organized ideas for (Blood-Drives), Suggestion Box, Employee of the Month Awards, State IDs, Voters Registration, Oktoberfest, Summer Picnics & outdoor Concerts, Penny & Nickel Carnival. SAH Summer Fest. Suggested to Administration, employees who signed up for quick pay auto-deductions the ability to be used in the Gift Shop, etc.

History: Over 45 years in the Health Field Industry completing Medical Applications for both H.A.S Hospital Assistance Services & N.H.S- Nursing Home Services. Appealed cases that were denied cases were reconsidered, reopened & backdated for dates of services. Over 35 years as an Office Manager & Billing Specialist. Program Manager.

Education: St. Mary’s High School – 1978, Illinois Institute of Art – Business Management & Culinary associate degree 2012-2015.

Software & Experience: Ibex, Ceridian, Swank Healthcare, Excel, Microsoft Word, Spreadsheets, General Ledgers, Bookkeeping, GAAP (Generally Accepted Accounting Principles), Kronos, A/R, Billing, Adjustments & write-offs, Outlook, Many Insurance Portals, Disputes, Appeals & Reconsideration Request. eCare/Nebo, Healthcare, WellCare, Medi system & I Exchange, (HIQA, FSS0) Florida Share System, CompData, DDE/Medicare, Waystar, SSI Clearinghouse & Epic, Matrix, Assessmentpro, Aida, Aidin, Allscripts. Paragon. Epic

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