Customer Service Follow Up

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Norbert Berko

RCM Revenue Specialist

Career Summary

Skilled and experienced Revenue Cycle Specialist in healthcare industry. Strong knowledge of medical billing practices, insurance payors, and government program reimbursement. HIPPA compliant, excellent interpersonal skills. Ability to train, develop and manage AR, claims, denials, appeals, contract and contract matrix. Strong medical denial and appeals collection practices.

System Proficiency

Brightree, Kinser, Contract Matrixes, Availity, Navinet, Waystar, gGastro and various provider portals.

Experience

April 2018 – Current Convergent RCM

Claims/Collections Analyst

Leveraged multiple communication platforms and portals to ensure complete, thorough follow up on denials and AR issues.

Reviewed and interpreted clinical documentation / medical records for coding accuracy as well as support for claim reconsiderations and appeals

Detail oriented, highly efficient and high amount of overturn on claims appealed.

Managed denials and conducted AR follow up for assigned accounts.

Appealed all relevant denied claims to ensure payment per contract.

Established and maintained strong affiliations with team members, management and payors.

Prepared appeal packets, clarifying problem workflows to recover reimbursement for all unpaid claims and minimize future denials.

Identified, categorized, and investigated denial patterns and generating special projects to resolve denials.

August 2014 –March 2018 Intrepid USA

Reimbursement Specialist

identify report, categorize, and investigate denial patterns and generating special projects to resolve denials.

Monitored and audited aging and other related RCM related issues.

Resolved rejected, underpaid and denied claims by submitted corrected claims and appeals in a timely basis upon review of unpaid claims.

Implemented standard solutions such as writing appeal letters, clarifying problem workflows to recover reimbursement for all unpaid claims and minimize future denials.

Established and maintained a network of key contacts with senior level management with various carriers to expedite and ensure claim appeal resolutions.

Ensuring all provider agreements with insurance carriers are implemented correctly and auditing ERA/EOBs to ensure reimbursement is issued per fee schedule.

February 2012 – June 2014 Medline

Collections Specialist

Coordinated communication with payors to ensure accurate reimbursement for proper payment.

Reduce outstanding receivables and consistently exceeding established collections goals.

Exemplifying professionalism and providing high-quality customer service and facilitating effective financial operations.

Education

Bachelor’s Degree

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