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0-5 years of experience
Highly experienced in all phases of medical billing: Medicare, Medicaid, Champus, HMO's, PPO's and private insurance carriers, including secondary claims
- Maintained a highly above-average billing ratio and patient collections
- Reduced returned claims from Medicare/Medicaid by nearly 95%
- Significantly reduced outstanding account receivables over 90 days
- Promoted to Quality Assurance Analyst enhancing productivity and higher performance standards of the Admission Department
- Developed and implemented highly successful strategic plans for employee training and education on the proper identification of insurance for billing purposes
0-5 years of experience
Responsible for overseeing patient accounts, including charges, payments, coordinating financial arrangements, and collections.
- Advised patients in compliance with company's policies and procedures.
- Followed proper insurance protocol, which included verifying eligibility and benefits, obtaining pre-certification, and billing as directed.
- Analyzed patient financial data to determine eligibility of financial aid and assistance programs.
- Developed and distributed patient correspondence and notification protocols that increased business profits.
- Created successful training programs that were used across teams to increase company - wide communication and effectiveness.
6-10 years of experience
Provided education on the mechanics and management of consumer credit to individuals
- Conducted HUD required HECM reverse mortgage counseling
- Provided available loss mitigation options available dependent on specific individual situation
- Created customized budget and financial plans
- Participated in community outreach regarding housing, budget and credit education
0-5 years of experience
Monitored reports to determine financial responsibilities of payors and patients
- Prepared medical care proposals for physicians to be approved by head directors
- Reviewed patients' medical records to determine services medically necessary
- Communicated discrepancies to payors and patients to correct billing errors
- Read medical notes to summarize patients immediate health needs and clarify areas of anatomy affected medical condition and/or medical treatment suggested
- Researched patients with similar diagnoses and courses of treatment to acquire information needed for medical/financial proposal
0-5 years of experience
Conducted case by case financial evaluation of self-pay admissions assigned to determine if reimbursement was available through various Governmental and non-Governmental programs or other third party sources
- Reviewed patient financial reports daily and performed follow-up with patients and coworkers as necessary
- Provided the approval for continuation of care services for patients that were pending medical coverage
- Assisted patients and families in applying for charity care and other state funded programs
- Trained other financial counselors in the Emergency Department as well as the Care Centers
- Provided financial approval to the infusion departments for patients suffering chronic illnesses
- Selected to be apart of the Rapid Improvement Team to assist with developing a new process flow for the registration department to decrease denials from Medicare
10+ years of experience
Member of former Focus Group, organized to promote employee engagement and recognition, and encourage collaboration and team building within the department.
- Helped design and launch the ER Financial Counselors in 2000 which has expanded from 3 positions to 8 positions at this current time.
- Extensive knowledge of insurance eligibility and benefit verification, procedure authorization, notification for surgery admits, observation stays, ER admits, and radiology exams including Breast Center MRI's and various exams and procedures.
- Trained and familiar with EPIC ADT, authorization/certification, and referral work flows.
- Experience with general billing practices and coordination of benefits.
0-5 years of experience
Provided individual counseling to families in the areas of pre-purchase, post-purchase, mortgage default, rental and homeless counseling
- Originated loans for the Tennessee Housing Development Agency's (THDA) Hardest Hit Program
- Assessed loan attributes and documentation for Hardest Hit loan program for soundness and accuracy
- Counseled individuals on a case by case basis to help prevent foreclosure by looking at all tools and programs available
- Evaluated debt ratio, loan-to-value ratios, credit score, property valuation and various other factors
- Cut loan processing time by fifteen minutes using existing technology
6-10 years of experience
- Daily practice of front end cash collection practices for both JHU & JHH and evaluated past due accounts from billing and assisted patients in paying off balances through payment plans, government or internal assistance.
- Opportunity to help inform and influence financial policy changes at the institutional level while being recruited to be 1 of 28 to train as a Certified Application Counselor (CAC) for the Affordable Health Care Act institution wide.
- Submitted weekly reports of progress as well as meeting monthly required 20% collection goal.
- Provided strong customer service excellence, such as detailed instructions on proceeding with billing or referral/authorization issues.
- Calculated estimates for surgery or procedures for Department of Surgery, Plastic Surgery and Avon Breast Center.
0-5 years of experience
- Managed over 1000 client accounts while maintaining the second highest account in the portfolio.
- Advised customers in budget positioning as well as budget balancing to help with their financial needs.
- Met or exceeded my team goals as well as individual goals every month.
- Increased productivity within my own team by 10%.
6-10 years of experience
Work as Team Lead providing leadership, direction and training for Financial Counselor I, II and Senior
- Assisted in implementing processes for expanding Practices for the Financial Counselors and Revenue Cycle staff positions
- Monitored SOX controls audits on claims and insurance processes
- Implements policies, procedures in regards to Financial Counselors
- Collaborated with all levels of Managements and Corporate for effective Best Practices
0-5 years of experience
Developed extensive knowledge of state Medicaid program and assisted uninsured patients enroll in Medicaid programs
- Developed problem solving skills by establishing payment plans and determining feasible solutions for underinsured population
- Obtained exemplary customer service skills
- Expanded knowledge on hospital's revenue cycle by performing cash collections and intervention lists
10+ years of experience
Responsible for assessing and coordinating payment resources and assist the patient/ responsible adult in obtaining resources for healthcare services while adhering to customer service standards.
- Assisted patients with sufficient and immediate resources in identifying funds for healthcare services.
- Provided support for patients prior to or at the point of service s by assisting with specific account problems.
- Coordinated and respond to patient request for information on charges, payment plans and non covered services.
- Analyzed and determine appropriate eligibility for financial assistance.
- Received CARE awards for excellence in teamwork.
10+ years of experience
Interviewed patients for the purpose of obtaining payment for hospital stay.
- Gathered documents to submit Medicaid and or Charity Care Application.
- Answered patient questions and provided additional information or resources.
- Provided positive and effective customer service that supported department and hospital operations
- Entered data in systems, Eagle, Ontrac, Cerner, MEMS.
- Utilized Outlook, Microsoft Word, Excel
- Made & answered calls, scheduled appointments, sent notices, filing, and faxing, made copies.
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