Managed overdue accounts by contacting payers and resolving payment-related issues, improving cash flow.
Ensured accurate account balances through meticulous reconciliation and precise payment allocation.
Investigated and resolved billing discrepancies, enhancing accuracy and client satisfaction.
Generated and reviewed payments, managed aging accounts, processed refund/write-off requests, and handled extensive data sets efficiently.
Collaborated with clients to address inquiries via phone and email, ensuring seamless payment operations and high client satisfaction.
Posted payments from residents, insurance companies, hospices, and other payers, maintaining up-to-date account accuracy.

Input all patient data regarding claims and prior authorizations into the system accurately.
Obtained and logged accurate patient insurance and demographic information for insurance providers and medical personnel use.
Verified eligibility and compliance with authorization requirements for service providers.
Reached out to insurance carriers to obtain prior authorization for testing and procedures.
Utilized various software systems commonly used in medical precertification processes (electronic health record systems, payer portals) and navigated these systems easily, enhancing efficiency and accuracy in obtaining authorizations.
Researched denied claims and contacted insurance companies to resolve these issues.
Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
Analyzed medical records and other documents to determine approval of requests for authorization.
Evaluated clinical criteria for approval or denial of services requiring pre-authorization.

Maintained updated and detailed records of calls in an electronic database.
Received incoming calls from patients requesting home services.
Collected customer information, such as location, contact details, and service requirements.
Scheduled appointments for service technicians based on availability and customer preferences.
Planned, organized, and managed the work of subordinate staff to accomplish consistent work within organizational standards.
Monitored the progress of ongoing service jobs and provided customer updates as needed.
Troubleshot any scheduling conflicts or issues that arise during the day.
Collaborated with other departments, such as customer support and sales, to ensure smooth operations.
Continuously optimized the dispatching process to improve efficiency and customer satisfaction.

Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Reviewed, analyzed, and managed the coding of diagnostic and treatment procedures contained in outpatient medical records.
Studied patient charts to understand health histories, diagnoses, and treatments.
Interacted with a physician and other healthcare staff to ask questions regarding patient services.
Sorted and distributed incoming and outgoing medical records.
Maintained accuracy, completeness, and security for medical records and health information.
Transcribed and entered patient medical information into electronic medical records systems.
Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

Maintained and managed customer files and databases.
Recommended solutions to complex situations through research and critical thinking.
Supported customer questions and issues by gathering data, analyzing needs, evaluating possible resolutions, and implementing the best solutions.
Delivered exceptional customer service by prioritizing emergency issues and developing and employing workarounds to solve problems expeditiously.
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Developed customer service policies and procedures to meet and exceed industry service standards.