BEATRICE SMITH southern 1
3
BEATRICE J. SMITH 6770 Buffington Road #3010 Union City, Ga 30291/ [email protected] 267-945-2797 Objective To seek a position that will allow me to display my highly organized business profession, with strong account billing and account maintenance experience. Also, to display my strong self-motivation, interpersonal and communication skills, with being noted for outstanding organization, problem solving and management skills. Billing Systems/ Skills IDX-term, Meditech, Nexgen, CIMCO, Medisoft, Centrix, NDAS, Epremis, NEBO and Ecare. Excel and Lotus .Promise, Trac, On Demand, SMS Invision , Xactimed and Document Imaging. Typing 40-wpm. Code-correct. Healthquest. Work station. Microsoft Word Experiences Southern Regional Medical Center Riverdale, Ga A/R Follow-up Rep/ DRG Denial and Appeal Coordinator 09/2015-05/2016 Responsibilities consist of: *Follow up with insurance companies on open claims including some Hospice and Forensics. *Resubmit claims for payment to insurance companies. *Process Appeals and DRG Denials *Process all request for medical records (Commercial and Traditional Medicare). *Submitted insurance appeal correspondences with Emergency room medical records. *Corrected payment adjustments on all correspondences received from insurance on emergency room claims Aria Health Philadelphia, Pa Billing Representative 12/2014-- 07/2015 Responsibilities consists of: *Reviews daily and monthly reports pertaining to charge control, specifically, OPD Service Report, Charge Exception Reports, 72-Hours Reports, and Inpatient/Outpatient monthly charge not matching service Data reports. *Edits Third party claims for submission to carriers, primary and secondary accounts. This includes initial billing, and rebills and late charges. *Retrieves claims from Xactimed Archive, as appropriate, for resubmission claims. *Order medical records when not available in Chart One. *Completes daily batches, conducting research, communicating with insurance companies, attorneys and patients via telephone, and accumulating needed documentation to expedite the resolution of outstanding receivables * Prepared appeals for 180 days denied claims from Medicaid
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Transcript of BEATRICE SMITH southern 1
BEATRICE J. SMITH
6770 Buffington Road #3010
Union City, Ga 30291/ [email protected]
267-945-2797
Objective
To seek a position that will allow me to display my highly organized business profession, with strong account billing
and account maintenance experience. Also, to display my strong self-motivation, interpersonal and communication
skills, with being noted for outstanding organization, problem solving and management skills.
Billing Systems/ Skills
IDX-term, Meditech, Nexgen, CIMCO, Medisoft, Centrix, NDAS, Epremis, NEBO and Ecare. Excel and Lotus
.Promise, Trac, On Demand, SMS Invision , Xactimed and Document Imaging. Typing 40-wpm. Code-correct.
Healthquest. Work station. Microsoft Word
Experiences
Southern Regional Medical Center Riverdale, Ga
A/R Follow-up Rep/ DRG Denial and Appeal Coordinator 09/2015-05/2016 Responsibilities consist of: *Follow up with insurance companies on open claims including some Hospice and Forensics. *Resubmit claims for payment to insurance companies. *Process Appeals and DRG Denials *Process all request for medical records (Commercial and Traditional Medicare). *Submitted insurance appeal correspondences with Emergency room medical records. *Corrected payment adjustments on all correspondences received from insurance on emergency room claims
Aria Health Philadelphia, Pa
Billing Representative 12/2014-- 07/2015
Responsibilities consists of:
*Reviews daily and monthly reports pertaining to charge control, specifically, OPD Service Report, Charge
Exception Reports, 72-Hours Reports, and Inpatient/Outpatient monthly charge not matching service
Data reports.
*Edits Third party claims for submission to carriers, primary and secondary accounts. This includes
initial billing, and rebills and late charges.
*Retrieves claims from Xactimed Archive, as appropriate, for resubmission claims.
*Order medical records when not available in Chart One.
*Completes daily batches, conducting research, communicating with insurance companies, attorneys
and patients via telephone, and accumulating needed documentation to expedite the resolution of outstanding
receivables
* Prepared appeals for 180 days denied claims from Medicaid
University of Illinois Chicago, IL
Medical Biller Specialist 10/2009-11/2014
Responsibilities consist of:
*Determine claims status, research, and collect on unpaid and denied Medicaid claims using NEBO.
*Analyzed monthly reports, and reviewed aging accounts through a detailed Trail Balance Sheet.
*Follow-up with third payers on payment cycle of each payer.
*Reviewed registration insurance information and account coding were properly inputted.
*Corrected and resubmitted claims when errors were identified through follow-up.
*Making adjustments and write-offs to necessary accounts.
*Billed all Outpatient, Emergency Room, Observation and Surgery claims electronically.
* Billing to outstanding account, and collect and follow-up on accounts.
*Billed all Physic and Reoccurrence claims.
*Prepare necessary paperwork on refunds/credit balances for processing.
*Billed all Medicaid claims on UB92 (UB04) and 2360. Verified eligibility.
*Assist in new employee training. * Worked rejection/denial report.
Jackson Park Hospital Chicago, IL
Medicaid/Medicare Biller 10/2007-5/2009
Responsibilities consist of:
*Billed all Inpatient/Outpatient, Emergency Room, Crossover and 2360’s claims electronically.
*Monitor accounts to determine the timeless of collection/verified coverage and certified days.
*Billing to outstanding account, and collect and follow-up on accounts.
*Account receivable data, make inquiries to insurance carriers.
*Prepare necessary paperwork on refunds/credit balances for processing.
*Determine claims status, research, and collect on unpaid and denied Medicaid claims using NEBO.
* Worked rejection/denial report.
Michael Reese Hospital Chicago, IL
Medicaid Biller 01/2005-10/2007
Responsibilities consist of:
*Billed all Medicaid claims on UB92 (UB04) and 2360. Verified eligibility.
*Determine thru SASS which claims were Discharge Planning or CMH.
*Verified certified/denied days and non-reviewable accounts with HSI
*Making adjustments and write-offs to necessary accounts.
* Work with case management for precertification HIM approved days for Inpatient
Education
Northeastern Illinois University Chicago, IL
Business and Healthcare Industry 09/1981- 06/1982
Moraine Valley Community College Palos Hills, IL
Business and HealthCare Industry 01/2005- 08/2005
Reference Upon Request
