Project Manager / Business Analyst

Theona Scott

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

************@*******.***

OBJECTIVE

To benefit a company through my extensive knowledge of billing and collections experience, whereby my skills and qualifications can be utilized to help the company achieve maximum productivity as a Collections Manager.

HIGHLIGHTS OF PERSONAL QUALIFICATIONS

• Dedicated: motivated to learn and grow in new responsibilities and business skills.

• Strong analytical capabilities, including reconciliation, with an emphasis towards problem solving and attention to detail.

• Superior interpersonal communication skills with patients, claims adjusters and physicians.

• Judgment: exhibits sound and accurate judgment, support and explains reasoning and decisions: includes appropriate people in decision-making process.

• Ethics: treats people with respect; works with integrity: ethically upholds organization’s code of conduct and compliance policies.

PROFICIENT IN THE FOLLOWING

Collections/Billing/Appeals Centricity/EClinicals/MediSoft/Allscripts

Submitted successful appeal letters MS Office applications

Microsoft Word/Excel Medical Terminology ICD-9/CPT

Commercial, Medicaid Manage Care Contract

Medicare, Workers Comp PIP Claims, Crime Victims Claims

PROFESSIONAL EXPERIENCE

Confidential, Houston /TX 2010-Current

Team Leader/Medical Collector

• Recently overseed a claim project with my team, that paid $965,000.00 within 1 1/2 months.

• The team and I manage are responsible for the entire Aging Report for United Healthcare.

• Follow up on unpaid claims; refile claims that are not on file and submit proof of timely filing.

• Currently working with an Out of Network facility whereby majority of their claims are processed out of network; therefore negotiations are constantly being made with various networks in order for the claims to be paid appropriately.

• Recently received an overwhelming vote as “employee of the month”.

Texas Automated Practice Management, Houston/TX 2008-2010

Medical Collector/Biller

• Designed filing systems that help manage the follow up process for unpaid eob’s for each physician.

• Administered: Billing and Collections for five physicians with different specialties: Family Practice, Internal medicine, Emergency Surgery, Wound Care and Chiropractic.

• Sent delinquent accounts to collections agency.

• Prepared the patients accounts with outstanding balances and submitted statements electronically and via mail.

• Resubmitted corrected claims to the insurance company with the appropriate codes and medical records to ensure proper payment.

• Establish payment plans to help patients manage payment of bills.

• Billed for the following: Hospital and Physician charges.

• Contacted patients regarding outstanding balances.

Texas ENT Specialists, Houston/TX 2005-2008

Medical Collector

• Performed and utilized the management of the aging report on a monthly basis by following up on all unpaid claims using a specialized date system.

• Resolved patients accounts via written or oral contract with successful payment arrangement or immediate payment.

• Resubmitted corrected claims to the insurance company with the appropriate codes and medical records within a timely manner which resulted in quicker payments.

Nancy Byrd, M.D., P.A, Houston/TX 1999-2005

Medical Biller/Collector: Pediatrics

2002-2005

• Billing: Inputting charges on a daily basis and filed claims electronically/mail.

• Handled the processing of unpaid claims by resubmitting with medical records or as a corrected claim within the time filing deadline.

• Prepared and made bank deposits.

• Processes insurance payments to patient accounts in computerized system.

• Month end close reporting and reconciliation

• Collections of outstanding monies

• Successfully developed effective working relations with internal and external customers regarding all aspects of accounts receivable.

• Effectively communicated projections and collection issues to management in a timely manner.

1999-2002

Front Desk Supervisor

• Supervised three employees by ensuring the front desk responsibilities were handled efficiently

EDUCATION

The Academy of Healthcare Professions 1998-1999

Diploma: Medical Billing and Coding Specialist

University of Houston-Downtown 1994-1997

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