Ana Laura Hays
Knoxville,TN
Summary
Medical Billing Specialist with 15 years' experience interfacing with insurance representatives, medical providers, and patients.
Overview
28
28
years of professional experience
Work History
Insurances Representative Level II
Covenant Health
01.2013 - Current
- All duties of follow up insurances claims (appeals, corrected claims for Medicare and Commercial)
- Adjust claims, posting payments, 2nd assistant for credential issues
- Resolved clearinghouse rejections and resubmit claims
- Carefully coded data to file and process correct claims for Medicare and Commercial Policies
- Reviewed & appealed unpaid and denied claims
- Understand patients insurance coverage to consult billing advice inside and outside the organization
- Worked diligently with insurance companies, Clinics and healthcare providers
- Call insurance companies regarding any discrepancy in payments, Denial claims and coding issues
- Answer all patient or insurance telephone inquiries pertaining to assigned accounts and clinics
- Performs various collection actions including contacting patients by phone correcting and resubmitting claims to third party payers
Insurance Representative A/R
Knoxville Orthopaedic
01.2012 - 01.2015
- Using coded data to produce claim, correct claims to submit to insurance companies
- Working directly with the insurance company, healthcare providers, and patient to get a claim processed and paid
- Reviewing and appealing unpaid and denied claims
- Verifying patient’s insurance coverage
- Answering patients’ billing questions
- Handling collections on unpaid accounts
- Accurately recording patient charges and ensuring that are submitted to insurance providers in a timely and efficient manner for MRI and X-rays
- Resolved clearinghouse rejections and resubmit claims
International Sales Manager
Regal Corporation
01.1997 - 01.2011
- Accomplishes marketing and sales objectives by planning, developing, implementing, and evaluating advertising, merchandising, and trade promotion programs; developing field sales action plans
- Develops specific plans to ensure revenue growth in all company’s products
- Accountable for collections, payments, receivables, profit activity reports, sales reports, marketing strategies, and managed the communications for exporting to international countries
- Promote and sell products and services at international level for (Caterpillar, Komatsu, John Deer, and Case)
- Sustain reports with key accounts by making periodic visits; exploring specific needs; anticipating new opportunities
- Created presentations to markets products to various decision making audience
Education
Medical Office Information Technology - TTCK
Tennessee College Of Applied Technology
Knoxville, GA01.2012
Associate Of Applied Science - Marketing Technology
Pellissippi State Community College
International College01.1993
Bachelor of Business Administration (BBA) -
UNAM -Univerity
International College01.1982
Skills
- Bilingual (Spanish and English)
- Customer service skills
- Organizational skills, Multi-Tasking
- Medical health information technology
- Electronic records (ICD9, CPT, HCPCS)
- Microsoft Outlook ,Word, Excell
- Medisoft Practice Management
- GE Centricity
- Allscripts Electronic Health Records
- ImpactMD/Touch Chart
- Cerner Health
- NextGen Healthcare
- Insurances Electronic Healthcare Solutions Systems
- Availity Revenue Cycle
- CMC and individual Insurances Systems
Timeline
Insurances Representative Level II
Covenant Health
01.2013 - Current
Insurance Representative A/R
Knoxville Orthopaedic
01.2012 - 01.2015
International Sales Manager
Regal Corporation
01.1997 - 01.2011
Medical Office Information Technology - TTCK
Tennessee College Of Applied Technology
Associate Of Applied Science - Marketing Technology
Pellissippi State Community College
Bachelor of Business Administration (BBA) -
UNAM -Univerity
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