Claims Analyst - Trend Health Partners - Nashville, TN
(2022-02)
WFH Position
- Processing and reviewing Inpatient and Outpatient claim denials, from all Major Insurances Completes.
- Writing appeals, processing and posting payments for the facilities.
- Meeting and exceeded client expectations by reaching the daily goals and monthly metrics.
- Consistently checking balances, such as 120 days past due and able to resolve accounts, both on Commercials and Government accounts.
- Our major clients are HCA and UPMC.
Claims Representative - HFRI, LLC - Chicago, IL
(2020-09 - 2022-02)
WFH Position
- Reviewing all denied claims for Underpayments, Overpayments as well as any coding corrections needed; to have the client's claims paid as per contract.
- Responsible for calculating the expected payments by using contract formulas.
- Proficient in meeting the metrics set out by the Company.
Patient Accounts Representative - HCA Healthcare - Nashville, TN
(2018-02 - 2020-07)
WFH Position
- My position as a patient account representative required me to handle all Incoming and Outgoing calls from patients as well as Insurance carriers.
- Daily activities included posting payments, adjustments, discussing balances and handling all mail and correspondence for the patient; all while meeting metrics set by the company.
- Updating all patient's demographics as well as adding Insurance information such as claims address, effective dates, and any other relative updates to assist the billing department; all while using the Epic System.
- This position also required calling on all major Insurance company to obtain the patient's current eligibility and benefits throughout the entire Vanderbilt System.
Verifications Representative / Central Registration - Vanderbilt University - Nashville, TN
(2017-08 - 2017-12)
CONTRACT POSITION
- Updating all patient's demographics as well as adding Insurance information such as claims address, effective dates, and any other relative updates to assist the billing department; all while using the Epic System.
- This position also required calling on all major Insurance company to obtain the patient's current eligibility and benefits throughout the entire Vanderbilt System.
Intake Specialist - Legal Intake Professionals - Nashville, TN
(2017-04 - 2017-10)
- Part time evenings and Overnight Call representative
- Received calls from potential clients who were requesting the advice or assistance of an attorney
- Processed the clients information completely and accurately to the designated attorney
- Handled Medical Malpractice, Slip and fall, Auto Accidents, and Whistle Blowers cases
Medicare Representative - CGS - Nashville, TN
(2017-05 - 2017-08)
CONTRACT POSITION
- As a Medicare contract employee, our team was responsible for clearing up incorrect payments made by Medicare to thousands of providers.
- These edits were made primarily on J codes.
- The claims were then reprocessed correctly and then paid to Physicians and Hospitals.
Outpatient Therapy Verifications Representative - Brookdale Senior Living - Brentwood, TN
(2015-01 - 2017-03)
Private Pay SNF PAR / Collections A/R
- Complete understanding of Outpatient PT/OT/ST Charges, EOB's as well as Medicare/Medicaid/Secondary and Private Pay charges
- Verification of all major insurances, State Medicaid Plans, Tricare/Champ VA. Determining benefits and Coordination of Benefits
- Working closely with the Skilled Nursing and Assisted Living Facilities. Also communicated directly with Site Directors and Therapists of needed.
- Team player and was able to provide past collection experience to the department. My goals were also met within the company as well as being a top performer
