Accounts Receivable Medical Billing
Resume:
LINDA BOYER
Wilmington, DE ***** +1-302-***-**** *****.*****@*******.***
Summary
Talented Medical Billing/ Accounts Receivable Specialist with 20+ years' experience in financial services related to billing across the healthcare industry. Knowledgeable, analytical and personable with excellent problem-solving skills. Strengths in areas of credit and collections, accounts receivable, medical billing, payment posting, appeals, and prior auths. Proven to improve workflow efficiencies while maintaining high standards in customer service. Highly skilled medical office manager with experience in Outpatient hospital billing, behavioral health, transportation, aids waiver, ophthalmology, oral surgery, and children’s dental. Well organized multi-tasker and demonstrated team player with a positive attitude.
Skills
Certified Revenue Cycle Representative
ICD-10
HIPAA
CPT Coding
Accounts Receivable
Payment Posting
Microsoft Office
Office Management Skills
Data Entry
Account Reconciliation
Math Skills
Analytical/Problem Solving Skills
Organization Skills
Multi-Tasking
Denials/Appeals
Communication Skills
Experience
Medical Office Practice Mngr
Brandywine Family Medicine 05/2024 to Recent
Responsible for submitting all credentialing documentation, licensure and liability insurance
Time sheet verification and submission
Weekly payment reconciliation and bank deposits, petty cash
Performed all in-house collection activity and collaborated with outside collection agency
Handled all AR reporting mechanisms to track insurance trends
Resolved all claim error issues daily
Submitted all orders for IT, office supplies and patient refunds
Accounts Receivable Representative II
Medhost (Remote) (Blue Ridge Hospital/Fannin Regional Hospital) 10/2023 to 05/2024
Medhost, Availity, Change Healthcare and multiple State MMIS Platforms
Reviewed patient accounts for accuracy and completeness of information.
Resolved billing discrepancies through research and analysis.
Processed claim denials and appeals in accordance with established procedures.
Reconciled payments received from insurance companies with expected amounts due.
Daily use of Microsoft excel spreadsheets for all reporting measures
Certified Revenue Cycle Representative 08/2022 to 04/2023
Ensemble Heath Plan (Remote) (Naples Community Hospital)
EPIC, SSI, NaviNet, Fin Thrive, Availity and Change Healthcare.
Reviewed patient accounts for accuracy and completeness of information.
Resolved billing discrepancies through research and analysis.
Processed claim denials and appeals in accordance with established procedures.
Reconciled payments received from insurance companies with expected amounts due.
Credentialing Specialist, Dental Biller 03/2022 to 08/2022
Health Care Practice Mngt Wilmington, DE
Credentialing over 40 providers with multiple insurance carriers excluding Medicare.
Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
Validated primary source documents such as licenses, diplomas, certifications and other related credentials.
Performed initial review for new providers to determine eligibility for enrollment into the network.
Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
Insurance Coordinator 06/2020 to 02/2021
Christiana Center for Oral and Maxillofacial Surgery Newark, DE
Verifying both Dental and Medical benefits/eligibility for patients.
Providing cost estimates for patients and collecting fees.
Participated in meetings with senior management to discuss current projects and develop action plans for implementation.
Assisted with the development of training materials related to insurance products and services.
Investigated any discrepancies between client's stated needs and actual coverage requirements.
Accounts Receivable 05/2017 to 02/2019
Children's Dental Mngt West Chester, PA
Daily posting/reconciliation of all Commercial and Medicaid payments.
Daily reconciliation of bank deposits vs AR Ledger.
Posting customer payments by recording cash, checks and credit card transactions.
Analyzing customer accounts and generating monthly statements of account activity.
Maintaining accurate records of invoices, debits and credits.
Billing Manager 09/2012 to 12/2013
Eye Physicians & Surgeons, P.A. Wilmington, DE
Reconciled all Medicare, BCBS, Medicaid, commercial and patient payments and appeals daily.
Learned the new software program Advanced Data Systems expeditiously and trained all office staff on proper billing procedures including surgeries, the use of modifiers, global periods and PQRI'S.
Developed and implemented billing procedures to ensure accurate data entry and timely payment collection.
Analyzed customer accounts and identified discrepancies in invoices, payments, credits, and deductions.
Reviewed customer contracts for accuracy of pricing, terms of payment, discounts.
Director of Medical Billing 12/1999 to 02/2011
Brandywine Counseling & Community Services Wilmington, DE
Member of the Provider Advisory Committee for Delaware Medicaid MCO DPCI.
Developed and implemented a new billing system for the medical office.
Reviewed patient accounts to ensure accuracy of charges, payments, denials and insurance reimbursements.
Oversaw staff responsible for processing claims and appeals with health insurance companies.
Ensured compliance with applicable state and federal laws related to healthcare billing.
Education
Diploma 06/1984
Alexis I DuPont High School - College Prep
Accomplishments
Certified Revenue Cycle Representative Aids Waiver Program
Certifications in What Works in Therapy
Understanding Addiction
Aids Waiver Program
Certifications in What Works in Therapy
Understanding Addiction
Conflict Resolution and Team Building
Foundation of Managed Care
The Essentials of Communicating with Diplomacy
Professionalism & How to Supervise People
Microsoft Excel & Advanced Word for Windows
ICD-10 Coding for Ophthalmology
Behavioral Health and Children's Dental
HIPAA Compliance
Financial Management with Addicts Workshop
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