Objective
I’m seeking an opportunity that will allow my experience as a Reimbursement Specialist to expand in the medical field.
Summary of Qualifications
I have over eight years experience as Reimbursement Specialist. Experienced in claims processing, collection practices, and identify fraudulent practices. I am proficient with McKesson/Horizon Homecare, Excel and Word.
Work Experience
July 2005 to Present
Nurse finders
Arlington, TX
Reimbursement Specialist II
• Insured that Monthly and weekly Medicaid billing claims are prepared and processed on HCFA/UB claim forms that adhere to state and federal regulations guidelines.
• Interacting with the Branches, to insure the accurate service that have been authorized and also have rendered for the Home Health services provided.
• Identify fraudulent / abusive practices, and unnecessary medical procedures.
• Investigate and pursuing delinquent accounts that have short paid and or denied.
• Balance account registers, remittance’s to determine all appropriate coding and charges were submitted, also filing appeals on denied claims.
• Maintaining AR reports for monthly and quarterly meetings with other upper management.
October 2003 to May 2005
Ivedco
Irving, TX
Reimbursement Assistant
• Performed multiple tasks in reimbursement to included billing, written appeals, insurance verification, posting, and monthly reports.
• Billing consisted of unit dose, nebulizers, and cpap and patient bills.
• Conducte...
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