Seasoned Collections Specialist eager to contribute extensive research, problem solving,

and project management expertise toward supporting a progressive company in achieving business goals and objectives.

 

 

         16 years experience in medical collections/billing, insurance, patient accounts and provider services, with proven success in reducing delinquent accounts and ensuring accuracy of billing codes.

         Advanced abilities in analyzing and interpreting contracts, understanding medical terminology, swiftly resolving billing discrepancies, and cultivating excellent patient relations.

         Considerable supervisory strengths spanning both office and staff management.

         Adept throughout entire range of medical billing and claims processing management including CPT and ICD-9 coding and referral process.

         Develop and execute administrative procedures to eliminate redundancy, standardize workflow, heighten productivity, and control costs.

         Reliably maintain strict confidentiality of files and documents.

         Extensive knowledge of all major insurance carriers as well as Workers Compensation, auto insurance companies, and non-contracted insurance firms.

 

 

Catholic Healthcare West (CHW), Pasadena, 2005 to Present

Contract Collection Specialist / Revenue Cycle Collector

         Rapidly mastered more than 10 office and document imaging systems to efficiently navigate complete spectrum of collections operations and play a key role in financial improvement initiatives.

         Proficiently apply contract terms/conditions and reimbursement rates to expedite reimbursement process and reduce overall aging of Managed Care receivables.

         Conduct in-depth payor research and recommend strategies to address problem payers.

         Proactively investigate sources of delays, denial and underpayments.

         Manage, motivate, train, coach and supervise five employees.

         Contributed to Managed Care Recovery Unit achieving departmental and company goals.

 

Alfigen-Genetics Institute, 1987 to 2005

Collection Supervisor

         Spearheaded full-scope collections operations from third-party payors, direct bill clients and patients, established and maintained cooperative relationships with Managed Care and Utilization Review personnel, and diligently prepared and submitted month-end reports.

         Administered Medicare accounts requiring proficiency in correcting ICD-9 codes, requesting retro authorizations, and submitting appeals.

 

Continued

 

 

 

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Professional Experience continued

 

         Researched, analyzed, and drove collections for 120+ delinquent accounts spanning HMO s, PPO s, and private/government accounts.

         Implemented new computer systems and coordinated conversion for government agency account.

         Applied dynamic leadership talents toward hiring, training, mentoring, coaching, and directing team of five employees; conducted regular performance evaluations and held accountability for discipline and terminations.

         Met with representatives from IPAs and health plans to establish codes, letters of agreement and contracts. 

         Resourcefully created profiles and reports to support analysis of aging and delayed payment issues.

         Accompanied Sales Representatives on visits to potential clients to assist with billing and contracting issues.

 

Additional experience: Front Office Manager / Collector, Dr. Babatunde Eboreime, Pasadena, CA.

 

 

Medical Manager           Touch Point                  EZ-Med                                    Meditech                       Novell

MS4                             Artiva                            Mckesson                     Ascent                          Invision

ESP imaging                 The SSI Group              Siemens EDM

Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook, Publisher)

 

 

Associate of Science Degree; Associate of Arts Degree C Pasadena City College

 

Medical Assistant Certificate, Glendale School of Business

 

Member, National Association for Female Executives (NAFE)

 

Attended numerous Padgett-Thompson-National Group seminars