Darlene

Medical biller/Payment Poster/Administrative

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Overview

Looking for full-time work (8 hours/day)

at $9.80/hour ($1,724.80/month)

high school graduate

Last Active

November 24th, 2024 (today)

Member Since

March 1st, 2017

Profile Description

Work as secretary cum administrative assistant.
Computer literate and know computer program such as MS Word, Excel and Outlook, Google Drive, Docs
Basic email, corresponding email and drafting.
Oversees filling and clerical works like preparing documents.
Data entry ,gathering information, organize and accurately entering information into spreadsheet.
Customer service oriented and have work in a multicultural environment.
I have five years of experience working in a US-based company. My specialty is working in Podiatry and Behavioral Health and handling clients/providers within the state of Texas, Louisiana, New Hampshire, and Kentucky. I worked primarily as an AR Representative Medical Biller and payment poster. I also do the patient collection - doing the non-claim charge, verifying balance, collecting and posting patient payment. Aside from this, I also do the following :•Verifies patient eligibility and correct insurance/payers such as MCO coverage•Updates patient’s demographic information (new insurance, address, phone number, email address,etc.)•Identifying and billing secondary or tertiary insurances•Creates non-claim patient charges•Verifies patient balance and apply patient payments•Verifies prior auth and referral•Works on claim rejections•Coordinating with EDI department•Verifying credentials of provider’s with insurance•Review medical record & Claim submission•Follows up claim status and makes sure claims are paid within the standard billing cycletime frame???Email providers and office managers for medical records•Reviewing medical records for accurate information•Pulling up EOB from the web portal and uploading to the system•Understands EOB/EOP and posts payment(cheque, EFT, credit payment)•Deals No pay/Zero EOP/EOP payment•Calling insurance for claims status, verify denial reason, appeals follow-ups, and verifyingprovider’s contract•Resolves claim denials and takes care of zero payments•Creates and uses insurance provider web portals•Creates appeals for claims with denials such as time filing issue, medical necessity, andgrievances
I’m very knowledgeable with :•Medicare and Medicare supplements•Medicaid and Managed Care•Commercial insurance•DME billing•Workers Comp
Familiar with EHR/Billing System :•NextGen (formerly known as Meditouch/HealthFusion) system•Therapy notes•Kareo•AdvanceMD for posting only
Familiar with the following tools :•Web portals(such as Availity, Optum, Tricare, Ambetter/Superior Health Care/ Ambetter, Molina, Medicare and Medicaid, Health Plan, Payspan, Navinet, Change Health, AetnaBHK, Passport, Zelis, Instamed, etc)•G suit,•Microsoft Office•Ebrige•Nextiva•Using different virtual desktops like Citrix and VMware
I have been known for the excellent quality of work. Once I start working in a site/assigned provider, I try to research the codes and way of billing - how they usually get paid and looking for updated coding guidelines with each insurance. I also coordinate with the client/manager and create an SOP Guideline with each client I handle to understanding how they prefer things to be done with the site
I am also equipped with interpersonal skills, having maintained a conducive working relationship with my colleagues, sharing knowledge, and helping them resolve their issues/denial they encounter with the site they handle.
Feel free to contact me should you require any clarification on my experience.

Basic Information

Age
31
Gender
Female
Website
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Address
Manaoag, Pangasinan
Tests Taken
DISC
Dominance: 32
Influence: 32
Steadiness: 28
Compliance: 9
English
C2(Advanced/Mastery)
Government ID
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