Medical Assistant Billing
Resume:
*** ******* *** ********** ** *****
Shirley L. Richardson
MILITARY SERVICE
United States Army, 101 Airborne Division, Clarksville, TN
** ****** & Service Company, Hanau Germany
PROFESSIONAL AWARDS
Army Commendation Medal, Good Conduct Medal, Overseas Service Ribbon, Honorable Discharge, Employee of the Month, Duke QA Recognition Award, Duke System Integrity Assistant Award
EDUCATION
Poca High School, Poca WV
Medical Assistant, Putnam Co. Technical College, Putnam, WV
Austin Peay University, Clarksville, TN
Medical Billing & Collections, Penn Foster Studies, Scranton, PA
Travel & Tourism Specialist, Penn Foster Studies, Scranton, PA
Advanced Web Programming & Design, Penn Foster Studies, Scranton, PA
HIPPA HiTech Security, ESC, CO
PROFESSIONAL LICENSE
North Carolina Life, Health, Sickness & Accident License
SKILLS:
Proficient in MS Word, Excel, Powerpoint, Data Trending and Web Design. Writing of Standard Operation Procedures, Employee Handbooks and Training Manuel’s.
HOBBIES
Screenwriting
WORK EXPERIENCE
Agency Services 4/1/2011 – Present Adjuster/Auditor
Work from home contract position contracting with Moving Companies across the United States to settle property damage claims.
Maintain and update status spreadsheets that are sent to Agencies on a weekly basis detailing cost analysis of claims.
Register claims via Corporate Claim Systems in a timely manner. Correspond with claimants regarding settlement and denial issues.
HMS, 8/1/09 – 1/15/2012 Medicaid Auditor
Maintained contact with Chief Financial Officers, Business Office Directors and Managers regarding the status of all state mandated requirements consisting of Credit Balance reports, signed final reports and refunds due back to Medicaid.
Broke collection record for North Carolina, Virginia and South Carolina.
Trained new Auditors in the process of provider notification, obtaining credit balance reports, requesting back up documentation, communication with Providers and how to perform on site reviews.
Perot Healthcare, 2/28/2008 -7/9/09 Cash Posting Manager
Managed a Cash Posting Department consisting of ten staff and a six member BPSI Team in India. Managed posting of an average of thirty million dollars of revenue on a monthly basis.
Traveled to facilities within Tennessee, Kentucky and Massachusetts to perform collection on all outstanding and problematic medical claims. Payors were a mixture of Blue Cross, Commercial, Managed Care, Medicaid HMO and Medicare Managed Care.
Met and exceeded key performance index requirements regarding follow-up activities of 75 accounts daily. Met and exceeded monthly collection goals.
Trained client employees in areas of collection techniques, how to increase their daily call rate thereby increasing their productivity and how to escalate aging claims to payor management for review and payment.
Coast 2 Coast Consulting 05/01/2007 - 2/20/08 Consultant
Troubleshoot and resolve unpaid Physician claims denied for services rendered in the following areas: Urgent Care, OB, Oncology, Family Practice, Pediatrics and Psychiatry.
Trained client employees in areas of collection techniques, how to increase their daily call rate thereby increasing their productivity and how to escalate aging claims to payor management for review and payment.
Collected aged accounts greater than two years of age from various Skilled Nursing Facilities and various local and national Managed Care Payers.
Duke University Hospital Systems, Durham, NC 05/06/2005 - 04/25/2007 Associate
Trained Duke University Auditors and IT Personnel in areas of Financial Classifications, Receivable Data Trending, Receivable Collections and Payer Processing Issues.
Worked with Clinical Trail Coordinators to obtain Research Grant Authorization for claims denied Managed Care claims in regard to FDA approved pharmaceuticals.
Collected problematic high balance accounts having a threshold of $250,000.00 and greater.
Reduced aged high balance accounts from 12 million to 4.2 million in less than 30 days.
A/R Solutions, LLC 12/01/2000 - 3/5/2005 (Self Employed) Contractor
CEO of A/R Solutions, LLC who contracted with North Carolina Hospital systems and Rex Hospital to perform Day 1 Billing and Collections services for Worker’s Compensation claims. Broke two collection records within a six month time frame.
Performed first, second and third level appeals on all claims denied for non-authorization, non-referral, non-covered and timely filing. The success rate on all appeals was 90%.
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