Medical Billing
Resume:
Ms. Tameka Y. Stewart
Missouri City, TX 77459
*******.********@*****.***
OBJECTIVE:
To obtain a position working in fast paced environment providing service to the general public, demanding strong organizational skills, technical and interpersonal skills where the skills will be fully utilized and further developed.
PROFILE:
Professional leadership and interpersonal skills.
Confident and poised in interaction with individuals at all levels readily developing rapport with
Physicians, medical staff, patients, and their families.
Highly trustworthy, ethical and discreet.
Committed to superior customer service and patient services.
Dedicated individual; achieving a reputation for consistently going beyond what is required.
Detailed oriented and resourceful in the completion of projects with the ability to multitask while meeting strict deadlines.
Proven ability collect, consolidated, organize, and prioritize business needs.
Highly regarded for a proactive attitude and ability to think laterally, providing ideas and
solutions.
Adopted a creative approach to problem solving through use of analytical skills.
Organized individual with exceptional follow through capabilities.
EXPERIENCE:
10/11 to present
Memorial Hermann Hospital Houston, TX
Patient Access Rep II
Processing patient registrations, including updating and verifying demographic information, verifying insurance eligibility and collecting patient liability amounts. Demonstrate excellent customer service skills and be able to function in stressful situations. Secondary duties include escorting patients to their scheduled departments for procedures, greeting patients and processing arrivals at the registration desk and other duties as assigned. Performs duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety, cost efficiency, and a commitment to the CQI process.
12/09 to 10/11
Memorial Clinical Associates Houston, TX
Patient Account Representative
Verify and update patient insurance plans. Collect co pays, co-ins, and deductibles per insurance. Entered patient charges, home health charges, hospital charges, and employee lab charges minimum 45,000 daily total charges. Collect on 30, 60, and 90,120, 180 day old accounts. Preview statements and export statements on a monthly basis. Process patient refund checks on overpaid accounts. Apply unassigned payments to payments accounts by running a monthly report prior to exporting statements. Adjust accounts on a as need basis. Correct claims and reprocess claims electronically on a as need basis. Post payments to patient accounts daily. Bill shingles vaccinations through E-Dispense for Texan Plus patients. Assist patients with denied Lab Corp and Quest Diagnostic billing. Provide excellent customer service skills while assisting irate and/or confused patient regarding billing/insurance issues. Print EOB to explain to patient charges covered or denied by insurance. Flags patient accounts with balances, return statements and checks. Void and re-enter payments to resubmit claims. Mail collection letters to patients with past due balances. Process credit card payments via phone per patients request. Custodian of Billing and Medical Records for MCA. Professional knowledge of All scripts, Clinical Module EMR applications, and
E-Dispense 5.
12/06 to 01/09
University of Texas Physicians Houston, TX
Customer Service Representative II
Float to different areas within the Pediatric department to assist when needed such as Cardiology, Endocrinology, Hematology, Pulmonary, Neurology, Urology, Pedi Surgery, General, Gastro, Bariatric, General Surgery, Urology, and Genetics. Entered patient charges for MD’s in All scripts on a daily basis. Knowledge of ICD-9, CPT, and procedures Codes. Responsible for the basic coordination and facilitation of clinical operations. Answer the telephone, schedule appointments as well as registers patients and process related paperwork in IDX and Flow Cast system. Perform clerical duties of the medical record department and work related to ensure that the patient’s insurance will cover their treatment plan. Schedules appointments and obtains proper demographics from patient in regard to insurance and billing information. Process referrals received from. Complete referrals and request authorizations from insurance companies for procedures/outpatient services. Generate referrals in IDX. View patient’s chart in All Scripts to find patient diagnosis or chief complaint. Process general referrals and request specialty referrals per physicians request. Verify eligibility and benefits. Request pre-cert for procedures to be administered on an outpatient level. Complete orders for Sedation, Basic Audiograms, Ultrasounds, X-Ray’s, EEG’s, EKG’s, Sleep Studies, PT, OT, ST, and Nutritional Consults. Provides extensive training to new employees in IDX that includes scheduling, referrals, charge entry and batch maintenance. Excellent knowledge of CPT and ICD coding for optimal reimbursement
08/05 to 04/06
Texas Children's Hospital Houston, TX
Patient Administrative Liaison (part-time)
Entered demographic information for new patients and existing patients into the IDX system. Collected co-pays, Verified private/commercial insurance and filed Medical Records upon patients discharge. Scheduled appointment for patients in the Micro MD system. Processed incoming requests from patients and physicians for provider appointments, while securing the financial integrity of each account generated to maximize reimbursement, including meeting any and all contractual requirements of managed care companies (pre-certification, referrals, authorizations, etc.) Educate and communicate to patient families or responsible parties arrival times, cancel and reschedule an appointment, and all other necessary information that streamline the process for patient arrival in a clinic. Ensures the Hospital is in compliance with state or federal regulations applicable in the Admissions setting. Knowledge of managed care industry, including an insurance company's role as a claims pay or a claims administrator, and their related utilization review process. Knowledge of indemnity coverage plans and government resources, specifically Medicaid and CSHCN. Excellent skills using office software, and modem-based query software for verification of insurance benefits, and demonstrates self-initiated work behaviors, good verbal communication skills, and excellent customer service skills. Collect co-pays and deductibles on HMO, PPO, EPO, POS, Military Insurance, and PHCS. Schedule Physical Exams, Procedures, Hormones, Office Visits, and all follow up Appointments. Process medical record request per release of information. Collected deductibles, co-pays per appointments and verified insurance. Maintained excellent oral and written communication skills to patients and all Staff.
08/95 to 12/06
SCCI Hospitals Houston, TX
Intake Coordinator Liaison
Conducted face to face interviews with potential patients for all SCCI Hospital Programs. Received and coordinated all referral source telephone calls and screened individual's criteria for admission. Completed referral log form on all referral source calls, whether for admission, information or alternative disposition. Informed caller of available programs and specialized treatment. Made appropriate referrals for prospective patients who did not meet the clinical and/ or financial intake criteria. Conducted initial clinical pre-certification with managed care reviewers as needed. Coordinated managed care reviews with hospital case managers. Identified potential pay or sources, verify benefits, negotiate rates and obtain initial authorizations.
EDUCATION
09/90 to 05/94 CLC High School Houston, TX
High School Diploma
Received a 4.0 GPA and a Member of KSI G Alpha Sorority and Honor Club.
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