Rahina A.

3 years full-time Customer Service Representative for Anthem of CA. 3 years full-time Accounts Receivable Specialist 2 years full-time Eligibility and Benefits Verification Specialist 3 years full-time Authorization Specialist for TMHP Major Insurance Companies handled and locations: * Medicare Health Plan (California, Georgia, Illinois, New Mexico, North Carolina, Michigan, Ohio, Texas) * Medicaid Health Plan (California, Georgia, Illinois, New Mexico, North Carolina, Michigan, Ohio, Texas) * Humana, Aetna, Anthem Inc., Illinicare, Cigna Health, Meridian / Wellcare, Molina Healthcare Inc., UnitedHealth Care * ChampVA, Tricare East, Tricare West, Tricare for Life, Medical Billing Specialization: 1. Accounts Receivable on ENT, Speech Therapy, Behavioral Health (Mental Health and Substance Abuse) 2. Processing of Insurance Claims 3. Claims Creator, follow up on Claims, Sending Appeals for Denied Claims 4. Posting payments of Insurance Companies and Patients to Providers (physicians, clinics, etc.) 5. Comprehensive monthly reports on payments, rejected claims, pending claims. 6. Assess the eligibility of patients for insurance claims or benefits. 7. Providing solutions for Health Care Providers in order for insurance claims to be approved and paid. 8. Team leader for a group of Medical Billers to make sure all claims are posted before the deadline, payments are posted on time, and appeals are processed quickly. 9. Verification of patient's eligibility and benefits 10. Verification of the provider's participating status with the patient's plan Customer Service Specialization: 1. Handling Customer Service for BlueCross and BlueShield providers. 2. Quotation for eligibility and benefits of patients. 3. Providing information for claims process inquiry, claims status, and claims denials. 4. Processing Appeals for Denied Claims. 5. Providing easy communication between Health Care Providers and Medical Billers. Billing Software Experience: * Phicure * Citrix * Trizetto * Company-owned Electronic Health Record (EHR) and Practice Management Systems (for WRS Health) *Kareo With proven ability to collect and manage information efficiently and accurately. Can manage multiple assigned tasks and prioritize according to the level of urgency. Excellent written and verbal communication skills and a team player enjoying work and learning process. Conscientious in time management to make sure all deadlines are met beforehand. Willing to be trained for specific programs your company may be using. Above else, all data I come across are handled with utmost privacy and security. Contact me for full-time or part-time projects. I am available (and I prefer) to work during US business hours and can be flexible with any US time zones.