Patient Account Coordinator Resume Samples

Description :

1. Reviewed Physician and Respiratory Therapist charts/notes to prepare medical claims for billing and reimbursement to Medicare, Government Insurances, and Private Insurance companies for the Pulmonary Rehab Services Division.
2. Verified and processed electronic billing for Medicare and most payors, as well as paper claims when reporting is necessary using VERACITY software.
3. Responded to all correspondence in Billing, reviewing and validating all codes, Reviewed and corrected denied claims, review of denials and underpayments for reimbursement Resubmission of Corrected Claims to include written appeals to complete the billing process to ensure clean claims and maximum reimbursement.
4. Worked Aging Insurance and Patient A/R using the software.
5. Reviewed and verified all new patient admissions using the software.
6. Responded to claim denial mail and resubmitted claims with necessary corrections.
7. Identified overpayments on accounts and initiate a refund on overpaid accounts.
8. Ran claims for secondary payors, copied EOB's for submission of claims to the patient secondary insurance carrier.

Experience

5-7 Years

Level

Executive

Education

Information Management

Description :

1. Worked as a Patient Account Coordinator in the Audit Department.
2. Worked with Medicare and various Commercial insurances to resolve outstanding accounts receivable.
3. Contacted payers for claims status, follow-up on denials or partial payment.
4. Processed all incoming and outgoing correspondence as they are assigned to me.
5. Maintained a positive and cooperative manner in working and communicating with individuals at all levels of the organization.
6. Obtained payer requirements for timely adjudication of claims.
7. Initiated the review/appeals process on disputed claims.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Identifies improvements that can be made in Providence Hospital billing and collection procedures.
2. Identifies discrepancies between amounts posted and amounts received the reasons for the discrepancies, and the actions being taken to correct discrepancies.
3. Identifies when a service is medically necessary and/or denied appeals When explanations of benefits are received, identifies the month to which payments should be applied.
4. Ensures that denied claims are posted to the billing control log and that the billing control log is transmitted to Program Directors.
5. Identifies corrections that must be made in billing to correct denials and prevent future Denials.
6. Monitores Daily Billing by CPT codes for not billable services.
7. Requests and post mandatory authorization according to insurance services.
8. Participates positively in liaison with government agencies, payment intermediaries, and Providence Hospital personnel.

Experience

2-5 Years

Level

Junior

Education

Certificate In Health

Description :

1. Resolved claim denials and accounts.
2. Submitted clean and corrected claims for processing.
3. Answered a multi-line phone system.
4. Submitted reconsideration and appeals for private insurance.
5. Specialized in Blue Cross Blue Shield, United Healthcare, Cigna, CareCentrix, and other less known insurance policies.
6. Resolved major issues with a third party supplier that was ongoing.
7. Processed all billing for eap, make calls and answer all questions as needed.

Experience

2-5 Years

Level

Junior

Education

Associate Of Science

Description :

1. Performed multifaceted administrative tasks in this six-provider dental practice.
2. Generated plans for recommended treatment to best utilize insurance benefits and financial options for patients.
3. Tracked predeterminations, amended treatment plans, and patient contact with information.
4. Generated monthly billing and collections.
5. Communicated with difficult and tense patients.
6. Provided support for front desk duties (e.g., appointments, billing questions, charts, insurance verification).
7. Increased monthly receivables by 15%.
8. Implemented the use of electronic medical record with charting performed by assistants for more accurate treatment plans.

Experience

7-10 Years

Level

Management

Education

B.A. In Management

Description :

1. Confirmed patient insurance eligibility and/or benefits.
2. Generated patient statements.
3. Answered phone calls.
4. Provided customer service to patients inquiring about their patient statements.
5. Determined required deposits, and follows up to make sure payments were made in accordance with the Center's policy.
6. Audited charts for the correct income verification process.
7. Adjusted bad patient checks off and enter notes in the practice management system.

Experience

2-5 Years

Level

Junior

Education

Associates In Arts

Description :

1. Responsible for collections and making calls to assigned accounts.
2. Expedited claim submission and payments.
3. Worked correspondence is timely with an appropriate response.
4. Detailed documentation provided of each account worked.
5. Processed adjustments and transfers in each account.
6. Processed and coordinated changes in patient status timely.
7. Understood and utilized account invalidations appropriately.

Experience

7-10 Years

Level

Management

Education

Healthcare Management

Description :

1. Captured all patient charges in the billing system.
2. Worked with department managers in the review of daily charges.
3. Posted all payments and adjustments to the billing system.
4. Filed all documents in the patient's billing record.
5. Relieved the receptionist for breaks/lunch as assigned.
6. Reconciled accounts and processed claims with Medicare.
7. Processed claims through SSI.
8. Corrected and submit claims for Medicare Part B.
9. Performed chargemaster maintenance as needed.

Experience

2-5 Years

Level

Junior

Education

MBA In Healthcare

Description :

1. Prepared insurance claim forms or related documents and review them for completeness.
2. Recouped 41% of oustanding balances from patients and insurance companies Review insurance policies to determine coverage.
3. Prepared itemized statements, bills, or invoices and record amounts due for items purchased or services rendered and resolve discrepencies in billing records.
4. Consulted sources such as rate books, manuals, or insurance company representatives to determine specific charges or information such as rules and regulations.
5. Performed bookkeeping work such as credits and collections; preparing and sending insurance claims and bills; maintaining payment records; posting data and keeping other records such as invoices; and, cataloging support documents and the shipment of goods.
6. Collected and analyzed data to detect duplicate billing, overpayments, or non-compliance with laws, policy regulations, and management policies.
7. Contacted patients to obtain or relay account information.

Experience

5-7 Years

Level

Executive

Education

Bachelor's Of Art

Description :

1. Coordinated insurance verification and scheduling for new and current patients.
2. Served as a patient advocate and responds to patient complaints.
3. Participated in Quality Assessment and Improvement programs.
4. Ensured compliance with regulatory requirements in regards to JCAHO.
5. Collected and post payments to the hospital information system.
6. Performed insurance verifications and updates eligibility software.
7. Administered audit and payment adjustments in the hospital information system.
8. Explained financial responsibility directly to patients.

Experience

10+ Years

Level

Senior

Education

Bachelor Of Arts