Manager Customer Service
Resume:
De Loris Taylor
******@***.***
Highly experienced in all phases of medical billing, Expertise in meeting high standards of quality and company mission.
Goal –oriented with ambition to meet reimbursement quotas. Effective leadership able to motivate team
members Ensuring quality standards are met.
AREAS OF STRENGTH
HMO's and private insurance carriers including secondary insurance claims..: reliable self-starter can be counted on to
complete assignments without supervision., who willingly provides assistance. Trained in various healthcare software,
proficient in ERA transmissions and healthcare-claim reimbursement.. Knowledge of medical accounts receivables; billing,
follow up and strong collections. proven results with 90+ aging .
Able to do third party billing
Able to negotiate contractual agreements with insurance companies Knowledge of bad debts w/o/ SNF'Ss, DME,
Knowledge of CDM .
Knowledge of medical claim forms; CMS 1500 and UB 04
Knowledge of LTC billing, VA billing,
Knowledge of HCPCS (CPT’S, ICD-9, REV CODES)
Knowledge of Vision Share System ( FISS system ) Medicare A & B claims status, and corrections Input of Part B charges
with proper codes.
WORK EXPRERINCE
HICA HEALTHCARE July -03 Business Office Manager–
Responsible for all Accounts Receivable activities including private billing, Medicaid, Medicare insurance billing, Census,
Resident Trust and Ancillary input. Other responsibilities include meeting with new admissions; collecting and inputting
demographic and financial information; resolve billing inquiries with residents and/or responsible parties; private billing
and collections i.e. prepare, review and send private statements; and maintain delinquent A/R with Administrator as post
and balance census, cash receipts, charges and adjustments on a daily basis and submit month end balances to
Corporate Office. Supervise Reception, Accounts Payable and Payroll functions, along with assisting in recruiting,
selecting and training efforts for administrative and accounting personnel as necessary. Achieve targeted days process
month-end close Cash flow forecasting and processed improvement.
Prepared monthly financial reports for upper management that provides an analysis of all billing and collection efforts for
month end closings
ELECTRONIC CLAIMS SPECIALISTS April 1998 - June -03 Business Office Manager
Responsible for the timely and accurate billing and collections of of Medicare, Medicaid, Insurance, and private pay and
all other Government Programs and payors. Entering Levels of care for Assisted living residents/ . Researches for missing
information and ensures accurate and complete information is input into the Electronic Billing System. Researches
rejects/denials and resubmits within the designated time constraints. Handles all correspondence in regards to the
designated group of accounts. Prepares accurate account adjustments following reimbursement guidelines and hospital
policy. Performs as a resource person in regards to Medicare and Medicaid billing regulations strong in collections
experience working in hospital access, physician office, billing and collections Insurance Claims experience in a
Healthcare setting .Customer Service experience, both in person and telephone Experience with Managed Care
Contracts . Ability to understand hospital bills, insurance plans, managed care contracts and the Charge master. Ability to
understand ancillary functions for each of the facility's departments. Strong negotiation skills. Strong data and
organization skills. Ability to communicate orally and in written form. Team oriented with strong interpersonal skills Cash
flow forecasting and processed improvement.
Prepared monthly financial reports for upper management that provides an analysis of all billing and collection efforts
month end closings
IDX* AMERICAN HEALTH TECH/ MEDI-SOFT*/ ACHIVE MARTIX E-PREMIS/E-Z CAP/POINT CARE CLICK / MEDICAL
MANAGER VISON /SHARE FISS SYSTEM GHP WEB PORTAL /EXCEL WORD OUTLOOK QUICKBOOKS MEDIPAC
References can be provided upon request. __________________________________________________
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