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Elisha Bedford
bedfordelisha@yahoo.com
559-904-5655
Billing Follow-Up Associate
Seeking a rewarding, full time position as a remote associate.
Caring and compassionate medical professional, with a proven determination to consistently excel at all assigned duties, seeking to turn medical professional skills into continuation of a rewarding career with a dynamic organization.
WORK EXPERIENCE
Billing Follow-Up Associate
Government Adventist Health Physicians Network
Hanford, CA - October 2015 to Present •
Responsible for daily processing of the patient account following discharge in order to submit a timely and accurate bill. ◦ Reviews all information for accuracy, completeness and compliance. ◦ Prepared and submit clean claims to various insurance companies either electronically or by paper ◦ Work with other departments of the hospital in conjunction with the PFS Billing Supervisor to improve the quality of information directly related to submitting a compliant bill. ◦ Resolves credit balances by requesting refunds to the Accountants by region to refund patients and/or insurances ◦ Answered questions from patients, clerical staff and insurance companies ◦ Identified and resolved patient billing complaints. ◦ Processed payments from insurance companies and prepares a daily deposit. ◦ Communicates any/all potential concerns clearly and timely to department management, offering suggestions to resolve &/or avoid any negative impacts. ◦ In cooperation with the PFS Leadership team, coordinates and ensures adherence to hospital financial and department policies. • Promotes positive relationships with patients, coworkers, physicians and the community. • Portrays a positive image for the hospital and PFS department • Participated in educational activities and attended monthly staff meetings. • Maintained strictest confidentiality • Adheres to all HIPAA guidelines/regulations.
Lead Authorization Coordinator
Foundation For Medical Care/Key Medical Group - Visalia, CA - October 2005 to September 2015 •
Verify eligibility and benefits through the health plans web portal. • Identify and provide accurate CPT/ICD-9/ICD-10 codes during authorization check and/or authorization request. • Maintain all authorizations/notifications related faxes from physicians, and/or health plans. • Received incoming documentation from providers in order to support the appeals process if a claim is denied. • Communicates professionally and timely to the patient, physician, and clinical staff regarding authorization status or authorization delays. • Processed 100 plus referrals in one business day. • Handles difficult situations in a professional demeanor • Trained new employees to on process ◦ Request for authorization ◦ Check claim status ◦ Follow up on claim denial/ appeal/grievance ◦ Verify Eligibility Status • Operate multi-line phone systems with ease
Accounting Clerk Accountemps - Visalia, CA
August 2004 to September 2004
Processed and reported on debit/credit transactions and total accounts on excel documents and databases, and using specialized accounting software. • Operate 10-key calculators, typewriters, and copy machines to perform calculations and produce documents. • Comply with federal, state, and company policies, procedures, and regulations. • Perform financial calculations such as amounts due, interest charges, balances, discounts, equity, and principal. • Perform general office duties such as filing, answering telephones, and handling routine correspondence, etc.
Customer Care Representative/Department Secretary-Appeals Grievance
San Diego, CA - February 2003 to August 2004 • Operate office equipment, such as voice mail messaging systems • Worked daily with MS word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records. • Answer telephones and directed calls to appropriate staff. • Schedule and confirm patient appointments, surgeries, medical consultations, pharmacy authorization. • Transmit medical records by mail, e-mail, or fax. • Provide claim status to patients. providers, and hospitals. • Process referrals by incoming fax.
EDUCATION
Certification in Medical Billing and Coding Ultimate Medical Academy - Tampa, FL 2014 to 2015
Patient Care Assistant Technician Maric College - San Diego, CA 2001 to 2002
Hanford High School - Hanford, CA 1995
Medical Billing and Coding-Associates Degree Grantham University - Lanexa, Kansas 2016
ADDITIONAL INFORMATION SKILLS
CPT coding courses, HCPCS, Analytical and Critical Thinking, ICD-10 CM, ICD-9 CM, Payment Poster, EZ-CAP, Cerecons, IDX, Medical Billing and Coding, Customer Service, Multi-Line Phone System, Problem Solving, 10-key, Microsoft Word, Excel, Outlook, PowerPoint, Spreadsheet 50 WPM, Power Chart, SSI, MS4/AS400, RCI, Medical Terminology, Collections
bedfordelisha@yahoo.com
559-904-5655
Billing Follow-Up Associate
Seeking a rewarding, full time position as a remote associate.
Caring and compassionate medical professional, with a proven determination to consistently excel at all assigned duties, seeking to turn medical professional skills into continuation of a rewarding career with a dynamic organization.
WORK EXPERIENCE
Billing Follow-Up Associate
Government Adventist Health Physicians Network
Hanford, CA - October 2015 to Present •
Responsible for daily processing of the patient account following discharge in order to submit a timely and accurate bill. ◦ Reviews all information for accuracy, completeness and compliance. ◦ Prepared and submit clean claims to various insurance companies either electronically or by paper ◦ Work with other departments of the hospital in conjunction with the PFS Billing Supervisor to improve the quality of information directly related to submitting a compliant bill. ◦ Resolves credit balances by requesting refunds to the Accountants by region to refund patients and/or insurances ◦ Answered questions from patients, clerical staff and insurance companies ◦ Identified and resolved patient billing complaints. ◦ Processed payments from insurance companies and prepares a daily deposit. ◦ Communicates any/all potential concerns clearly and timely to department management, offering suggestions to resolve &/or avoid any negative impacts. ◦ In cooperation with the PFS Leadership team, coordinates and ensures adherence to hospital financial and department policies. • Promotes positive relationships with patients, coworkers, physicians and the community. • Portrays a positive image for the hospital and PFS department • Participated in educational activities and attended monthly staff meetings. • Maintained strictest confidentiality • Adheres to all HIPAA guidelines/regulations.
Lead Authorization Coordinator
Foundation For Medical Care/Key Medical Group - Visalia, CA - October 2005 to September 2015 •
Verify eligibility and benefits through the health plans web portal. • Identify and provide accurate CPT/ICD-9/ICD-10 codes during authorization check and/or authorization request. • Maintain all authorizations/notifications related faxes from physicians, and/or health plans. • Received incoming documentation from providers in order to support the appeals process if a claim is denied. • Communicates professionally and timely to the patient, physician, and clinical staff regarding authorization status or authorization delays. • Processed 100 plus referrals in one business day. • Handles difficult situations in a professional demeanor • Trained new employees to on process ◦ Request for authorization ◦ Check claim status ◦ Follow up on claim denial/ appeal/grievance ◦ Verify Eligibility Status • Operate multi-line phone systems with ease
Accounting Clerk Accountemps - Visalia, CA
August 2004 to September 2004
Processed and reported on debit/credit transactions and total accounts on excel documents and databases, and using specialized accounting software. • Operate 10-key calculators, typewriters, and copy machines to perform calculations and produce documents. • Comply with federal, state, and company policies, procedures, and regulations. • Perform financial calculations such as amounts due, interest charges, balances, discounts, equity, and principal. • Perform general office duties such as filing, answering telephones, and handling routine correspondence, etc.
Customer Care Representative/Department Secretary-Appeals Grievance
San Diego, CA - February 2003 to August 2004 • Operate office equipment, such as voice mail messaging systems • Worked daily with MS word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records. • Answer telephones and directed calls to appropriate staff. • Schedule and confirm patient appointments, surgeries, medical consultations, pharmacy authorization. • Transmit medical records by mail, e-mail, or fax. • Provide claim status to patients. providers, and hospitals. • Process referrals by incoming fax.
EDUCATION
Certification in Medical Billing and Coding Ultimate Medical Academy - Tampa, FL 2014 to 2015
Patient Care Assistant Technician Maric College - San Diego, CA 2001 to 2002
Hanford High School - Hanford, CA 1995
Medical Billing and Coding-Associates Degree Grantham University - Lanexa, Kansas 2016
ADDITIONAL INFORMATION SKILLS
CPT coding courses, HCPCS, Analytical and Critical Thinking, ICD-10 CM, ICD-9 CM, Payment Poster, EZ-CAP, Cerecons, IDX, Medical Billing and Coding, Customer Service, Multi-Line Phone System, Problem Solving, 10-key, Microsoft Word, Excel, Outlook, PowerPoint, Spreadsheet 50 WPM, Power Chart, SSI, MS4/AS400, RCI, Medical Terminology, Collections