Candidate Information Title Medical Billing Service Representative Target Location US-OH-Cincinnati Phone Available with paid plan	20,000+ Fresh Resumes Monthly     View Phone Numbers     Receive Resume E-mail Alerts     Post Jobs Free     Link your Free Jobs Page     ... and much more Register on Jobvertise Free
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LAURENHARLEYStreet Address PHONE NUMBER AVAILABLEPERSONAL PROFILE: Adaptive, open-minded team &customer detailed oriented and seasoned professional billing analyst, seeking a Management career in the Healthcare Receivables. EDUCATION: University of Cincinnati, 8/1980 - 6/1984***B/A Degree in Business Adm. EXPERIENCEMaple KnollVillage RetirementCommunityRevenue Cycle Analyst 04/2010 - 10/ 2015Over 20 years of extensive Medical billing and collections background coupled with theability to train and teach in this area of expertise. In addition to strong accounting skills which focus onbalancing deposits to receivables transactions for auditing and reporting purposes. Knowledgeable in billing all payers including Medicare A & B, Managed Care and Private insurance. Coordinate billing informationwithMDS and Therapy to ensure correct coding of claims to Medicare and Managed care policies. Verify charges to inventory to assure proper billing for vendors. Manage all authorizationsand claims filing for timely filing. Manage and workwithSocial services, admissions, MDS coordinator and Therapy Department in order to insure properMedicare reimbursements. Experienced in Home Health billing withPalmettoGBA. Set up newbilling procedures and processes based on federal standards. Cash receipts, Fiscal Year Audits /Month End CloseProcedures andCompliance driven EXTENDEDEXPERIENCE: Medical Collections, Appeals all levels including Redetermination Reconsideration Administrative Law Judge (ALJ) Departmental AppealsBoard (DAB) Review Federal Court (Judicial)ReviewSLSeasonRetirementCommunity - Cincinnati,OhAccounting Manager 03/2008 - 04/2010Major role:Actively maintain and manage allaspects of the business office in its entirety. Responsible for all daily and monthlybilling activities. Set up patient information for billing in AHT. (American Health Tech) Knowledgeable in billing and obtaining higher reimbursements oncertain levels of care byusing cost analysis' tools. Focused onallmanaged care products and contracts to complywith billing & reimbursement rules which includes verification of benefits, obtain authorizations and advise members of patient responsibility. Part AandPart BMedicare expience. Tracked case mix scores and their reimbursement. Reduce andmonitor aging of receivables to insure prompt payment from insurance. Post cash,issue credits, reconciliation's and assist with tax preparations.Monitor fiscal changes and present standings. Input charges and assisting residents with billing questions. Reported directly to the corporate controller in order to report GL entries and charting of accounts. Processed deposits and reconciled cash to A/R to days to Rugs Score. Complete financials for corporate reporting for our investors and auditors and Month end close. Long TermCare &physician credentialing experience. HCR-Manor Care,Toledo, OhioCollection Specialist/Accounts Receivable Trainer,06/2005 - 02/ 2008 Major job duties consisted of 100% travel to and frommultiple skillednursing facilities to assist &train business office managers in billing &collections of medical claims. Minor duties constituted andmanual adjustments, write off's reconciliations and appeals. In addition, follow-up with Insurance Companies. MillenniumReceivables,Tampa, FloridaMedical Accounts Receivables, 09/2003 - 04/07/2005 A/R medical billing and collections for the following hospitals which include, University Community Hospital, Helen Ellis Memorial Hospital and Sarasota Memorial Hospital. Job entails reducing A.R for hospitals & skilled nursing facilities. Experienced in all facets of billing which includes radiology, mammography and much more. Excellent follow up on claims billed, pending and appealed. Direct data entry for Part A claims submission. Programs used, Excel & Access. Close follow up on aging accounts involving all payers, Medicare Part A &B, Medicaid, Insurance and self pay.Cardiology, Inc., Columbus,OhioMedical Accounts Receivable Analyst, 08/15/2002 - 09/30/2003 Responsible for investigating claim reimbursements, inquiries and ensuring prompt correct reimbursement of medical claims submitted. In-depth knowledge and experience in ICD-9 and CPT coding review and corrections and HIPAA regulations. Familiar with multiple payor reimbursement types, including Medicare, Medicaid and private insurance payers. Systems usedMedicalManager. WorthingtonChristian Village SkilledNursing Facility, Columbus,Ohio Book-keeper /Account Receivables, 08/30/1999 - 08/01/2002 Responsible for billing receivables insurance companies for payment which would include a working knowledge ofMedicare, Medicaid, Private pay and all Supplemental insurance for more than 300 residents within the nursing and independent part of the facility. Knowledgeable in billing PT, OT speech therapy. Completion of 9400 form for Medicaid. Update patient liability. Tracked case scores from the state, estimating cost over time,monitor aging of receivables to insure prompt payment from insurance, posting cash,issuing credits, reconciliation's, tax preparations,reimbursements, collections, receipts, monitor fiscal changes and present standings. Input charges and assisting residents with billing questions. Experiencedwith general ledger, cost accounting and forecasting of trends vs. seasonalandgeographical demographics. Ability to analyze cost by using visualtools such as time lines, graphs, charts and the Bassets FixedAssets System Program. Current programs usedare Excel, Microsoft, E.C.S. (Electronic ChartingSystem) PowerPoint andLotus. COB experience.NationalCentury Financial, Dublin, OhioAccounts Receivable Analyst, 08/16/ 1998 - 07/ 16/1999 Duties involve analytical review on medical receivables to insure clients aging less than 180 days. Resolving issues by client contact and follow up. Tracking, monitoring and pulling reports for month end completion of analysis, set up A.R. Book's for new clients. Experienced with Proforma and have a clear understanding of how it works. Figured and adjusted contractual based on the net reimbursements. Set up spread sheets on Lotus 123 to track charges, payments adjustments and defaults on individual locations. Report findings and make suggestions on future funding to upper management. Minor duties include collections and accounting functions.AdminastarFederal, Inc., Cincinnati, OhioMedicare Customer Service Representative, 06/20/1995 - 08/01/1998 Call center serviced Medicare part A&B claims submitted by providers of Hospitals, SkilledNursing and C.O.R. F.'s. Knowledgeable in HCFA's standards, operations and laws governing the Medicare program. Familiar with Ohio Fee Schedule's and DRG Coding, in addition answered provider and beneficiary question regarding denied or unprocessed claims. Identify processing errors throughclaims examination and on line reports.