Medical Billing Customer Service

Jianhua Guo (Connie Guo)

**** ***** ******* ****, ****, NC 27502; Tel# 646-***-****; Email: ***********@*****.***

OBJECTIVES: Strive for professionalism and excellence in a career where I contribute my 20+ years of experience in Healthcare Finance, Medical billing & collection, and Customer service.

WORK EXPERIENCE AND FOCUS:

A/R specialist performing medical billing / collections:

● Scrub & submit claims. Resolve billing problems. Send corrected claims or appeal claim denials, via phone calls, in house mainframe system, or online portal.

● Follow up with insurance companies, patients, and medical providers, to ensure timely and accurate filing and payment from all commercial, managed care, Medicare, Medicaid insurance plans.

● Monitor payer accounts to verify compliance with contract payment terms and schedules.

● Handle patient’s complaints and reconcile patient account balance.

● Assist Business Director in making decisions regarding delinquent or bad debt accounts.

● Identify, research, and resolve billing variances to maintain system accuracy and currency.

● Identify and report new trends, changes in billing /coding rules, government & insurance policies and regulations. Work with all parties involved for effective update and resolutions.

CURRENT AND PREVIOUS EMPLOYERS / POSITIONS:

HOLLY HILL HOSPITAL: Business Office / Billing department. 5/2021– Current

— A/R specialist of commercial insurance plans for this mental health facility.

PROHEALTH CARE ASSOCIATES: Corporate Central Billing / Revenue Cycle Unit. 10/2017-4/2021

—A/R specialist of 6 Pediatric provider groups, total of 22 physicians; Previously for 35 Surgical and OBGYN providers.

PROGRESSIVE ENT ASSOCIATES: Finance Department. 2/2007-10/2017

— Biller/Collector performing cash application, collection and patient account management for 5 ENT surgeons.

CHARLES B. WANG COMMUNITY HEALTH CENTER: Flushing Branch 12/2004-2/2007

—Branch Administrator in charge of daily operation.

ST. MARY’S HOSPITAL FOR CHILDREN: Finance Department 11/2002 – 11/2004

—Collection Supervisor for long term care facility, all insurances.

NORTH SHORE LIJ HEALTH SYSTEM: CLINICAL (PHYSICIAN) BILLING 1/2001-10/2002

—Managed Care Account Representative for >400 physicians

VISITING NURSE SERVICE OF NEW YORK: Business Support. 12/1990-12/2000

—Business Service Supervisor/ Infusion Care Program;

--- Trainer / System Application & Implementation Unit;

--- Customer Service Coordinator /AHOP AIDS Program

EDUCATION:

Baruch College, CUNY (NYC): Master of Public Administration (1990)

The Northeast University of Finance & Economy (PRC): Bachelor of Arts (1982)

ABILITIES & SKILLS:

Creative Problem solving; Excellent speaking and writing communication

Efficient time & priority management; Data analysis and reporting

Persistence in follow through research and documentation

Willingness in teamwork cooperation and easy, friendly personality

Quick learning and adapting to new business

Proficiency in Microsoft office, Excel, Word, GM Centricity and EMR systems, MS04 mainframe; familiarity in Adobe & Power Point

Bilingual English / Chinese Mandarin, speak, read, and write fluently.

Reference upon request

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