Customer Service Manager

Corey Allen

Current Address:

**** ****** ***** ****: 281-***-****

Humble, TX 77338 Email: ********@*****.***

Objective:

An energetic and outgoing individual with quality and intelligent experience in Medical Administrative Services. Providing customer service, 17 years of patient accounts and medical billing, resolve billing and patient collection issues, worked closely with physicians, hospitals billing and reviewing and resolving patient accounts, arranging patient payment schedules and working follow-up accounts. Trained on Medicare and Medicaid guidelines to ensure proper billing, payments received and denials are correct.

Summary of Skills, Attributes, and Abilities:

Excellent Proven Coding Billing Ability to interpret data Proficient in oral and written communication Problem solver Computing skills (MS Word, Excel, Access) Work well individually and in teams Excellent time-management capabilities Provider Credentialing

Relevant skills: Current Harris County Clinic representative, Perform ICD-9, CPT, HCPC, PQRI codes excellent, physician documentation, Third party Medicare/commercial billing, Claims Processing, Charge entry, Correcting and updating signature and IE errors, professional relationships with physicians and staff to finalize documentation correctly and accurately. Office Management, Managed Healthcare, Medicare background, Supervisory Skills, Medicaid background, UB04 knowledge, Epic (Current), TMHP trained. Experienced working with Ophthalmology, radiation oncology, nephrology, infectious disease, ER and impatient and outpatient status, signature / Invision billing system, claims and manager edits, correspondence with physicians in person and in writing, with proven excellent communication skills.

Experience

Baylor College of Medicine, Houston, TX 2007 to present

Patient Accounts Representative

Work in a professional group setting working assigned Paperless Collection System (PCS) work file by initiating follow up activity on accounts with third party payers.

Meets established performance standard for accounts receivables follow up.

Meets monthly collection goal.

Documents collection activity in financial comments and assigns the appropriate action/rejection codes.

Initiates Charge/Payment disputes to resolve coding and payment

issues on accounts.

Researches and processes basic insurance denials and appeals with minimal assistance.

Contacts patient/guarantor/third party payer either by telephone or in writing to resolve open issues on account.

Requests itemized statements and insurance claims.

Updates patient insurance and demographic information.

Requests patient collection and form letters.

Researches and prepares documentation for adjustments according to the PBS Adjustment Policy.

Reports trends or information pertinent to insurance claims, provider or systems issues to the Supervisor/Manager.

Performs job duties as defined in approved policies and procedures.

Trained on the Epic, Cirius and TMHP systems.

Per-Se, Houston, TX 2004 to 2007

Insurance Claims Specialist

Research and reolve unpaid claims for hospital facilities.

File appeals for unpaid claims on behalf of hospitals.

Negotiated and established agreements with insurance companies for unpaid claims.

Coding.

Job History:

First Colony, Insurance Claims Representative ’03 -‘04

Coca-Cola Bottling Co., Refabrication Specialist ‘02-‘03

Macgregor Medical Assoc., Professional Coding/Billing Spec. ’97 -‘02

References upon request

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