Account Representative Patient
Resume:
Dawn Lee
Seattle, WA *****
*******@*****.***
Professional Summary
Resourceful professional in finance management, known for high productivity and efficient task
completion. Specialized skills include negotiation tactics, account reconciliation, and regulatory
compliance. Excel in communication, problem- solving, and time management which ensure outstanding
performance in client interactions and financial resolutions. Patient Account Representative versed in
administration, medical billing, and coding. Results-driven and proactive team player with years in
medical insurance field.
Work Experience
Patient Account Representative
Pacific Medical Centers-Seattle, WA
August 2024 to Present
• Reviewed flagged items daily and resolved issues.
• Worked closely with insurance companies to obtain authorization for services rendered.
• Generated detailed reports outlining billing, flagged items, and other important data.
• Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
• Maintained confidentiality of patient information in compliance with HIPAA regulations.
• Submitted appeals on behalf of patients when appropriate based on findings from research conducted
into denied claims.
• Verifying and accessing the credentials of healthcare professionals. Making sure all healthcare providers
meet the necessary qualifications to provide care and comply with insurance payer requirements. Paying
close attention to detail.
• Investigation of claims to determine worker compensation coverage and benefits that are due. Have
extensive experience of handling workers compensation claims, for large national clients.
• Provided information to automobile insurance and assist in following up on liability claims.
Referral Coordinator
Amedisys Home Health-Baton Rouge, LA
May 2023 to November 2024
• Performed data entry related to referrals into electronic health record systems.
• Collaborated with interdisciplinary teams to discuss patient care plans and adjust referral strategies
as necessary.
• Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
• Prepared and distributed referral reports to healthcare management, highlighting performance metrics
and patient outcomes.
• Participated in training and professional development opportunities to stay current with best practices
in referral coordination.
• Maintained accurate records of all referrals, including contact information and follow-up activities.
• Advised staff on appropriate protocols when making a referral.
• Ensured compliance with HIPAA regulations when handling patient information.
Insurance Service Representative
Acclara/R1-Houston, TX
May 2023 to August 2024
• Met deadlines consistently while maintaining high standards of quality assurance.
• Navigated computer system to look up customer information and update policies.
• Participated in team meetings and contributed to team goals and objectives.
• Assisted customers with filing and tracking of insurance claims, ensuring timely resolution.
• Called insurance companies to ascertain pertinent information regarding policies and payment benefits
for patients.
• Attended training and educational seminars to enhance knowledge and credentials.
• Handled billing related activities focused on medical specialties.
Revenue Cycle Team Lead
Unified Women's Healthcare-Boca Raton, FL
April 2022 to May 2023
• Assisted with recruitment efforts by interviewing potential candidates and providing input on hiring
decisions.
• Delegated daily tasks to team members to optimize group productivity.
• Worked closely with human resources to support employee management and organizational planning.
• Evaluated needs of departments and delegated tasks to optimize overall production.
• Maintained open lines of communication with senior management, reporting team progress and
challenges.
• Led a team of 18 individuals in achieving quarterly productivity targets, exceeding goals.
Revenue Cycle Specialist II
Trinity Health-Columbus, OH
March 2021 to April 2022
• Oversees crucial financial tasks with healthcare organizations such as a hospital or clinic.
• Analyze account receivables and correct all problems.
• Met all productivity and collection goals including dollars collected and accounts handled.
• Initiated appeals of denials of payment for services.
• Reduced rates of delinquent accounts.
• Make calls to insurance companies regarding claims in the AR.
Reimbursement Specialist
Better Health-Philadelphia, PA
March 2020 to March 2021
• Upload, create and report daily reports to clinics.
• Post remits from banking lock box, making sure that posting and balancing is correct.
• Have exceptionally good knowledge of all commercial and Medicaid insurances.
• Maintain confidentiality of all patient demographic, medical and financial information.
• Create a positive working environment with the clinical staff.
Professional Billing Specialist
Viadent Medical Group-Greenville, NC
December 2018 to March 2020
• Establish and maintain medical records security to ensure patient confidentiality.
Review patient records daily for accuracy, supply any missing information and ensure compliance with
policy and Medicare guidelines.
• Access patient records as needed for review by physicians, technicians, and other medical staff
members.
• Follow professional standards and meet the requirements of local, state, and federal regulations.
• Utilize monthly aging accounts to follow up on unpaid claims aged over 30 days.
• Cover Medicare A/R high dollar claims, seeking missing authorization and referrals.
Insurance Follow-up Representative
University of Washington Physicians-Seattle, WA
February 2014 to November 2018
• Research and review insurance denials from reports or documents from insurance companies.
• Review outstanding accounts. Complete and submit reconsideration request or appeals to insurance
companies.
• Correct and resubmit corrected claims with supporting documentation as appropriate.
• Work with other departments to resolve outstanding/unpaid accounts, track work/production daily.
• Work from Home 4 days out of the week with provider availability via phone and/or e-mail.
• The single day of the week that is in the office collecting correspondence and attending necessary
office meetings.
• Work with Home health and Hospice providers throughout the Pacific Northwest Region.
• Provide billing education to families and patients concerning behavioral health.
• Charge entry back up for UWP research staff.
• Verify patient insurance via phone and/or computer software.
Education
Certificate in Certified Nursing Assistant
North Seattle Community College-Seattle, WA
September 1980 to June 1981
Some college
Skills
• Epic
• IVR
• Management
• Mentoring
• Clinic
• Hospice
• Workers' compensation law
• Microsoft Word
• IV infusion
• Client services
• Office experience
Front desk
• Inpatient
• RemotePC
• Advanced MD
• Documentation review
• ICD-9
• Insurance verification
• Primary care
• Fraud
• EDI
• Computer literacy
• Medical claims
• Word processing
• Claims processing
• Athenahealth
• HIPAA
• Medical collection
• Analytical thinking
• EHR systems
• Meditech
• Financial services
• Organizational skills
• Microsoft Outlook
• Accounting software
• Supervising experience
• Google Suite
• Clinical laboratory experience
• Microsoft Project
• Workday
• Home health
• Communication skills
• Medicare
• Windows
• 10 key typing (10+ years)
• Clerical experience
• Medical billing
• Healthcare management
• NetSuite
• Time management
• Care plans
• NextGen
• Home & community care
• Customer support
• Customer service
• Patient payment collection
• Zendesk
• Revenue cycle management
• SharePoint
• Oracle
• Billing reconciliation
• Analysis skills
• Multi-line phone systems
• SAP
• Banking
• Typing
• Databases
• Salesforce
• Research
• Search engines
• Athena
• Intake
• Data analysis skills
• Phone triage
• Medical Terminology
• Smartsheet
• Microsoft Access
• Microsoft Office
• Debits & credits
• EMR systems
• Microsoft Excel
• Problem resolution
• Google Docs
• Contracts
• Cash handling
• Leadership
• Patient interaction
• Writing skills
• Self-direction
• Medical office experience
• Computer skills
Certifications and Licenses
Driver's License
CPR Certification
CNA
Contact this candidate