Customer Service Data Entry

Julie Lomas

**** ******

San Angelo, TX *****

Cell: 325-***-****

Email: ********@*****.***

Enthusiastic and quick-learning Collections professional with 25 years experience in a healthcare environment demonstrating strong clerical management skills and medical coding knowledge. Working positively and professionally at all times to provide exceptional customer relations skills. Able to successfully manage multiple, concurrent tasks and remain detail focused. Adapt at quickly learning new systems and processes that are required to be compliant due to the increase of audits and insurance regulations. Areas of Expertise:

● Medicaid/MC Billing ● Medical Software-

Centricity,

Logician,TIMS,

Eclinical, Prognosis

● HIPAA/OSHA

● Insurance Appeals ● Credentialing ● Patient Collections

● ICD-9/CPT ● A/R ● MS Word/Excel

Education

Central High School, San Angelo, TX

● Diploma (1991)

Practice Management Institute, Dallas, TX

● Certified Medical Insurance Specialist (2010)

● Coding by Specialty-Primary Care (2010)

● Chart Auditing Workshop (2010)

● ICD 10 Implementation (2010)

● Understanding Modifiers (2010)

Work Experience

Methodist Hospital: 3/21 to 10/22

A temporary contract position to collect on all ER hospital claims as well as the different specialties in the office. Work on pulling Aging ques and appeals. Baymark Health: 7/19 to 3/21

A temporary contract position to collect and appeal denied mental health facilities. Worked on getting the drugs approved for care. A/R Billing/Appeals: June 2019 to current, Texas Pain, Dallas, TX Responsible for learning all of the payors guidelines and allowable amounts so that I could appeal before timely filing. Review for accuracy the billing codes we used and refiled a corrected claim. Review reimbursement and appeal if underpaid. Customer Service/Sitel San Angelo: April 2018 to June 2019 Provide Customer service for Credit Union by helping members with account issues, fraud on account, and loans.

A/R Insurance Collections: February 4/2016 - 3/01/2018, Questcare Hospitalists, Dallas, TX Responsible for collecting and appealing accounts that the insurance had denied due to under coded, low reimbursement, and not following guidelines. A/R Cash Applications/Collections: October 2011-January 2016, Breg, Plano, TX Responsible for posting insurance payments and appealing low reimbursement. Appealed claims that were denied due to the lack of medical necessity. A/R Specialist : March 2007-October 2011, Family Medicine at Willow Bend, Plano, TX Follow up on outstanding A/R all payers and/or including self pay and/or including resolution of denials. Responsible for working EDI transactions, edits and rejections reports. Then research and resolve accounts appearing on delinquent insurance report and patient collections. Responsible for auditing charge tickets for coding and insurance errors. Medical Receptionist: March 2006-February 2007, Dermatology Surgery Center, Allen, TX Responsible for checking in patients, data entry, verifying insurance, scheduling, answering phones, check out, and filing.

Medical Receptionist/Billing Clerk : May 2001-February 2006, Family Medical Specialist of TX, Plano, TX

Responsible for verifying benefits, data entry, check in patients, collect co-pays and balances, take messages using electronic medical records software, schedule via website, inventory management, cross trained to enter charges, post payments, insurance follow up, insurance appeals, and file.

Medical Billing : August 1997-May 2001, TX Regional Heart Center, Plano, TX Responsible for coding hospital charges, payment posting, insurance follow up, appeals, and balancing the day for all billing transactions performed that day. Medical Receptionist : July 1992-August 1995, TX Regional Heart Center, Plano, TX Responsible for data entry for new patients and hospital patients, verify benefits, code/charge entry for basic cardiovascular testing.

REFERENCES

JANET RICE

FORMER COWORKER AT FAMILY MEDICINE

PHONE NUMBER: 469-***-****

MICHAEL GILMORE

FORMER COWORKER AT BREG ORTHO

PHONE NUMBER: 469-***-****

EMAIL: MR.MICHAELGILMORE.COM

SHERRY VELOZ

FORMER COWORKER AT BREG ORTHO

PHONE NUMBER: 469-***-****

EMAIL: *****.*@*********.***

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