In Patient Interim Supervisor Resume
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Melville, NY
SUMMARY
- Detail - oriented with good analytical problem-solving skills
- Excellent computer, time management, organizational and analytical skills with proficiency in Excel and Microsoft Office Suite as well as A/R systems and associated applications.
- Outlook experience
- Ability to work independently, exercising good judgment, and multi-task in a high stress, fast-pace service environment with patients, insurance carriers and leadership
- Excellent customer service skills to communicate effectively with insurance carriers, patients, and colleagues.
- Knowledge of CPT, ICD9 utilized in medical billing and medical terminology.
- Established and demonstrated competency in accounts receivable systems and associated application ( Relay Health Assurance, STAR)
- Ability to maintain professional conduct and good working relationships with staff, management, and payers.
- 10 Years experience in Health care billing and Customer service.
- 1 year in Management of staff - Patient Revenue Realization - IP billing/follow up
PROFESSIONAL EXPERIENCE
Confidential, Melville, NY
In Patient Interim Supervisor
Responsibilities:
- Coordinate the daily activities of the A/R operation ensuring that the aging accounts are reviewed and resolved, collector work files are completed on a daily basis and appropriate actions are taken by staff to ensure timely and correct claim payment’s
- Assists in development of and participates in ongoing staff educational programs
- Communication with Dept Heads for all Inpatient Denials.
- Prepares Monthly spreadsheets for VP’S.
- Prepares Budget reports
- Coordinates Aging reports/ spreadsheets for staff.
- Supervise 28 staff members
- Created two new depts. Within In Patient to better handle volume and accountability
- Help define Work Station criteria for rebuilding of employees Workstation.
- Communication with Directors of all 6 Hospitals to get bills out and for follow up payment
- Monthly meeting with finance to discuss A/R balances.
Confidential, Melville, NY
EDI Specialist
Responsibilities:
- Billing of all inpatient & outpatient facility bills for all 6 hospitals
- Work claims on 277 reports. (denials)
- Research/resolve discrepancies on claims for all payer and patient types
- Communication with personnel and Department heads to resolve processes related to transmission of claims to all payers’
- Creation of reports/spreadsheets of all claims failing in system & communicating with sites to resolve
- Obtain and balance claims transmission data to ensure the claims are received by payers
- Education of staff t assist in avoiding billing delays
- Creation of job aides/procedures to outline specific processes EDI staff needs to follow.
- Building of bridge routines to RELAY (our billing system) to solve billing issues.
- Reviews billing work queues and reports to determine accounts/claims requiring action.
- Ensures claims are crossed over to secondary and tertiary payers and reports any delays in unbilled claims.
- Collaborates with internal departments, external vendors and IT for issue resolution and operational effectiveness.
Confidential, Melville, NY
Patient account representative
Responsibilities:
- Process Workman s comp/NF insurance claims for outpatient accounts using electronic billing system
- Work all reports pertaining to billing of Out Patient Accounts (failed claims, late charge, and dx/da reports, two a day)
- Heavy contact with hospital staff/dept to obtain correct dx, hcpcs, modifiers etc to validate claims in timely manner.
- Knowledge of Medicare, No - Fault and Workman comp rules and regulations
- Proficient in electronic billing system.
- Proficient in Denial and Appeal follow up.
- Proficient in Omni Pro.
- Proficient in Micro Soft Excel
- Excellent interpersonal communication skills