Less Than Customer Service
Resume:
Patricia Bess
Collections Specialist III
Farmers Branch, TX 75234
*********@*****.***
is my desire to obtain a position which will enable me to utilize the knowledge, experience and abilities that I have acquired through my years in the Health Insurance field. Work Experience
Collections Specialist III
Miraca Life Sciences - Irving, TX
June 2013 to April 2015
Responsible for filing claims to insurance companies and follow up to ensure proper payment has been posted.
• Communicated to carriers, patients, other facilities to get max payment • Identified and resolved billing issues to achieve profit • Researched and resolved delinquent insurance accounts • Appealed claims, followed up on patient statements • Acquired knowledge of payers fees and denials • Worked many special projects related to duties as required • Ability to work independently and make appropriate decisions on accounts to be worked to maximize payment • Resolutions on accounts Insurance Collector
Insight Global - Irving, TX
October 2011 to January 2012
• Responsible for 90 days and over for hospital claims • Worked 450 appeals for other hospitals.
• Worked Medicaid/Medicare accounts to clear old accounts. Insurance Collector
Intrepid USA Healthcare - Dallas, TX
December 2007 to September 2010
Biller • Responsible for timely resolution of insurance claims including appeals.
• Follow-up on overdue accounts through research, phone calls, resubmissions and adjustments for billing errors.
• Verify billing frequency, required forms and general billing requirements.
• Communicates with agency personnel on incorrect payor data that is identified.
• Assisted with the authorization process within an established timeframe.
• Responsible for all of the Self-Pay and Co-Pay accounts bringing in money for accounts over 120 days Old.
Insurance Collector
Medix Staffing - Richardson, TX
January 2007 to June 2007
• Responsible for all patient balances up to 360 days and all commercial insurance carriers.
• Set up patients with payment plans to ensure continuous supply of medications and patient credit.
• Educate patients on applicable (FHP) that is available for specific medications.
• Extensive documentation for follow up purpose on accounts for timely resolve.
• Audit accounts to ensure correct processing of claims and resolve denials. Legal Assistant/Collections
Manziel Law Office - Dallas, TX
November 2006 to June 2007
• Responsible for THR(Texas Health Resources)Hospital systems, M/N Hospitals, for maximum • Collections on timely accounts • Extensive investigation on W/C, TX Medicaid, Medicare and Commercial Insurance troubleshooting • Worked appeals, resolving collection problems and claims issues • Extensive documentation for follow up purpose on accounts to ensure timely resolve for claims • Account issues
• Managed caseload of complex time loss cases • Applying creative solutions which would result in the best financial outcome
E.D.S - Dallas, TX
September 2003 to November 2006
Insurance Collections Biller(Professional and Hospital charges)
• Responsible for all Doctors and office locations in the Baylor Network • Auditing accounts to ensure correct processing of claims and resolve denials • Audit to correct billing and coding of claims • Updated on State Regulations, HIPPA Compliance, Senate Bill 418 • Handled all Commercial Insurance, Medicaid, and W/C claims
Insurance Collector
Clearsky MRI - Farmers Branch, TX
May 2002 to March 2003
• Responsible for a large group of Radiologists for the Professional and Technical charges.
• Audited patient's Demographics, coding, billing and corrections of claims if needed to be resubmitted for • Payment.
• Involved with all Commercial Insurances, Medicaid and W/C Carriers. Insurance Collector
CPR Heartplace - Dallas, TX
August 2001 to May 2002
Responsible for large group of Cardiologists including all locations for the Professional charges for services provided • Customer Service for all Insurance Companies, various providers, Dr's offices, the insureds in resolving Claim submission and payment issues • Successfully work appeals dealing with a timely issue frame for reconsideration and worked accounts up to 180 days, working oldest accounts first. Insurance Collector
Unipath Lab - Dallas, TX
May 1999 to May 2001
• Responsible for a large group of Pathologists including all of their locations • Audit accounts regarding coding claims, billing, correction of claims and resubmit for payment • Worked daily aged report up to 180 days on accounts • Receiving payment via phone for CC and assisted on posting payment on patients account
Unicare Insurance Co - Dallas, TX
May 1996 to January 1999
• Processed claims for All Commercial Insurance Carriers, Medicare, Medicaid • Worked systems for Electronic processing of claims utilizing the HCFA 1500 and UB92 forms • Educated claimants on the administration of their Medical coverage to include Eligibility, Coding, Cal Yr. Ded., Co-payments, Insurance regulations and payment issues Education
North Texas Central College
December 2011
BS in Nursing
Atlantic Christian College
January 1977 to September 1977
Skills
• 40 wpm (Less than 1 year)
• Billing (Less than 1 year)
• Cpt (Less than 1 year)
• Excel (Less than 1 year)
• Icd (Less than 1 year)
• Icd-9 (Less than 1 year)
• Mckesson (Less than 1 year)
• Mckesson software (Less than 1 year)
• Medical invoicing (Less than 1 year)
• Medical terminology (Less than 1 year)
• Medisoft (Less than 1 year)
• Office medical (Less than 1 year)
• Outlook (Less than 1 year)
• Typing (Less than 1 year)
• Word (Less than 1 year)
• ICD-10
• Analysis skills
• Microsoft Outlook
• Medicare
• Customer service
• Microsoft Excel
• Computer skills
• Debits & credits
• Contracts
• EDI
• Research
• Insurance verification
• Medical collection
• Medical coding
• Communication skills
• Windows
• Organizational skills
• Medical billing
• Microsoft Word
• Phone etiquette
Additional Information
Skills:
• Heavy Medical Background and work experience in Nursing
• Extensive knowledge in Medical Terminology
• Typing 30-40 wpm
• Medisoft, Medysis, McKesson Software
• Extensive knowledge of ICD-9, CPT-9 and HCPCS codes.
• Proficient in Outlook, Excel, Word
Contact this candidate