Medical Billing / Accounts Receivable

ARETHA SEWARD

                                                                           300 North Drive

                                                                       Fayetteville, GA 30214

(240)-285-2632

arethaws@yahoo.com

 

Objective:  Maintain status as a proficient Medical Billing Specialist while aspiring to become an Educator in Music.

                                    Spherion Staffing                                                      Frederick, MD

4/2014 – 5/2014          Carey Limousine Services

                                                Administrative Assistance

  • Support Permanent Staff updating all Passenger and Arranger/Agent Accounts  to the current company system upgrade.

 

06/2013 –12/2013       FMH Home Health Services

                                                Clinical Coordinator / Medical Billing

  • Clinical support and review for pre-authorization of Home Health Care services.  Concurrent Review of pre-authorized services. Handling of rejection appeals
  • Maintenance of Patient Summary reports and Clinical Notes for Physical Therapist, Skilled Nursing, Occupational Therapist, Speech Therapist and Medical Social Workers.
  • Follow up HCFA claims via Medi-Tech 6.1 for Commercial Insurances, MCO, Medicaid and Third Party Organizations. Run A/R reports daily to determine status

 

10/2010 – 1/2013        LPL Medical Billing Services                                   Frederick, MD

                                                Medical Billing Specialist

  • Customer service support regarding claims adjudication, explanation of benefits, collections and billing inquires for Psychiatric Providers and their clients.
  • Medical Billing via Office Therapy: Scheduling, Charge Entry and HCFA claims submittal
  • Accounts Receivable: HCFA claims follow up, post insurance payments, rejection appeals and administrator payment history for billing reconciliation: Medicare, Medical Assistance, Commercial Insurances, Managed Care Organizations, Third Party Organizations. Run A/R reports daily to determine status
  • Renew  Provider credentialing and licenses

 

3/2007 – 2/2010          United Healthcare of Mid-Atlantic                          Frederick, MD

                                                Customer Service Representative

  • Provide customer service support to members and providers regarding claims adjudication, explanation of benefits and general policy information within a call center environment

 

                                    Adecco Staffing                                                         Owings Mills, MD                                                          

12/2003 – 4/2006         CareFirst Inc. / Blue Cross Blue Shield                               

                                                Customer Service Representative        

  • Provide enrollment and billing services for HMO plans in a call center environment; assisted caller regarding billing inquiries, over the phone payments and general questions pertaining to enrollment status and insurance plans via FACETS, FLEXX, CARES AND Lotus/ Pay My Bill

 

 

 

 

 

Aretha Seward (cont.)                                                                                                                                                                                                                    

 

                                        (CareFirst Inc. / Blue Cross Blue Shield cont.)

                                    Medical Collections Specialist I

  • Processed pricing amendments for group policies
  • Followed up claims status from insurance and administrative correspondence. Reviewed claims, rejection appeals and administrator payment history for billing reconciliation: Medicare, Medical Assistance, Commercial Insurance, Managed Care Organization, and Worker's Compensation
  • Run A/R reports daily to determine status, transferred balances or submitted claims to appropriate parties via Services Link. Reviewed and confirmed adequacy of CPT and ICD9 coding entry

 

                                    Intra Staff                                                                  Baltimore, MD

9/2004 – 12/2005        Johns Hopkins/ Bayview Medical Center     

                                               Account Receivable / Management

  • Collected and analyzed data to investigate patient accounts with surplus balances. Reviewed payer history / reports via CARES, KEANE and RAM system. Reported to management of progress review. Prepared audit report with theory to resolve account surplus balances
  • Ascertained accurate claims adjudication through medical records, explanation of benefits, appeals correspondence, report of injury, UB92, HCFA 1500, itemized bills to reconcile unpaid balances
  • Review department cash posting logs, insurance and self pay correspondence, including other financial reports to assess A/R status and resolve grievances of rejected claims. Assigned entries to accounts via Medi-Tech 5.4 system. Located and monitored delinquent accounts. Recorded financial status of customer and collections efforts              
  • Front desk medical offices assistant to incoming patients. Scheduled appointments via IDX system and recorded payments

 

5/1998 – 9/2002          Lucent Technologies                                                   Cockeysville, MD

                                                Administrative Associate

  • Order Entry: Processed incoming Verizon telephone equipment orders. Performed routine billing procedures for Verizon North and South regional areas via the Multiple Application Routing System
  • Interacted with Verizon / Lucent engineers and contract vendors to confirm valid entry of telephone orders
  • Quality Assurance: Entered incoming engineering discrepancies via the Productivity Regional Order Management System. Interacted with engineers to seek resolutions

 

EDUCATION:                                    Baltimore City Community College                 Baltimore, MD

                                                1992 – Certificate in Information Systems

                                                Frederick City Community College                  Frederick, MD

                                                2010 – Major: Music Studies

                                                            Minor: American Sign Language 

 

 

Additional Computer Software: Windows 1995-2008, Services Link, WP 5.1-6.0, MS Word 1996- 2007, MS Excel, MS Power Point, MS Works, FoxPro Visual 5.0, Lotus Notes 6.5, MS Out-Look, MAMSI Desktop, Avaya IP Agent, MS Office Communicator.

  • ID#: 84642
  • Location: Fayetteville, GA , 30214

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