virginia robison

Submitted physical therapy, urology, mental health, substance abuse, plastic surgery, pediatrician, cardiology, PCP, and pain management clean claims to government and commercial insurance companies. Identified and resolved patient billing complaints. Evaluated patient’s financial status and established budget payment plans.

Insurance billing and follow-up for Medicaid, Aetna, Cigna, First Health, CCN, PHCS Networks, UHC, Access Health, Tricare, and other insurances. Reviewed overdue and high dollar accounts, making appropriate adjustments and collections within each insurance company’s billing rules. Completed monthly computerized physician AR reports within designated deadline. Direct data entered all Medicaid claims in the EDS web portal; stayed current on all Medicaid updates. Followed up on all zero payment explanations of benefits, exercising all options to obtain claim payments; interpreted fee schedules, utilizing them to ensure proper payment.

Reviewed overdue and high dollar accounts, making appropriate adjustments. Managed correspondence from CMS through First Coast Service Options and all correspondence from Tricare. Gathered information and documentation to write Medicare, Medicaid, and Tricare reviews and appeals using an electronic medical records system. Insurance billing and follow-up for Medicare, Medicaid, and Tricare.

Managed and trained employees; cultivated relationships with churches and other organizations. Handled computer problems including hardware and software issues. Responsible for all special orders and resolving any vendor discrepancies. Resolved customer complaints in a professional and courteous manner. Generated computer systems reports for the day’s activities and resolved any discrepancies. Performed various and numerous customer service duties.

Reviewed all inpatient E&M charges and diagnosis codes, corrected coding errors specific to each payer. Generated bill error report to identify errors and made corrections. Created claims and sent them electronically to Medicare, Medicaid, Self Pay, and Commercial Insurances. Handled month end reconciliation for all billing. Posted all payment remits received from Medicare, Medicaid, Commercial Insurance, and Self Pay. Reconciled patient records; handled customer service calls and letters with patients. Worked with Billing Coder to identify coding coaching needs for providers.

Activities and Societies: Phi Theta Kappa, PTK 5 Star Competitive Edge

Phi Sigma Theta National Honors Society Golden Key International Honor Society