Simone W.

Account Specialist @Prime Healthcare

Patient Account Specialist,(Lynwood, CA)• Proactively initiated follow-up procedures for a diverse range of claims, including high-dollar/low-dollarmanaged care, HMO, PPO, work comp, and commercial claims• Successfully reduced accounts receivable by overseeing the collection of over employing strategiccollection methods• Demonstrated efficiency in managing a high volume of claims, processing 45-50 claims per day• Achieved significant reductions in accounts receivable by consistently meeting collection goals and conductingthorough reviews of aged accounts• Engaged with insurance carriers and patients to address delinquent accounts• Spearheaded appeals and follow-up efforts for denied and underpaid claims, leveraging expertise in retro-authorization and Diagnosis-Related Groups (DRGs) to maximize reimbursement.• Negotiated payment terms following company policy and guidelines• Identified and flagged bad debt accounts for write-offs to outside collection agencies• Managed the re-billing process for insurance companies as needed• Provided exemplary customer service in resolving patient billing and collection issues• Processed Explanation of Benefits (EOBs) to ensure accurate reimbursement according to contract terms, feeschedules, and negotiated rates• Conducted thorough reviews and reconciliations of bad debt accounts• Initiated and oversaw Medicare follow-up procedures