Service Representative Billing Specialist
Resume:
Lori Mccaulie
Billing Specialist Customer Relations Account Rep Commercial Collections and Verification. Cedar Hill, TX 75104
********@*****.***
Professional Summary
Salary is negotiable
Authorized to work in the US for any employer
Work Experience
Asst. Store Manager
Rudy's Chicken-Dallas, TX
January 2023 to Present
Customer Service Representative
Quest/ Alacrity Solutions-Richardson, TX
April 2023 to September 2023
Working with customers that has had some kind of damages to their home or business, locating and dispatching out contractors to go to the site and get the client back to a safe living environment. Working with commercial insurance company to ensure that the jobs are done professional and in a prompt manner.
Medical Biller/Collection
Apple Home Care DME-Richardson, TX
November 2018 to February 2023
Billing on Durable medical products.Settling appeals and Disputes, ensuring the patient have their needs meet to remain a stable life at home
Revenue Manager
Conifer Health Solutions
April 2016 to July 2018
• Responsible for all aspects of follow up and collections, including making telephone calls, accessing payer websites. An identify issues or trending and provide suggestions for resolution.
• Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity.
• Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed.
• Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
• Participate and attend meetings, training seminars and in-services to develop job knowledge. Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues. Warehouse Worker
LGSTX
October 2016 to December 2017
ASSEMBLY LINE WORKER WITH MORE THAN 5+ YEARS OF EXPERIENCE IN LARGE MANUFACTURING PLANTS. PROVEN STRENGTH IN QUICKY LEARNING NEW PROCESSES, TECHNOLOGIES AND MACHINERY. PATIENT ACCOUNT REP
HEALTHSCOUTS USA
April 2016 to December 2016
• Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Participate and attend meetings, training seminars and in-services to develop job knowledge.
• Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues.
• Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Participate and attend meetings, training seminars and in-services to develop job knowledge.
• Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues. Patient Service Representative
ADDISON GROUP
October 2015 to April 2016
Contractor)
* Responsible for servicing delinquent accounts for a host of Medical Centers across the nation.
* Use of skip tracing tools to get updated contact information for debtor.
* Once debtor is contact negotiated payment plans for services rendered by Medical Center and if qualified negotiated settlements for delinquent accounts as per the Medical Center policy. Contact insurance company to verify active insurance policy status and coverage and submit claims on accounts that qualified for resubmission of insurance claims Patient Service Representative
HMI FINANCIAL
February 2015 to August 2015
Contractor)
* Responsible for servicing delinquent accounts for a host of Medical Centers across the nation.
* Use of skip tracing tools to get updated contact information for debtor.
* Once debtor is contact negotiated payment plans for services rendered by Medical Center and if qualified negotiated settlements for delinquent accounts as per the Medical Center policy.
* Contact insurance company to verify active insurance policy status and coverage and submit claims on accounts that qualified for resubmission of insurance claims RGS
COLLECTIONS-Richardson, TX
March 2014 to December 2014
3rd party collection on credit card that have defaulted
* Processing payments. Skiptracing
Billing and Collections Specialist
CCMS-Irving, TX
July 2013 to January 2014
Medicare Billing for multi states working a Med Adsets, PIMS which area systems.
* Collecting on claims from 30 days to one year or more
* Processing claims and resubmitting claims, sending Appeals to ensure payment.
* Most claims worked Government claims where the patient was in a facility or home based. Claims filed where INCON, UROLOGY, or ONCOLOGY known in the Medical field as IOU Customer Service
SECURUS CORRECTIONAL BILLING SERVICE
June 2013 to October 2013
* Assisting customers with account set ups
* Assisting customers with payment options and balances on accounts
* Trouble shooting line to clear problems w account Home Health Nurse
NESS HOME HEALTH SERVICE
April 2009 to June 2012
* Visit Patients home assist then with daily living skills
* Billing for Medicare (Part A&B)
* Collections for unpaid billing processing payments Education
High school diploma or GED
Some college
Skills
• Project management
• Financial services
• Medical terminology
• Medical Receptionist
• ICD-10
• Guest services
• Credit analysis
• POS
• Quality Assurance
• Outpatient
• Office management
• Quality assurance
• ICD-10
• Customer relationship management
• Revenue cycle management
• Medical Insurance
• Managed care
• Computer skills
• Hospital experience
• Cash register
• ICD-9
• Windows
• Medical Terminology
• Typing
• Clerical experience
• Negotiation
• Order fulfillment
• CRM software
• EMR systems
• Medical Records
• DME
• Epic
• Home health
• Fraud prevention and detection
• Word processing
• Computer skills
• Google Docs
• Debits & credits
• Financial planning
• Filing
• Analysis skills
• Sales
• Revenue management
• Excel, Centricity, Centrix, ADP,
• Microsoft Office
• Accounts payable
• Medical Office Experience
• Operating systems
• Security
• Research
• Customer service
• SharePoint
• Accounts Receivable
• CPT Coding
• Order entry
• Supervising experience
• Ophthalmology
• Medical coding
• ICD coding
• Data collection
• Accounting
• Medical Billing
• Communication skills
• Product management
• Documentation review
• Medical Scheduling
• ICD Coding
• Relationship management
• Recruiting
• Oracle
• Laboratory experience
• Medical collection
• ICD-9
• Documentation review
• Databases
• Insurance verification
• Training & development
• Technical support
• Accounts receivable
• Hospice Care
• Accounting software
• Conflict management
• Medical records
• Microsoft Access
• Medical Coding
• Banking
• Leadership
• Account management
• Accounting
• Communication skills
• Organizational skills
• Information security
Certifications and Licenses
Medical Billing Certification
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