Board Secretary & Web Host @ Valley Sports Little League
A/R Specalist @ The Pain Medicine & Rehab Center
I have worked in the Healthcare field since 2000 from many different aspects. That has given an incredible advantage because I know the Insurance company and I know claims. I have collected Millions of dollars for my clients. I have a wide arrange of knowledge and experience. Also I love to create web sites which I do
I have worked in the Healthcare field since 2000 from many different aspects. That has given an incredible advantage because I know the Insurance company and I know claims. I have collected Millions of dollars for my clients. I have a wide arrange of knowledge and experience. Also I love to create web sites which I do in my spare time. I am on the Board at Valley Sports Little League.
A/R @ Thoroughly investigated past due invoices and minimized number of unpaid accounts.
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
Resolved and clarified issues with patient accounts and collaborated with local clinics.
Applied payments, adjustments and denials into medical manager system. Posted charges, payments and adjustments.
Carefully prepared, reviewed and submitted patient statements. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.
Consistently informed patients of their financial responsibilities prior to services being rendered. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials. From March 2013 to Present (2 years 10 months) Board Secretary & Web Host @ I make games schedules for over 500 players. Coordinate with coaches, team parents, Board members, Little League and scouts. Keep the offical roster for Pitch count and send out all reminders and any new information. Update and maintain the website. Plus Much Much more. :) From January 2003 to January 2014 (11 years 1 month) A/R Specalist @ Took copays & past due balances at check in counter.
Scheduled and Pre-cert MRI's, and made follow up appointments at check out.
I made daily reminder calls to the patients of their appointments & balance due.
Billed and collected on aging & current accounts.
Worked with a collection company to get paid due accounts off the books.
Answered phones and routed calls to Nurse's line. From May 2012 to January 2013 (9 months) Medicare Coordinator @ Worked Special Projects as directed by my Supervisor. Corrected claims in IVANS daily in order for the claims to pay in sequence for 13 Skilled Nursing Facilities. Followed up and collected on past due claims. Contact person for all Medicare claim issues for the Nursing Facilities. From June 2011 to May 2012 (1 year) Central Billing Coordinator @ Corporate office of 19 Skilled Nursing Facilities and 43 Assisted Living Facilities Maintain AR accurate and prompt billing.
Post all cash receipts, file all adjustments, File all NO Pay bills to Medicare.
Process all refunds; File the Medicare Credit balance Report.
Send out Patient Statements; make sure all Administrators are following our collections and Bad Debt policies.
Analyze outstanding accounts Receivable and process old outstanding claims From June 2010 to June 2011 (1 year 1 month) Customer Support @ Extensive knowledge with the ZirMed system/ALL functions
Answer incoming calls from customers, vendors, intermediaries and payers
Assist customers with overall website inquires/Support Emails
Communicate effectively with internal & external departments
Handle escalate calls and issues for full resolution.
Participate in internal and external conference calls as well as face to face internal and customer meetings.
Investigate complex EDI issues and determine resolution. From June 2009 to June 2010 (1 year 1 month) Claims Service Rep @ Passport Healthcare
Answer incoming calls from providers regarding managed care issues. Review claims for reconsideration that was paid incorrectly for physicians and Hospitals. Supported providers in order to get their problems/issues resolved. Work appeals and correspondence review for reprocessing per the Medicaid/Medicare rules. Worked special projects given by Managers. From July 2008 to July 2009 (1 year 1 month) Claims Examiner @ Third Party Administrators
Paid claims daily that didn't make first pass. Reviewed & Reworked claims that were paid incorrectly. Priced claims per their individual contracts and per coding before paying. % of pay was taken if there were errors. Worked on commission only. Pay per performance. From March 2006 to July 2008 (2 years 5 months) Auditor @ Reviewed clients systems to determine if claims were paid per coordination of benefits. During my investigation I communicated with Medicare, Patients, and Employers. If an error was found I would request the money from Providers. Was a Mentor for new employees. Constructed training manuals and implementations of new clients. Trained new employees.
Million Dollar Club From May 2000 to March 2006 (5 years 11 months)
Associates, Business Management @ Sullivan University Lelehna Elder is skilled in: Healthcare, Accounts Receivable, Medical Billing, Customer Service, Techinical, Medical Coding, Hospitals, Managed Care, Applicant Tracking Systems, Invoicing, Leadership
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