Tamika Mcgee
LITHONIA,GA
Summary
Dynamic Medical Billing Specialist with proven success at Merchants Preferred, excelling in claim submission and payment posting. Adept at negotiating with insurance providers and fostering patient relationships, achieving significant improvements in collections efficiency. Skilled in ICD-10 coding and committed to HIPAA compliance, ensuring accuracy and compliance in all billing processes.
Overview
18
18
years of professional experience
Work History
Medical Billing Specialist
Merchants Preferred
04.2016 - 11.2024
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Responded to customer concerns and questions on daily basis.
- Maintained accurate records of customer payments.
Auto Deficiency Collector
United Acceptance Inc.
12.2012 - 04.2016
- Collaborated with team members to achieve monthly targets, promoting a positive work environment and boosting overall productivity.
- Contacted over 100 customers daily to discuss payment schedules and set up or immediately process payments.
- Reduced outstanding debts by implementing strategic collections tactics and maintaining open lines of communication with customers.
- Streamlined debt collection processes for increased efficiency in the workplace.
- Maintained accurate records of all collection activities, ensuring compliance with industry standards and regulations.
- Improved customer satisfaction by effectively resolving delinquent accounts through negotiation and payment plans.
- Negotiated settlements in a timely manner, reducing the number of long-term delinquent accounts.
- Trained new collections representatives on collections processes and incentivized team members to achieve production goals.
- Utilized various software programs to efficiently manage account information and track progress towards collection goals.
- Balanced persistence with empathy when pursuing overdue payments from individuals experiencing financial hardship.
- Negotiated to collect balance in full.
- Negotiated re-payment plans by identifying causes of delinquent payments to assist in recovery of debt and meet realistic timeframes.
- Used skip tracing and other techniques to locate debtors.
- Counseled debtors on payment options and arranged installment agreements.
- Entered client details and notes into system for interdepartmental access and review.
- Compiled and analyzed data for review by senior management of loan loss reports to measure portfolio performance.
Medical Collections Representative
Nations Recovery Center
03.2007 - 10.2012
- Implemented new strategies for recovering outstanding balances from unresponsive patients, resulting in a higher rate of successful collections efforts.
- Reduced delinquency rates by maintaining consistent communication with patients regarding payment plans and outstanding balances.
- Managed a high volume of accounts, 150 daily, prioritizing those requiring immediate attention while consistently meeting performance targets.
- Consistently exceeded performance metrics for collections efforts, contributing to the overall success of the Medical Collections department.
- Collaborated with cross-functional teams to identify areas for improvement within the medical collections process, leading to reduced errors and increased revenue recovery.
- Developed strong relationships with insurance companies, facilitating successful negotiations for disputed or denied claims.
- Proactively identified fraudulent or inaccurate charge submissions through careful review and analysis of patient records, minimizing potential losses for the organization.
- Generated and distributed monthly customer statements.
- Prevented impending loss and increased profitability by enforcing scheduled collection campaigns, consistently achieving targeted recovery rate.
- Located customers with overdue accounts and solicited payment in compliance with fair debt collection practices.
- Entered client details and notes into system for interdepartmental access and review.
- Worked with customer to create debt repayment plan based on current financial condition.
- Monitored changes in healthcare regulations including HIPAA compliance standards, ensuring adherence throughout the Collections department''s activities.
- Ensured timely reimbursements by diligently researching insurance claims and negotiating settlements on behalf of providers.
Education
Some College (No Degree) - Nursing Assistant
Detroit Business Institute
Detroit, MISkills
- Payment posting
- Claim submission
- Insurance verification
- CPT knowledge
- ICD-10 proficiency
- Medicare and medicaid process
- Accounts payable
- Collections management
- Medical terminology
- Billing and collection procedures
- CMS-1500 billing forms
- Electronic health record software
- Patient collections
- Commercial and private insurance
- HIPAA compliance certification
Timeline
Medical Billing Specialist
Merchants Preferred
04.2016 - 11.2024
Auto Deficiency Collector
United Acceptance Inc.
12.2012 - 04.2016
Medical Collections Representative
Nations Recovery Center
03.2007 - 10.2012
Some College (No Degree) - Nursing Assistant
Detroit Business Institute
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