I have over 25 years in Management, customer service and administrative support experience. I leverage my excellent supervisory/management skills as well as telephone and interpersonal skills, I utilize knowledge of CPT, ICD-9-CM and HCPCS coding while relying on data supplied from the states to interact with State and Provider contacts to request medical records and ensure that legible and applicable recipient records are available to the reviewers. I have the necessary qualifications and knowledge of the job to be performed and its components for the overall function of the position. Through my past experiences, I have developed a proven ability to effectively work individually as well as in a supervisory capacity, and can effectively communicate …show more content…
Collects and reviews all patient insurance information needed to complete the billing, collections, appeal, and/or cash processes. Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payers. Researches and resolves any electronic claim denials. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. Independently analyzes, reports, and communicates any reimbursement trends/delays (e.g. billing denials, claim denials, pricing errors, payments, etc.). Processes any necessary insurance/patient correspondence. Prior Authorizations .Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians. Coordinates with inter-departmental associates to …show more content…
I was available to answer any questions about workflow, coding, special procedures, and resolution of any issues or problems as they arise, as well as coaching and mentoring team members. I ensured HIPAA compliance was followed. I supported our training unit both in the classroom and our Telephone Research Center (aka Telephone Call Center). A significant part of my responsibilities included the verification of abstraction performed by Data Collection Specialists as well as telephone monitoring. I worked closely with the teams to assist with all questions and review of materials. I worked with hospital administration, physician offices, home health providers, pharmacies, VA-Tri Care providers on a daily basis. Before being promoted to a supervisory position, I went from role play to abstraction based upon my 20 plus years experience in the insurance industry. As an Abstractor, I was assigned to the high and mega burden cases abstracting both medical records (ICD-9) and patient accounts (CPT4) (UB92) (UB04) (EOB). I am familiar with all Federal, State, and Managed Care requirements for billing as well as reimbursement. I was responsible for signing timesheets and assuring all employees adhere to our company policy and procedures. I was responsible for knowing and
I am very familiar with medical coding and understand how it is used because I worked in the medical field for many years, and I used those codes for much of that time. At my last job, I helped with the billing for some time, did the insurance referrals for several years and got the insurance pre-authorizations/pre-approvals
Ronda as one of my ARMs you have the responsibility of being well versed in all programs that are offered by our department. You have shown you extensive knowledge of policy by training Rev Team and H & I staff, assisting with the temporary supervision of Assessors and by handling and responding to protective services inquires. You able to articulate our program polices and regulations to providers, participants and agencies. Your knowledge is also shown during discussions regarding policy clarifications and/or changes with other managers, Bureau Chiefs and the policy units. You review completed cases in WT, you complete care plan change request as needed and you assign and reassign hotlines in Case Compass in an effort to keep yourself abreast of how all automated systems work.
Amy holds a bachelors degree in accounting and has worked in the medical billing field for over twenty-five (25) years. Her exhaustive knowledge of reimbursement coupled with her attention to detail has been essential in servicing new and existing clients. Her leadership and knowledge, has in every aspect of the revenue cycle
Follows efficient, logical sequence; balances screening/diagnostic steps for problem; informs patient; sensitive to patient’s comfort, modesty.
Customer Care Representative. Received inbound telephone inquiries and written correspondence from patients, insurance companies, and employers to assist them with claim issues, and paying of radiology bills that they may have received.
Please explain how your past personal and professional experience make you a quality candidate for the position for which you are applying.
I am writing this letter in response to your posting for the Medical Data Specialist/Receptionist at Student Health Services.
My career that I am researching for my junior project is Medical Coding and Billing. Medical Coding and Billing are two different jobs. Medical Coding is when a patient has any medical procedure or exam such as going to the doctor for the stomach virus or even going to the hospital for a broken bone. They work with the insurance companies by putting a specific number into the computer. There’s CPT Codes which stands for Current Procedural Terminology which is “ Codes to better understand the services their doctor provided, to double check their bills or negotiate lower pricing for their healthcare services. (About Health, 2014).”
In my positions over the past 14 years, I have proven to be a successful educator, team member, change agent, and leader. I approach every
Elizabeth, you continue to meet the expectations in this area. You are familiar with HCBS policies and procedures, but are quick to ask questions as different situations arise. You are knowledgeable on the automated systems and are able to provide guidance on those as needed. You understand the importance of HIPAA and confidentiality and have been quick to follow up anytime there is potential cause for concern. During this period, you assisted with completion of HIPAA Event Forms when a potential breach was identified and the cause was unknown. You have great interview/assessment skills and continue to work with participants in a very calming fashion.
verification of services for which the individual or a third-party payer is being billed, evaluates the adequacy and appropriateness of care, educating health professionals, research
The first two skills I bring to this role are strong organization and endurance. I know how to handle a large range of responsibilities in a short period of time, assigning different
My academic achievements and work experience meet, if not exceed, the requirements of the position. I strongly believe my intimate knowledge of the College of
Extensive experience in Rational tools and skilled in using MS office applications for day to day activities, and MS Project for prioritizing and managing individual tasks.
My extensive communications, problem-solving, and program implementation with hospital personnel located in purchasing, materials management, distribution and risk management departments statewide led to an expeditious buy-in rate by these departments with-in a matter of one month. I prepared and presented cost value analysis briefings and presentations on analytical findings and recommendations; represent company at meetings, seminars, conferences and symposiums. I had and still continue to have the ability of building customer rapport and trust through professional and courteous communications. I was able to answer physicians’ and patients’ questions and resolve simple, informal complaints of product wear and tear, duration, refunds, return policies and shipment procedures. I had numerous opportunities to conduct and participate in surgical and therapeutic work site in-services and relay success stories to co-workers as needed. In addition, when it came to being a team leader and player, I assisted sales management with physician, therapist and patient inquiries for information and competition investigations.