Experienced Medical Personnel

Valencia A. Simpson

**** ******* ***** #*** ***** TX 77511

713-***-**** MOBILE 281-***-**** ALT

Email: ***************@*****.***

OBJECTIVE: To learn, grow, and succeed with a dynamic organization utilizing my collection/medical skills, and business office skills.

Professional Highlights

NESCORESOURCES

Sr Insurance Follow-up Rep May 2010 - Present

Collection reimbursement on medical facility claims with denials, underpaids, and appeals. Performing timely resolution on each call or website review. Running insurance verification on all claims before attempting to re-bill

ITSRX, INC

Pharmaceutical Collector- October 2008- April 2009

Verify insurance eligibility for services provided, Verify insurance eligibility for all accounts with questionable status or billing addresses, Perform price negotiations and discount, Review and audit accounts from Aging reports for missing payments .Collect reimbursement for billed/aged accounts. Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures. Participate in patient care conferences

MEMORIAL HERMANN SYSTEM SERVICES

Patient Account Rep II -High Dollar- October 2006 May 2008

Collection reimbursement on medical claims for facility charges. Timely filing of medical claims

High dollars claims consisting of rebills, appeals, and contractual adjustment. Excellent customer service with Memorial Hermann code of ethics. Handling commercial collections with all insurance companies, mainly Aetna but familiar with all. Assisting with paperwork to obtain charity or Medicaid assistance. Responsible for researching unpaid and denied medical claims and sending to appropriate department for timely resolution.

CHRISTUS HEALTH-

FINANCIAL COUNSELOR/APRIL 2004- APRIL 2006

Financial counseling to patients, setting payment arrangements, assisting with charity programs and other programs.

Provided collection/reimbursement services in an effective manner for CHRISTUS TLRA.

Performing collection activities related to follow-up and timely account resolution *Communication to patients, clients, while adhering to all policies. Handling patient complaints and disputes in a timely fashion. Claims monitoring, adjustments, and appeals Accounts payable/receivables on collection accounts .Traveling/floating financial counselor in absence of regular, training for financial counselors

HCA HEALTHCARE-

FINANCIAL COUNSELOR OCT 2003-APRIL 2004

Responsible for researching unpaid and denied medical claims.

Excellent customer service.Expeditious manner for account resolution. Working knowledge of EOBs, HCFAs, and UB92s. Secondary billing, handling adjustments and appeals. Promote positive customer service. Hospital registration and admissions (outpatient, day surgery, in-patients) Provide collection/reimbursement services in a timely and effective manner for in-house patients. Generate insurance verification and pre-certification for all hospital registrations. Scheduling, Processing varieties of paperwork. Hospital and physician office settings

EDUCATION

University of Phoenix - Aug 2006-Present / Associate Degree in Healthcare Administration

44 hours of 60 to completion.

SKILLS

Front Desk Clerk, Collections, medical insurance, billing, accounting, and customer service, ICD-9, CPT coding, medical records, data entry, basic office functions-fax, mail, sort, and handling of multi-line phones, Medicare, Medicaid. Computer skills Microsoft (Excel, Word, PowerPoint), database software- (HBOC, MEDITECH, MEDISOFT, CUBS, IDX, SMS), Hospital and physician billing. Customer service certification Healthcare Collectors Association

References Available Upon Request

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