vernell dix

* Insurance verification and claims submission * Reviewed charges on inpatient and outpatient trial balance report * Electronic billing on Claimstar, Caremedics, and APCs/Split billing * Filed appeals and some DME billing on HMO’s and Managed Care claims * Customer service duty on denied claims

* Taking in-bound and outbound calls for various hospitals * Kept track of insurance information, credit card payments, payment arrangements, and patient information * Requested medical records and itemized bills to send directly to patients or insurances

* Billing Commercial claims (UB04) using system X-Claim, Paragon, Meditech 5&7, Epremis * Queue and request bills for claims submission with the use of CPSI, SMS and Series * Read contracts through IMACS system * Verified insurance and followed up on claims to completion for payment * Appealed when necessary for inpatient and outpatient claims * Set up refund packets for claims that were overpaid by the insurances or patients * Reviewed bad debt and used Excel to keep track of accounts

* Billing In and Out-of-Network Commercial, No Fault, Workers Compensation, Managed Medicaid and Medicare hospital claims * Follow up with claims that have been denied and/or underpaid * Initiate appeals when necessary such as no authorization, medical necessity and timely filing issues * Submission of electronic/hardcopy medical records along with itemized bills to the insurance * Ability to adjust claims accordingly * Identify contracts thoroughly and manage over 40 accounts per day * Basic Excel skills to keep track of accounts on a daily basis * Currently using Soarian and SSI Group billing system * Previous experience with hospital systems such as EPIC, Eagle, Meditech 6 Live, SMS, Gaffe and Epremis billing system