Skilled Healthcare Expert with over 15 years of experience specializing in Medical Field. Highly organized, solid time management and decision making skills ensuring proper processing of medical accounts. Superior research and investigative skills used for internal/external resolutions . Self - starter, motivated, and dedicated with the ability to work on a team or independently and perform tasks with minimum supervision. Ability to facilitate meetings, train new employees and, adhere to company best practices and government guidelines.
Microsoft Office Suite, SQL Database Query, Microsoft Access, MS Excel, MS Power Point, MS Word, ACIS Software System, Outlook, Lotus Notes, Internet Explorer, Google Chrome, Quickbooks, NextGen, Meditech, STARS, Georgia Web Portal.
Business Financial Analyst
- Medical client outreach during ICD-10 pre planning process and prioritize and organize deadlines.
- Providing level 2 support to our internal and external clients for billing products
- Respond to standard support requests coming from level 1 team and other functional groups.
- Provide explanations and interpretations within area of expertise for clear and concise communication back to clients. Analyze and drive resolution of client problems/issues.
- Gather appropriate information and perform initial problem investigation to determine problem.
- Ensure proper documentation of client problem/issue (research conducted, steps required)
- Provide support for applicable products such as CPT/HCPC Codes, ICD9/10, UB04, HCFA 1500, 837, Compliance checking NCD/LCD data. Revenue codes.
- Work order incidents from different facilities. Maintain ongoing communication with client during resolution process/communicating updates.
- Identify and communicate needed product documentation changes to appropriate internal function teams Product/QA Team.
- Knowledge of Microsoft Office Suite, SQL Database Query, client relationship and product software support experience within a matrix organization. Understanding medical business office operations and billing operations from a hospital. Experience with medical claims data and payer regulations.
Confidential, Alpharetta, GA
Client Services Medical Billing and Coding Representative
- Month End Close Duties. Closing Files, Placing files on Hold.
- Answer questions regarding billing for FCM.
- Working closely with CEO.
- Payroll for Field Nurse Case Management.
- Assist with letters, certified letters, faxing, scanning, and telephone calls. staff members on new policies and procedures . ranch prescriptions and s of Medical Necessity with the local sales team.
- Provide coding on medical claims UB04 ICD-9, CPT-4 coding for procedural and diagnosis codes.
- Assisting in Prepayments for FCM.
- Submit Month End Reports for CEO & CFO
- Abstracting clinical information from the medical record.
- Proficient in Word, Excel, and Power Point.
Confidential, Norcross, GA
Government Discrepancy Analyst
- Obtained patient information from Confidential facilities to perform audits on Government Accounts (Medicaid, Medicare Tri-care, Champus) needed for order processing or reimbursement.
- Maintained excel spreadsheets for 16 facilities compiled in excel and exported from a bad debt database Artiva.
- Used word and access on a daily basis with Confidential 16 facilities.
- Reconciled assigned general ledger accounts on a monthly basis..
- System knowledge, HOST/PA, Artiva, DEI, Document Direct, Web Portal, GHP. Georgia Medicaid & Medicare, Managed Care Payers, GA, Las Vegas, Medi-Cal California Markets, Far West Division Make all corrections of non-payment related discrepancies. Forward all other discrepancies to Overpayment or Underpayment Analyst Practice and adhere to HIPPA Procedures and Regulations.
- Verified the accuracy of numbers and discuss any discrepancies and recommend accounting methods.
- Worked Discrepancy Report to determine types of discrepancies and assign appropriate reason codes
- Maintained spreadsheets and file folders on the Public Dive for the company.
- Performed Audits and reconcile petty cash funds on a monthly basis and replenish as needed..
- Processed and scanned all invoices, requests for payment, and expense reports.
- Verified the accuracy of numbers and discuss any discrepancies. Recommend accounting methods and procedures . Totaled month-end close responsibilities for entities. Perform other duties as required
Confidential, Alpharetta, GA
- Coordinated month-end closing/reporting process to ensure all entries were entered and posted.
- Maintained general ledger, accounts payable, accounts receivable and fixed assets accounts and developing associated financial statements and reports.
- Reconciled bad debt accounts, write off accounts to bad debt, balance spreadsheets, and set up payments plans.
- Medicare & Medicaid Follow-up, billing insurance managed care and government companies.
- Forwarded Charity writes offs for management approval. EOB, HCFA1500, ICD-9 Coding Insurance Contracts Refunds to patients. HCFA1500, CPT4 Coding & Medical Terminology.
- Resolved any overpayment & collections issues.
- Processed patient refunds. Budget of 2 million a week to Collections Agency. Responsible for recording inter-company transactions, and reconciling inter-company and intra-company accounts. Submit accounts for audit. Input patient data.
- Maintained internal contact with various departments, including other accounting sections.
- Systems used at Confidential Healthcare AS400, Meditech, STARS HBOC, IMACS-Insurance payer