Billing Specialist Administrative Assistant

Marie Albert

Mobile: 857-***-**** / Email: *************@*****.***

POSITION OBJECTIVE

I am looking to pursue and secure a rewarding position that fits my career goals in a challenging and healthy work environment to utilize my skills and knowledge efficiently for continuing growth.

QUALIFICATIONS

Over fifteen years of experience in the healthcare field

Experience in core administrative functions of confidential correspondence, invoicing, billing, scheduling, referrals, insurance verification and telephone communication

Strong technical skills

Takes the initiative and is resourceful

Strong follow-up skills

Able to work independently and with minimal supervision

Ability to plan and organize workload in an efficient manner (Multi-tasking ability)

A quick study and not afraid to tackle new areas

EXPERIENCE SUMMARY

When

Position

Employer

Location

Oct 2022 - present

Administrative Assistant

Beth Israel Deaconess Medical Hospital

Boston, MA

Jan 2021 – Jan 2022

Referral Coordinator

Harbor Health

Boston, MA

Sept 2019 – Oct 2020

DME Billing Specialist

Sullivan’s Pharmacy and Medical Supply

Roslindale, MA

Mar 2018 – Mar 2019

Referral Coordinator

Roslindale Pediatrics Associates

Roslindale, MA

Jan 2017 – Nov 2017

Patient Access Coordinator

Boston Medical Center

Boston, MA

Jan 2016 - Jul 2016

Funding Consultant

Tobbi Dynavox, LLC

Dedham, MA

Mar 2013 – Jan 2016

Reimbursement Specialist

Outpatient Infusion Incorporation,

Stoughton, MA

Jun 2006- Jan 2012

Insurance Verification Specialist

Beacon Hospice

Boston, MA

Nov 2004- Jun 2006

Medical Biller

Partners Healthcare

Boston, MA

Jun 2002 – Nov 2004

Billing Specialist

Lambert and Nielsen Eye Center

Quincy, MA

Jun 1999 – Nov 2001

Assistant Biller

Care Group Homecare

Waltham, MA

SKILLS and EDUCATION

Computer Skills:

Medical Billing Applications Software: Milbrook, Suncoast, Meditech, Versys, BrighTree, EPIC, SDK, MMIS, and NEHEN TriZetto

Microsoft Office/ Outlook Email/ Internet/ Various Search Engines

Certification/ Education:

Medical Office Management Program Certificate National Education Center/Bryman

Dorchester High School, Boston, MA

Soft Skills:

Customer Service Oriented

General Office and Administrative Skills

Marie Albert

Mobile: 857-***-**** / Email: *************@*****.***

EXPERIENCE DETAILS

Beth Israel Deaconess Medical Center, Boston, MA 10/2022 – present

Administrative Assistant

Ensures all credentialing system data and documentation comply with internal and external auditors compliance and all applicable accreditation standards

Coordinate, complete, and maintain the primary source verification and confidential research required for credentialing licensed healthcare practitioners for the medical staff

Analyzes errors and traces back to the root cause using the raw data in the appropriate file or database as it relates to the initial appointment and reappointment files

Maintain medical staff credentialing files with filing, purging, and creation of new files and maintenance of archived

Communicates and works with appropriate medical staff office to resolve data discrepancies

Coordinate data collection to maintain an accurate database for hospital use and to gather information as required in order to maintain a current record of all practitioners

Harbor Health, Boston, MA 01/2021 – 1/2022

Referral Cooridinator

Processes referrals/authorizations using appropriate methods provided by insurance companies

Acts as a liaison between insurance and healthcare providers to ensure required referrals have been processed correctly for medical specialty visits

Documents/updates records to ensure all parties have accurate information

Communicate with patients to ensure follow-through with referrals or other care-related needs

Supports care team and patients in synchronizing care with specialist and diagnostics offices

Communicates with specialist offices to ensure medical records are received back in a timely manner

Accurately charts all information in EHR/EMR

Functions as a resource for patients around managed care plans, insurance, and referral issues, with an ability to perform electronic insurance verification

Provides support and information to patients and providers to problem-solve and manage complex administrative issues

Sullivan’s Pharmacy and Medical Supply, Roslindale, MA 09/2019 – 10/2020

DME Billing Specialist

Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing.

Follows up on unpaid claims within the standard billing cycle timeframe.

Checks each insurance payment for accuracy and compliance with contract discount-

Answers all patient or insurance telephone inquiries about assigned accounts

Set up patient payment plans and work collection accounts

Keeps manager informed of backlogs and opportunities for improvement

Roslindale Pediatrics Associates, Roslindale, MA 03/2018 – 011/2018

Referral Coordinator

Ensured complete and accurate registration, including patient demographics, insurance, and authorizations

Responsible for providing patients, patient advocates, nurse case managers, adjusters, referring physicians, and

with pre-registration instructions

Oversee the referral process and tracking all incoming referrals and referral sources and scanning and indexing

documents into patient charts and insurance authorization

Collected and processed payments from patients and reconcile cash reports daily

Maintained patient confidentiality and HIPAA compliance according to Federal guidelines

Boston Medical Center, Boston, MA 03/2018 – 11/2018

Patient Access Coordinator (Contractor)

Greeted and verified patient needs in a prompt and courteous manner and educated patients about required legal forms.

Registered patient demographics information in SDK and EPIC and applied the appropriate hospital service codes

Followed strict hospital guidelines, policies, and procedures for crime victims/high-profile intakes

Verified insurance coverage using NEHEN to ensure that insurance is active, eligibility date, benefits, and coverage

Collaborated with peers in the appropriate care areas, such as Admitting and Patient Finance

Tobbi Dynavox, LLC, Dedham, MA 11/2016-07/2017

Funding Consultant

Fulfilled DME equipment request for Sales Consultant, Social Language Practitioner, and Client

Entered demographic information into the database and transferred the request to the Funding Consultant for processing

Assisted the Funding Consultants by preparing prior authorization forms and packets

Contacted insurance company to verify eligibility, benefits coverage, and prior authorization requirements.

Researched third-party insurance requirements to complete prior authorization forms

Communicated the status of orders with members of the sales team clients and Speech and Language Pathologists

Outpatient Infusion Incorporation, Stoughton, MA 03/2014–07/2016

Reimbursement Specialist

Recertified insurance when insurance coverage changes or insurance claims are denied

Attained prior authorization, in-network considerations, and case agreements from insurance companies

Monitored proactively expiring prior authorizations to ensure authorization is in place

Worked to gather accurate demographic and insurance data for patient registration into BrighTree system

Completed benefits investigation of patient's primary/secondary insurance coverage to identify proper payer billing

Beacon Hospice, Boston, MA 06/2006-01/2012

Insurance Verification Coordinator

Verified patient insurance by contacting the insurance company

Documented the insurance and authorization verification information in the applicable computer system

Ensured authorization and pre-certifications were correct and contacted doctors’ offices for necessary authorizations

Validated account receivable report for outstanding balances for patient accounts

Reference Available Upon Request

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