Billing Collections Specialist

Janeice Hall

Home 312-***-****

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

SUMMARY

Skills and Qualifications: Ability to communicate appropriately and effectively with patients and insurance companies, standard administrative and secretarial word processing skills, basic understanding of federal and state regulations, knowledge of (UB-92, UB-04, CMS-1500, EOB, HCPCS, DRGs, ICD-9, CPT Coding and Medical Terminology.) Programs: Meditech, Medical Manager, E-Care, HMS, Lastword, Sirius, Citrix, Microsoft Word, Microsoft Excel. Exceptional problem solving abilities, excellent critical thinking and analytical skills, strong work ethics with great interpersonal skills, highly detailed and organized.

EMPLOYMENT EXPERIENCE

Health Information Services

RADIOLOGY COLLECTIONS SPECIALIST (temp to hire) 04/28/10-06/17/10

I was assigned a project to resolve unpaid, denied, over due old accounts. This included but was not limited too reviewing the EOB, placing calls to all Insurances, Third Party Payers and Patients. I billed claims, submitted corrected claims, sent medical information and appealed denials. I checked account eligibility for correct payer information, checked payment history for errors in posting, did follow up on resubmitted claim information on the web on e-care, I adjusted account balances, established payment arrangements and assigned patient accounts to collection. Duties also included my reporting all the issues I found to the department head.

Fresno Regional Medical Center

MEDICAL ACCOUNT COLLECTOR, Mar. 2007 - 2009

Accountable for managing patient account receivables from admission to the final collection. Contacted insurance companies, patients, or necessary agency to establish payment source. Maintained accounts receivable age days in compliance with hospital standards. Researched refunds, discounts and allowance adjustments, and verified payment accuracy. Follows up on payments in a timely manner. Appealed denied claims, assign accounts to bad debt as applicable. Made collections calls to patients and made payment arrangements as required.

Fresno Regional Medical Center

PATIENT ACCOUNT BILLER, May 2003 - Mar. 2007

Screened accounts in computer system for accurate billing information, re-bills accounts as needed, billed secondary and late charges in accordance with established procedures and guidelines, reviewed billing for appropriate charge entry's, completed physician billings, completed all third party billings per regulations of the payer, processes hard-copy claims and transmitted electronic claims, made necessary debit/credit adjustments as required, keeps daily record of how claims billed and date sent with dollar amounts.

Fresno Regional Medical

ADMITTING VERIFICATIONS SPECIALIST, Jun. 2000 - May 2003

Interviewed patients or there representative to collect required financial, demographic data for registration. Recorded physician orders both verbal and or written, organized and compiled admission packets with all required forms, test, photocopied insurance cards, drivers license, provided admission orders, medical record chart, obtained appropriate signatures according to established procedure guidelines. Verified insurance eligibility and plan type, contacted insurance to obtained authorizations or to give inpatient notification, verified services and coding with insurance.

EDUCATION

Fresno City College, Fresno Ca, Graduated June 2000, GPA: 3.9

AA: Medical Administrative Assistant; Certificates of Achievement: Business Office Occupations, Clerical, Office Professional, Integrated Computer Technology, Medical Receptionist, Medical Billing Clerk, Cert: Outstanding Business Student.

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