Results-driven medical billing professional with 14 years of experience in claims management and follow-up. Expertise in navigating complex billing processes and enhancing patient satisfaction through efficient dispute resolution. Proven track record of ensuring compliance with healthcare regulations while maintaining precise documentation.
Overview
1
1
Certification
22
22
years of professional experience
Work History
Patient Account Representative 4
FMOLHS-Franciscan Missionaries of Our Lady of the Lake HS
Baton Rouge
2024.06 - Current
Verified patient eligibility for medical claims, confirming benefit coverage to facilitate accurate processing.
Filed and monitored medical claims with insurance companies, ensuring timely submission through electronic and paper channels.
Analyzed denials, rejections, and underpayments from insurance carriers to confirm accurate reimbursement receipt
Identified discrepancies on invoices by cross-referencing contracts and fee schedules, ensuring alignment for accurate billing.
Collaborated with healthcare providers to address claim discrepancies.
Senior Medical Billing Specialist-Follow up
NewSouth NeuroSpine Pain Facility
Jackson
2012.04 - 2024.04
conducted follow-up on claim receipt verifications with insurance carriers to ensure timely processing
track and oversee claims processing until completion
Conduct timely follow-ups to accurately identify errors, denials, or rejected claims once denial is recognized.
followed up and monitored payment allowances from payors to confirm accuracy and compliance
accountable for detailed documentation of findings and resolutions related to accounts
followed up with patients about claims disputes and general inquiries
facilitated timely and precise charge submissions through electronic capture using billing and accounts receivable (BAR) system and clearinghouse, enhancing revenue cycle efficiency
Medical Billing Specialist
University Medical Center
Jackson
2011.05 - 2012.04
Verified patient information and copays while confirming insurance coverage to ensure billing accuracy.
Executed follow-ups to verify provider charges, ensuring accuracy of service dates and diagnosis details.
Analyzed medical and surgical records to identify billable services accurately.
Facilitated communication between billing department and third-party payers to expedite resolution of reimbursement issues.
Lead 3rd Party Claims Adjustor
PharMerica Pharmacy
Jackson
2007.10 - 2011.05
Submitted Medicare and Medicaid claims to ensure compliance with regulatory standards, minimizing risk of denial.
Established rapport with nursing facilities and residents, securing timely payments for outstanding accounts.
Facilitated team training to resolve billing discrepancies, enhancing overall accuracy in claims processing.