Accounts Receivable Account Representative
Resume:
Andrea Reyes
Bakersfield, CA *****
661-***-**** ***********@*****.***
PROFESSIONAL SUMMARY
Competent Accounts Receivable Specialist bringing 17 years' experience carrying out all
Accounts Receivable functions in high volume environments. Proficient in tracking payments,
resolving billing issues and preparing account statements. Recognized as a dedicated
professional driven to meet team targets and enhance bottom line performance.
SKILLS
Microsoft word Forecast reports
Excel Eye for detail
10 key Deadline orientated
Typing 55 wpm Attention to detail
Team Leader
WORK HISTORY
Patient Account Representative 10/2021 –Current Memorial Hospital
In a high call volume setting, provides clarification and education to, as well as research of, patient billing inquiries.
Addresses broad range of inquiries covering items such as insurance regulation and processing protocols, charge coding discrepancies, benefit interpretation and adjudication.
Provides financial counseling both in advance and post receipt of services. Provides assistance with reimbursement for under or un-insured individuals (including uncompensated care).
Make sure that the patient’s account has the correct insurance that is being billed.
Provides daily productivity statistics to support management analysis of receivables, as defined by Revenue Cycle leadership
Reviews assigned accounts for the following and takes appropriate course of action, including but not limited to internal or external problems that may cause a delay in payment; denial, resubmissions to insurance, and billing of patient; partial payments
Lead Patient Account Representative Bakersfield Behavioral Healthcare Hospital
09/2018 – 04/2020
Communicates with patients via phone or mail to obtain additional insurance information and interacts with departments/clinics to resolve charging issues affecting the claims
Make sure that the patient’s account has the correct insurance that is being billed.
Reports trends with other departments that may improve the claims submission process and accounts receivables
Provides daily productivity statistics to support management analysis of receivables, as defined by Revenue Cycle leadership
Responsible for collection of an assigned section of the accounts receivables, following all policies, procedures and established guidelines.
Reviews assigned accounts for the following and takes appropriate course of action, including but not limited to internal or external problems that may cause a delay in payment; denial, resubmissions to insurance, and billing of patient; partial payments.
Contacts insurance companies or any other person, organization or department whose assistance is needed to obtain payment of our claim, until it is paid or rejected.
Responds to telephone or written correspondence from insurance companies, employers, state agencies and patients regarding accounts receivables balances. Applies contractual allowances where necessary
Develops relationship with internal and external customers and partners to facilitate payment and to ensure regulatory and contractual compliance.
Bank Deposits
Train new employees and current employee
A/R REPRESENTATIVE/LEAD 07/2014 to 09/2018
Pacific Pulmonary Services - Bakersfield, CA
● Responsible for all collections and receivables functions associated with oxygen and sleep related services.
● Strong sense of service excellence to both patients and payers and can navigate the balance between customer service and arranging for collection of payment.
● Critical thinking, active listening and persuasion are a few traits that are in the A/R
Representative’s wheelhouse.
● Responsible for working aging reports daily to ensure the timely collection of accounts;
Reports may include but are not limited to denials, balance after payment, and deductible
collections.
● Works all accounts thoroughly that are over 45 days aged with 100% completion.
●Supports team members within or outside of the Revenue office when necessary to
Achieve company goals and objectives.
● Contacts patient or payer to obtain needed information for timely collection of payment.
● Maintains compliance with PPS' Compliance Program at all times.
● Timely completion of all mandated compliance training.
● performs additional duties as necessary.
Lead FINANCIAL COUNSELOR 07/2004 to 07/2014
San Joaquin Community Hospital - Bakersfield, CA
● Verifies hospital coverage for all insurance companies or agencies financially responsible
For patient's hospital bill.
● Interview patients who have minimum or no insurance coverage to arrange methods of
Payment.(Either charity application or the pre-qualification for state Medi-Cal) Bills all insurance carriers.
● follows up on patient accounts until zeroed or moved into bad debt.
● prepares all refunds and write- offs for posting.
● Verifies reimbursement when payments are received.
● Gathers and sends all needed information to physician offices, auditors, outside billing
oServices etc.
oWorks follow-up reports daily.
oSSI, Excel, Microsoft Word, Aeos, and Cerner billing system.
Review for Expected reimbursement for contacts that the insurance companies are paying
According to contractual rates.
Reviewed claims to make sure that the claims were billing with the correct modifier,
Unbundled codes or billing with universal coding to the payers correctly.
EDUCATION:
University of Phoenix - Bakersfield, CA
August 2017-Aril 2020
Edison High School - Stockton, CA High School Diploma
Finance Business, June 1993
Additional Information:
Authorized to work in the US References upon request
Contact this candidate