Medical Billing Support | Managed Care | Provider Practice Management
I am a Healthcare Consultant Professional (Top Rated on Upwork) with over 10 years of combined experience in Managed Care Insurance, Medical Claims, Patient Registration and Provider Relations. In college, my area of study was in Health Science and Liberal Arts.
My qualifications include:
*Recipient of the Top Quality Assurance award in patient registration data entry and insurance accuracy at a large hospital.
*Recovered $4+ million in claim payments (otherwise lost revenue) for a large hospital.
*Negotiated and contracted 200+ healthcare providers with a major health insurance company in the US.
*Managed 25 + markets of in-network healthcare providers addressing fee schedule changes, demographic changes, product education, claims issues and contract management.
*Led a special project team in recovering $5+ million in claim overpayments at a major health insurance company in the US.
*I co-developed a new streamlined internal audit and training program at a major health insurance company for our physician contract loading team. The result measured a 20% increase in employee production, 43% increase in quality standards and a 41% increase in provider network satisfaction within 2 years.
While working at United Healthcare in Provider Network Management, I noticed many medical providers and their staff struggled with managing claims issues, patient insurance, and health plan contracts. This was the start of my Consulting business. I am passionate about helping healthcare providers deliver top-notch care to their patients; grow their revenue and business.
How My Services Can Improve Your Business:
A). Is your staff having a hard time managing your patient appointments?
-I will call, email or text reminders to patients of their upcoming appointments and schedule new appointments.
-Make sure appointments do not overlap by managing your appointment calendar.
-Handle missed or no show appointments by following up with patients.
B). Need help with verifying the patient’s insurance PRIOR to appointments?
-I will call to verify insurance at least 1 week prior (or more) to appointment time and obtain full benefits, copays, deductibles, out of pocket expenses, authorizations or referrals if needed.
-I will communicate any patient financial responsibility prior to scheduled appointment time to be sure there are no surprises on appointment day.
C). Do you have a growing, unmanageable, or aging Billing Accounts Receivable report or DENIALS?
-I will follow up with insurance companies, advise on billing issues, and collect from health insurance companies so you can get paid.
D). Is your medical practice struggling with maintaining all of the various health plan contracts, credentialing, or contract updates?
-I will manage your communication with health plans, manage contracts, assist with provider credentialing, provider enrollment and contract maintenance updates.
Additional experience: In my Freelance Consulting capacity, I've also worked with a Telehealth Start-up, Healthcare Data Analytics Company, Insurance Website, Healthcare Media company and Fitness company.
Payment Terms: Payment method must be verified and escrow funded for fixed rate projects. Payment must be made either weekly, monthly, or bi-weekly depending upon agreed contract terms.
I am extremely tech savvy, and most of my business clients have a virtual office set up but here is a burgeoning list of programs, websites, and software I have experience using:
-File Sharing/Collaboration: Google Drive/Docs, Box.com, Dropbox.com, Slack, Skype
-Meetings: Webex, Go-To-Meeting
-Operating Systems: MAC-iWork Suite, OS X, PC-Microsoft Office Suite (Intermediate to Advanced in Excel, Word, Powerpoint, Outlook)
-Schedule/Calendar Management: Google Calendar, Genbook, Schedulicity
-Medical Proprietary Software (Cerner, Epic, and Legacy are among the few I've used. I am tech savvy and can grasp and learn quickly)
Don't take my word for it. Here are a few performance feedbacks!
“Queen is focused on the customer and the outcomes and works within her team and others to deliver what is expected.” R. Chism, former supervisor @ United Healthcare
“Great work, on time and on budget." Client on Elance.com
“Queen did amazing work on this project. The clarity and organization of the results she provided was fantastic. She had obviously done thorough research to find these results, and even negotiated some of the rates which was great. She followed my instructions perfectly. She was also very responsive, friendly and a pleasure to work with. I will definitely be using Queen again!” Client on Elance.com