Follow Up Medicare Claims

Vanessa Davis

*** ** ************, ******** **** OK 73114

405-***-**** cell

(ad7r24@r.postjobfree.com)

OBJECTIVE: To join an organization that can utilize my skills and expertise in a challenging position.

WORK EXPERIENCE:

Coordinated Care Health Solutions, LLC/On-Point Billing Service

MEDICARE BILLER

10120 Broadway Ext Ste# 220

July 1, 2021 to Oct 31, 2022/Nov 1,2022 to 01/31/2024

I was responsible billing all Medicare claims on the Novitasphere website for Medicare. On a daily basis. I worked the accounts that was assigned or located in my Work Que. I would check the accounts on DDE to see what is needed to get claim(s) processed or paid. This was for all clients that CCHS serviced for lab work. This required me to make calls to insurance companies and or search websites to see what the status of claims. My job also required me to work denials and make corrections ad resubmit corrected claims. If new information was available like new insurances and etc. I would make the changes needed to get claims paid. I worked hospice accounts, and added modifier’s if needed. I would also work commercial insurance, Medicaid, Blue Cross and etc.

Integris Health/Baptist Medical Center OKC, OK

INSURANCE FOLLOW UP/PATIENT ACCOUNTING SPEC I

Dec 30, 2019 -August 28, 2020 (I went on Furlough from April 16, 2020 to August 28,2020.

I was responsible for processing all Medicare claims on DDE system. Which is the Medicare website for claims.

SMG/Solutions Management Group OKC, OK

COLLECTIONS/AUTHORIZATIONS

EIH: Essential Integrative Health Nov/2017 – April 12, 2019

I was responsible for ALL Authorizations for Pain Management Providers. Working all insurance denials, no response and follow up, posting adjustments. Audit patients accounts. This was multi specialist providers. Handle patient cost estimates for ALL large surgeries, collections. Handle refund review & requests, Patient & insurance. Schedule appointments & run front desk reception. When needed, I set up payment plans and informed patients of their part to pay, this included deductibles, copay’s and coinsurance. Run reports for providers to let them know what the numbers look like. Turn accounts to collections if needed.

Vanessa Davis page 2

September 2003 – June 2017

FINANCIAL COUNSELOR (PSR)

OU Medical Center, Oklahoma City OK

Duties: Interview patients and responsible parties to obtain personal, demographic and financial information and schedule up appointments, follow up. Review registrations, admissions and appointments for accuracy. Receive physicians’ orders to admit, register or schedule patient. Collect co-pays. Maintain various reports and logs. Assist supervisor in developing work schedules. Provide indigent patients (about 70%) with information on programs and facilities that may help them with their medical needs.

March 2003 – August 2003 (lay off)

MED-CHECK ANALYST

Corvel Inc., Oklahoma City OK

Duties: Before Corvel Inc., suffered losses and laid off most staff, I oversaw processing Workman’s Compensation Claims for several of the company’s clients. Reviewed and priced the claims according to the Workman’s Compensation Law for Oklahoma, Nebraska, Virginia and New Mexico. Processed the claims and entered data to maintain files to satisfy the federal guidelines.

June 1996 - February 2003

CREDIT COLLECTIONS/PRIVATE PAY/PAY ARRANGEMENTS

Deaconess Hospital, Oklahoma City OK

Duties: Processed all self-pay accounts for payment in full by the patients and processed Hospital deposits. Handled refunds for private pay accounts. Developed flat rate contracts

for patients without insurance and set up loans with outside sources for patients who could not pay in full. Turned accounts to collections or Credit Bureau as necessary and followed up by reporting payments, working with insurance companies, physicians, and their office staffs. Posted and/or removed charged from accounts after audit, including invoices for the Hospital. Processed bankruptcies and liens. Provided clerical support for all Nursing Home and special accounts. Maintained accounts for Shared Services.

EDUCATION:

Northwest Classen High School, Oklahoma City, Basic Accounting, Graduated January 1980

Belle Isle Vo-Tech, Oklahoma City, Banking & Accounting, Graduated January 1980

Draughon’s School of Business, Oklahoma City, Business Machines, Graduated October 1980.

SKILLS:

10-key by Touch, Windows 95/10, Accounts Payable/Receivable, E-clinicals Works (EPIC)

Medical Terminology, Customer Services, Medisoft software, Typing, CRT Experience, some Coding, Medic Software, HBOC/AS400, TELCOR

REFERENCES AVAILABLE ON REQUEST

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