GetHiredToday

Medical A/R Recovery Specialist

Posted on: 2011-03-14

EXPERIENCE:

 

02/2010 – Present

Private

Annapolis, MD

Business Manager

  • Coordinating efforts between our office and our billing company to streamline procedures and update practices used.
  • Training staff on HIPAA policies and office procedures.
  • Streamline forms and paperwork to better suit both patient and provider needs.
  • CAQH attestation and credentialing
  • Assist company in managing Open AR and strategizing with both office and billing company to collect monies owed by patients and insurance companies.
  • Work with staff to help ensure clean claim submission and whole patient information entry.
  • Coordinate between owner, staff and providers
  • Problem solving both with contractors and with patients
  • Back up the front desk when necessary
  • Patient scheduling,  authorization and benefit checks.

 

 

03/2008 – 02/2010

Riva Road Surgical Center

Annapolis, MD

AR Recovery

 

  • Compile billing packets for each patient seen per day, including encounter forms, demographic sheets, insurance information and any other information needed to process claims
  • Complete encounter forms for each patient including patient information, insurance information, payment due as well as CPT and ICD-9 codes. 
  • Post charges and patient payments into patient account. 
  • Post payments from insurance companies and verify payment batches. 
  • Post payments and adjustments from Medicare EFT\'s 
  • Create electronic claim batches. 
  • File insurance claims electronically 
  • Work edits in electronic billing system, fix edits and resubmitting claims 
  • File Workman Comp claims 
  • Pulling Operative Notes from MedTek  
  • Print and mail statements to patients 
  • Regularly obtain status of open claims in order to decrease company\'s AR and to increase income. 
  • Process denials for appeal, reprocessing or write-offs.
  • Correspond with patients to collect monies due after time of service; including but not limited to past due balances and insurance remittances made to the patient 
  • Contact primary care doctors, cardiologists, laboratories and any other necessary facilities to obtain needed pre-operative information as needed by the PACU nurses. 
  • Create and utilize spreadsheets to track patient balances, monthly AR, implant logs and daily patient and insurance payments. 
  • Create and utilize spreadsheets to track appeals, payment negotiations and claims audits.
  • Retrieve mail and log insurance payments into patient accounts. 
  • Document payment breakdown by CPT code, calculating percentages allowed and paid. 
  • Creating, compiling and mailing appeal documents to insurance companies. 
  • Creating and mailing letters to send to patients requesting the release of insurance payments 
  • Answering and addressing patient questions and concerns regarding billing. 
  • Provide back up for schedulers which includes but is not limited to phone relief, scheduling patients, creating patient files and checking benefits. 
  • Provide back up for business manager by entering payments into Quickbooks, balancing daily spreadsheet, corresponding with Nurse Administrator and biller and creating daily deposits.

 

 

03/2007 – 03/2008

Oasis; The Center for Mental Health

Annapolis, MD

Office Manager

 

As of April 01, 2007 I was promoted to Day Manager.  I perform the same duties as I did prior to the promotion, but I also am responsible for:

•             Manage a staff of 4 office employees and designating duties and upholding office policies.

•             Train staff to maintain HIPAA compliance.

•             Manage and maintain staff schedules.

•             Set up and run monthly meetings with the office staff and upper management.

•             Work with staff to address patient questions and concerns.

•             Work with billing agent to ensure accurate billing and charging.

•             Help the staff triage and coordinate individual level of care needed per patient.

•             Responsible for monthly budgeting and purchasing of office supplies.

•             Responsible for providing upper management with weekly and monthly statistical reports.

•             Created a report for upper management tracking patient procedure histories to be used for contract negotiations.

 

 

2/2004 - 03/2007

Oasis; The Center for Mental Health

Annapolis, MD

Administrator

 

Played a key role in start up of company. Created forms both for office use and for obtaining information from patients. Helped to create practices and policies for company. Handled marketing, set up monthly meetings with outside businesses, trained other employees, in charge of purchasing office supplies. Maintained patient files, both paper and electronic, which involved strict confidentiality practices. Managed patient intakes, handled insurance needs; found out copays, co-insurance and deductibles for our patients, obtained prior authorizations when needed, prepared Uniform Treatment Plans, tracked claims and assisted with claim adjudication.  Performed regular office duties, such as answering phones, filing, data entry and routing mail. Greeted patients, helped with prescriptions, assisted patients with problems or questions regarding coverage or treatment.  Assisted in IEP\'s and inpatient routing. Compiled and maintained a press kit for marketing purposes.

 

 

5/2003 - 2/2004

Hartwell Engineering, Inc

Crofton, MD

Administrative Assistant

 

Daily office duties, answering phones, maintaining files, supply purchasing. In charge of assembling submittals for various projects throughout Maryland, DC and Virginia.

Set up meetings with contractors, put together bid packages, routed mail. Maintained daily correspondence with contractors. Created and maintained spreadsheets for jobs. Managed timesheets and entries for payments.

 

 

7/2002 - 5/2003

Next Wave Group, LLC

Severna Park, MD

Office Manager

 

Responsible for general office management duties; phones, daily maintenance of computer files, addressing customer concerns and weekly maintenance of various reports. Handle booking and coordinating conferences & meetings for division heads, as well as processing financial reports, updating and maintaining A/R tracking and Association Membership information. Key contact for a number of associations as well as helping to manage a nationally recognized trade association. Distributed news flashes regarding issues involving the association. Involved in Press Releases via blast emails. Assisted with a quarterly newsletter.

 

 

1/2002 - 7/2002

Spherion

Annapolis, MD

Administrative Assistant

 

Worked as a temp for Spherion. Responsible for data entry, mail merges, correspondence, mailings, and other general office duties. Maintained critical files in electronic and hard copy formats. Significant use of MSOffice and some Internet research.

 

 

12/2001 - 1/2002

MaximHealth

Baltimore, MD

Assistant to the Clinical Director

 

While working as a temp for MaximHealth, at Johns Hopkins working for the Clinical Director of the National Institute on Drug Abuse. I sat in on the Intramural Review Board meetings, one of which I was responsible for transcribing the entire session. I also helped in setting up a symposium in which visiting doctors from hospitals around the country would come in and review our IRB. I maintained confidential files, both hard copy and electronic. I also performed data entry, typing, and correspondence with other doctors and researchers in the department. Because of my responsibilities, I was required to take several online courses dealing with the confidentiality and safety of Human Subject Research.

 

 

1/2001 - 10/2001

IIT Research Institute

Senior Data Specialist

Administrative Assistant

 

While working for the Assistant Vice President, I was responsible for data entry of division\'s weekly time records, maintaining division\'s files, handling certain financial reports, updating and maintaining a series of cost tracking and data management spreadsheets, assisting in training coordination, web research, maintaining personnel files, making travel arrangements, booking and coordinating conferences/meetings for division heads, handling logistics of the needs of my division. I also assisted with maintenance of certain databases and applications for various advisors in my department.

 

 

8/1997 - 2/1999

Berliner Construction

Company

Annapolis, MD

Assistant Office Manager

 

Responsibilities included being in charge of the Payroll, Accounts Payable and Account Receivables Departments; data entry; collating drawings and specs as needed for our

subcontractors; preparing bids; attending bid meetings; acting as liaison between the Accounting Department and the public; checkbook reconciliation; the implementation and daily maintenance of computer files; generating correspondence letters to the customers; general office work. Used Ms Office on a daily basis.

 

 

 

SKILLS:

 

Microsoft Word

Expert

Currently used/10 years

 

Microsoft Excel

Expert

Currently used/10 years

 

Microsoft PowerPoint

Intermediate

Currently Used/5 years

 

Vision

Intermediate

Currently Used/2 Years

 

Zirmed Electronic Billing

Intermediate

Currently Used/2 Years

 

MedTek

Beginner

Currently Used/2 years

 

 

 

REFERENCES:

Available upon request