Healthcare
Resume:
Talya Weathers
Hickory Hills,IL 60457
yb5ctb@r.postjobfree.com
OBJECTIVE
Senior representative with extensive experience in management. Skilled in federal, state, policies. Excellent background in facility and professional billing, accounts receivables, scheduling and budgeting. Experience in developing and implementing programs for organizations.
PROFILE: 8 yrs.’ plus experience as professional manager.
Ability to direct complex projects from concept to fully operational status.
Goal-oriented individual with strong leadership capabilities.
Organized, highly motivated, and detailed-directed problem solver.
Proven ability to work in unison with staff, volunteers, and board of directors.
EXPERIENCE
Senior Patient Account Representative
Maximum Rehabilitation Services (team lead)
• Resolve all outstanding insurance pending accounts.
• Resolve all insurance and patient billing issues.
• Audit contracts and review collections policies.
• Resolve daily billing and coding issues.
• Efficient billing HCPS code, ICD-9codes, ICD-10codes, RV code, DGR and CPT-4 codes.
• Resolve all customer service complaints.
• Billing for Commercial Insurance, Medicaid, Medicare, HMO, Worker Comp, Auto, Managed Care, Home Health
• Insurance Verifications
• Review and Complete per-certifications.
• Review payment posting and contractual adjustments.
• Responsible for providing training for new employees.
• Prepare Credentialing and Contracts for all new payors.
Senior Patient Account Representative
Medical Business Office Service (MBOS)
• Resolve all outstanding insurance pending accounts.
• Assess all delinquent accounts for possible collection actions.
• Complete per-certifications and verifications for patients.
• Resolve all insurances and patient billing issues.
• Resolve all customer service complaints.
• Efficient billing HCPS code, ICD-9 codes, RV code, DRG and CPT-4 codes.
• Analyze patients’ accounts including medical review.
• Representative for Medicare, Medicaid, Blue Cross, Customer Service, Payment Poster, Managed Care, Home Health Worker Comp and Auto.
Senior Patient Accounts Representative
ATI Athletic & Therapeutic, Bolingbrook, IL (team lead)
. Research all insurances and patient billing issues on accounts.
• Research and resolved all customer service complaints.
• Resolved all outstanding insurance pending accounts.
• Assessed delinquent accounts for possible collections actions.
• Analyzed patients’ accounts including medical records review.
• Efficient billing HCPS code, ICD-9 code, RV code, DRG and CPT-4 codes.
• Representative for Medicare, Medicaid, Blue Cross, Customer Service and Payment Poster, Managed Care, Home Health
• Responsible for assisting manager on daily duties.
• Attend daily meeting with manager.
• Responsible for providing training for new employees.
Business Office Manager
Rehab Team Chicago, IL
• Managed a staff of 2 employees on daily operations.
• Prepared Credentialing for new insurance payor.
• Prepared Credentialing for new Doctors.
• Prepared weekly reports and spreadsheets.
• Prepared daily encounters/routing slips for doctors.
• Reasearch all insurances and patient billing issues on accounts.
• Resolved on all outstanding insurance pending accounts.
• Prepared daily in an out scheduling of patients appointments.
• Collect patients’ co-pays and all outstanding balances.
• Posted daily insurance and cash payments.
• Cashed out daily posting.
• Assessed deliquent accounts for possible collection actions.
• Assessed on all outstanding Account Receivables.
• Perform HIQA and insurance verifications.
• Obatin all required per-certifications and coordinates HMO and Managed Care cases, Home Health.
• Enter all billing and coding into census data master file system.
• Efficient billing HCPS code, ICD-9 code, RV code, DRG and CPT -4 codes.
• Participated in recruiting and hiring of new employees.
• Responsible for providing training for new employees.
Financial and Operations
Lexington Healthcare Orland Park, IL
• Maintain daily contact with key members if nursing and clients’ services to coordinate new admission processing and financial verifications.
• Performs HIQA and insurance verifications prior ro a resident’s admission.
• Obatains all required per-certifications and coordinates HMO, Managed Care and Home Health case with corporate staff.
• Contact resident representatives to schedule contract signing prior to or upon confirm admission.
• Enter all census data into the Master file sytem.
• Work collaboratively with the Assitant Administrator that census data is entered in correctly with the payer type.
• Collaborate with the Assitant Administrator all census data spreadsheet is sent to Royal Management in a timely matter.
• Attend Medicare and Medicaid meetings and coordinate appropriate follow-up as requested.
• Prepare (DHS) Public Aid applicants for family members.
• Worked at different sites as needed.
• Assure that all residents’ financial files are properly maintained and stored in a manner that ensures privacy and HIPPA compliance.
Senior Account Representative-Business Office
Centra Carol Stream ,IL
• Research all insurance and patient billing issues on accounts.
• Research and resolved all call routing slips for customer services.
• Resolved on all outstanding insurance pending accounts.
• Effiecient billing HCPS code, ICD-9 codes RV code, DRG and CPT-4 code.
• Responsible for assisting manager on daily duties.
• Assessed delinquent accounts for possible collections actions.
• Analyzed patients’ accounts including medical review.
• Assisted in daily cash payment posting.
• Completed per-cerfification and verifications of patients’ benefits for future services.
• Perpare training documentations for physicians.
• Worked at different sites as needed.
• Managed 8 physicains’ offices on daily operations.
• Assisted in training new employees.
• Representative for Medicare, Medicaid, Blue Cross
08/2011-01/2012(temp)
05/2011-07/2011(temp)
1/ 2010-1/2011
08/2009-02/2010
10/2007-07/2009
08/2003-06/2006
Supervisor of Business Office
Productivity Network Innovations Lisle, IL
• Managed operations of daily programs via internet for 85 clients for facility.
• Prepared weekly an monthly meeting for clients.
• Prepared weekly reports and spreadsheets for clients.
• Designed service development plans and conducted operations assessments.
• Efficent billiing HCPS code, ICD-9 code, RV code, DRG, and CPT-4 codes.
• Direct recruitment and retention of supervisor and staff of 7employees.
• Supervisor and evaluated staff coached improvement management skills.
• Evaluated daily staff operations.
• Demonstrated ability to maintain composure to work effectively in a fast paced environment while preserving strict confidentially with clients.
• Resulted in multilateral staff achievement work objectives.
• Successfully refine and implemented new projects.
• Balanced financial reports for facility.
• Developed and implemented processes to develop staff training.
• Particapated in recruitng and hiring new employees.
• Prepared training documentations for employees and facility. 07/2006-08/2007
Project Manager/Healthcare Consulting 02/1997-06/2003
Progressive Financial Resources Arlington Heights, IL
• Responsible for providing management of projects and maintaining the integrity of clients files.
• Supervisor and completed more than 10 projects.
• Managed a staff of 20 employees on daily operations.
• Prepared weekly an monthly meeting for clients.
• Maintained HR benefits for employees.
• Coordinated cash posting for clients, individual accounts and reimbursement.
• Audit contracts and reviewed collection policies.
• Prepared weekly reports and spreadsheets.
• Prepared and presented site visits of facility and physicians offices.
• Educated facility and physicians’ office on current information.
• Efficient billing HCPS code, ICD-9 code, RV code, DRG, and CPT-4 codes.
. Responsible for the implementation of directives, policies and update of management,
• Assisted in developing and implementing departmental policies and procedures to meet goals
and reduce accounts receivables.
• Developed and implemented processes to develop staff training.
• Participated in recruiting and hiring new employees.
• Responsible for providing training for new employees.
EDUCATION
Wabaunsee Comminity College
• A.S. Business Managament
SKILLS
Typing 55 wpm, Windows XP, Microsoft Outlook, Microsoft Publisher, Excel, PowerPoint, NEBO, Florida Share, C-Snap, HIQA, E-care ,DHS(Public Aid), Medical Terminology, Microsoft Office 2003, 2007 and 2010, Outlook 2003, Louts Notes, IDX/GMPS12.5V, ICOMET, MAGIC, Meditech Software, SMS Software, Misys, RTK, Medsoft, Spark, Encoder Pro,PTSO5.0,EMR, EPIC
Notay Public-State of Illinois
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