Accounts Receivable Specialist

Janet Myrick

***************@*****.*** 404-***-**** Decatur, GA

SUMMARY

Seasoned professional with 19 years of experience in medical revenue cycle management, specializing in claims accuracy and eligibility verification within Georgia healthcare systems. Proficient in HIPAA compliance, adept at addressing denials, and ensuring efficient claims processing. Seeking Eligibility Specialist role to leverage expertise in insurance follow-ups and resolution facilitation.

WORK EXPERIENCE

Northside Hospital

Government Specialist Jan 2020 - Present

• Review denials and submit medical records for reconsideration to correct patient information and maintain claim accuracy.

• Ensure timely processing of claims to support efficient revenue cycle management. FFAM 360 Contracting

Accounts Receivable Specialist Oct 2018 - Nov 2018

• Analyzed outstanding claims and conducted follow-ups with insurance companies to ensure timely resolution.

• Identified payer trends and addressed insurance denials, improving the claims management process. Optum 360 Contracting

Accounts Receivable Specialist Feb 2018 - Aug 2018

• Managed the coordination of claim activities and successfully resolved non-passing payer edits, ensuring accurate claim processing.

• Conducted diligent follow-ups on insurance claim denials, facilitating timely resolution and payment retrieval. Gentiva Healthcare

Accounts Receivable Specialist Oct 2015 - Jul 2017

• Managed the resolution of claims and facilitated prompt reimbursement of receivables through effective communication with agencies to ensure submission of clean claims.

• Addressed and resolved discrepancies in accounts, maintaining accurate financial records and contributing to the smooth operation of the accounts receivable process. Prestige/Contracting

Medical Insurance Collector Mar 2013 - Aug 2015

• Analyzed aging Accounts Receivable reports to ensure accuracy and facilitate the timely collection of outstanding payments.

• Validated patient insurance details and efficiently managed the processing of claim denials to uphold financial integrity.

Payments MD

Medical Insurance Collector Dec 2011 - Feb 2015

• Managed and updated insurance information for assigned accounts, ensuring accuracy and compliance.

• Prepared and submitted appeals for denied claims, facilitating the resolution process and maintaining financial integrity.

Mag Mutual

Medical Insurance Collector Sep 2001 - Apr 2010

• Verified insurance information and ensured accuracy in all claim submissions, facilitating prompt processing and payment.

• Communicated effectively with insurance companies to follow up on outstanding claims, resulting in timely updates and resolutions.

SKILLS

ICD/CPT/HCPCs Medical Coding Guidelines • Medical Terminology • Commercial Health Insurance Plans • Managed Care Provider Contracts • Medicaid and Medicare Billing • UB04 and 1500 Forms • Written and Verbal Communication • Time Management • Ethical Decision-Making • Claims Management • Gammis • Medicare Web Portals • Ssi • Claims IQ • Med Host • Cash Pro • GE Centricity Business • EMDEON Payment Management • Microsoft Office (Outlook, Word, Excel) • Problem Solving • Teamwork • Independence • Organizational Skills • Attention To Detail

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