Revenue Cycle Customer Service

Brenda Tucker

Sr. Billing/Revenue Cycle Specialist

Atlanta, GA

Work Experience

Revenue Advocate Associate

Piedmont Healthcare-Atlanta, GA

September 2022 to Present

• Maintain exceptional client services, Record all documentation as required. Monitor incoming calls from clients. Provide incoming calls with accurate information requested. Communicate effectively with clients with Healthcare navigation via phone, email and chat. Provide excellent customer service care to all clients needs.

Accounts Resolution and Denials Specialist II

Wellstar Health System-Atlanta, GA

March 2021 to September 2022

1. Assist with planning and Coordinating HB accounts resolution follow up activities for accounts portfolio approximately $375M-$500M. Collaborate working projects with Team Lead, Managers and team members. Assist with department workflow.

Provision of documentation establishing charges, Preparing Claim/Bill Submitting claim, and receiving payment. Manage the complexity of hospital billing cycle. Maintaining cash flow that enables healthcare facilities to deliver maximum care. Work and review accounts out of numerous work ques. Navigate accounts summary, History and verify patient insurance coverage for accuracy.

Collaborate with Coding and RMD for appropriate diagnosis and Procedures. Develops strategies to ensure eligible accounts are reviewed, Appealed, escalated or adjusted within the designated payer time frame.

Obtain verification of authorization and referrals to secure reimbursement of claims. Provide educational support in variety of departmental or Individual setting. Versatile actionable and Demonstrated knowledge of billing, Collections, Insurance follow up with Third party payers, Self pay Denial management, Contractual provision in all aspects of a Revenue Cycle through resolution of all patient claims.

Review and access remittance Rejections to Appeal, to determine payment. Ensure that accounts are brought final resolution reimbursed for services provided. Development and conformity to define Policies and Procedures. Strong understanding and capability of common business Technologies such as Epic, MS Office, Excel, Word, Outlook to perform and communicate and analysis multiple acute care facility accounts receivable. Sr. Collections Specialist

American Health Imaging-Atlanta, GA

February 2017 to May 2020

• Collaborate with healthcare insurance carriers for pending claims status. Submit claims to Commercial, Govt West coast insurance companies Triwest, Tricare East, Tricare for Life, VA, USAA Submit claims to commercial insurance carriers BCBS, UHC, Cigna through EDI via mail. Monitor A/R report to prevent timely filing. Maintain A/R aging report decrease revenue a working understanding of Local, Regional, and National trends. Identify claims rejections through availity. Navigate 26 facilities to insure valid Tax ID Multi task collection/Billing to resolution. Maximize claims processing in 30-45 days for reimbursement. Work claim appeals for maximum pay. Answer insurance co and patient requested calls to resolution. Provide attached authorization clinical notes to requested insurance company to retrieve payment.

• Enforce release form for policy and HIPPA violation. Meet required special assigned projects to completion. Proactively meet month end deadline task with team management. Contract Billing/Collection Specialist

OPTUM UHC-Atlanta, GA

February 2016 to February 2017

Work special projects in timely manner. Appeal claims submission to insurance carrier with appropriate documentation for reimbursement. Access denials to update corrections through RCM. Submit newly clean claims to insurance company for processing. Collaborate with insurance companies daily and follow up for outstanding payment status. Strong problem-Solving and handle discrepancies through follow up. Establishes and monitor patient payments upon request. Practice adhere to "Code of Conduct". Billing/Specialist Advocate

HCA Parallon-Atlanta, GA

January 2007 to February 2016

Submit claims to secondary insurance after primary insurance paid for processing. Monitor aging report (A/R) for processing, Upload EOB's and correspondence for review. Dev elope and maintain relationship with contracted payers via HIPPA violation, Generate Billing statements, Prepare statements via email or mail upon patient request, Address patient billing concerns. Identify, Resolve billing errors and updates through payer path system. Communicate with contracted insurance payer profiles through secure website. Negotiate contracts with insurance companies for comparable rates. Perform multi work task billing claims, Follow-up, Consistent contact with insurance co. Proactive with manager upon requested special projects due in timely manner. Education

Associate in Business

Ashford University - Clinton, IA

January 2012 to February 2015

Skills

• Medical terminology

• ICD-9

• Anatomy knowledge

• Retail sales

• Accounts receivable

• Epic

• Hospital experience

• Sales

• Customer service

• Analysis skills

• EDI

• HIPAA

• Typing

• Cash register

• Computer skills

• Communication skills

• Medical billing

• Organizational skills

• CPT Coding

• Microsoft Office

• Phone etiquette

• Account management

• Data entry

• English

• Outbound calling

• Time management

• Microsoft Word

• Windows

• Software troubleshooting

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