Accounts Receivable Quality Control
Resume:
Lori Johnson
Shorter, AL *****
************@*****.***
Objective: To secure a position with a stable environment that will utilize and improve my skills and lead to a lasting career.
Skills: Over twenty years of experience in a physician’s medical office, with the ability to work independently with little to no supervision. Excellent phone etiquette and time management. Goal oriented with the ability to learn new processes quickly. Specializing in filing accurate claims, adjusting/appealing rejected claims, & understanding insurance contracts. Additional expertise in quality control, reimbursements, implementing improved processes to enhance accuracy of business.
Proficient in Microsoft Office Suite: Word, Excel, Teams & Outlook, ICD-10 & CPT Coding, EMR, Medical Billing & Accounts Receivable, Medicare/Medicaid, CMO/HMO/PPO, Workers Compensation.
EMPLOYMENT HISTORY
Physicians Professional Management, Montgomery, AL
November 2022 - Present 2024 Accounts Receivable Specialists:
Review claims sent to clearinghouse; work claim denials daily, claim exception reports, payer mapping, and crossover claims.
Process credit balance accounts and determine refund source.
Maintain production logs.
Work closely with multiple collection agencies; via email and phone, upload bad debt files, verify patient & insurance payments. Handle all patient calls regarding bad debt accounts.
Ensure all customer/client/patient interaction and service is performed in a manner that consistently exceeds expectations.
Work A/R reports: check claim status, eligibility via clearinghouse or provider portals, review accurate payment posting and adjustments as well as making corrections as needed. Adjust accounts when needed due to timely filing, denied appeals.
Special projects as needed.
Claim Return, Escondido, CA
November 2021 – February 2022 Revenue Recovery Specialists:
Heavy phone work in a call center setting
Communicated with insurance companies by phone, email & fax
Follow up on overpaid claims per CMS guidelines & time limit for recovery per each state limitations.
Review accounts to determine overpayments
Identify and resolved issues impacting revenue
Assume additional responsibilities and perform special projects as needed or directed
Center for Physical Medicine and Pain Specialist Management, Montgomery, AL
Nov. 2018 – Nov. 2021 Billing/Collections Specialist/MR Coordinator
Daily input of patient charges, manual/electronic post payments from patients & insurance companies
Managed delinquent accounts in a timely and effective manner ensuring maximum collection, taking payments/payment arrangements.
Assessed NR report working with patient's insurance companies regarding claim denials and checking claim status, as well as unpaid patient balances.
Ensure all patient interaction and service is performed in a manner that consistently exceeds expectations.
Provide all aspects of workers compensation authorizations, electronic and/or paper claim submissions Call all insurance companies to verify claim status, eligibility, and benefits; confirm claim information via provider insurance websites.
As Medical Record Coordinator, responsible for all medical record requested following HIPPA guidelines sending via fax &/or email.
ENT Associates - Montgomery, AL
January 2018 – November 2018 Medical Receptionist
Answered multiple phone lines, registered patient demographics into system; Scheduled follow up appointments and sent referrals to outside providers.
Processed all medical record requests following HIPPA guidelines; Scanned in charges and medical records to and communicated daily with all physicians through EMR.
Verified patient insurance benefits and insurance referral.
Collected daily balances and copays after review of patient’s accounts. Reconciled daily charges, payments for multiple doctors. Deposited patient/insurance checks electronically.
The Center for Physical Medicine and Pain Management - Montgomery, AL
June 2006 – May 2017 Medical Receptionist
Checked patients in and out, entering demographic information, verifying insurance benefits.
Scheduled follow up appointments and sent referrals to outside providers.
Processed all medical record requests following HIPPA guidelines.
Scanned medical records into patient EMR chart.
Collected daily balances and copays after review of patient’s accounts.
Entered daily charges, filed all claims, electronically & via mail.
Provided all aspects of workers compensation authorizations, electronic and/or paper claim submissions.
A/R report: working with patient's insurance companies regarding claim denials and unpaid claims, as well as unpaid patient balances.
Assisted physician when needed.
Education:
High School Diploma
REFERENCES:
Available upon request
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