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MicheleValverde
WORKHISTORY
2006-present Patient Accounts CBO Supervisor, Mercy Health System
 Supervise staff numbering between 7-10
 Monitor high dollar claims
 Hold continuing education session for staff
 Manage staff payrollvia Kronos
 Payers responsible for assisting in billing and follow up: IBC , MCR ADVANTAGEPAYERS
 Completing Audits on staff
 Conduct meetings with Payers
 Conduct meetings with internal colleagues
 Education staff on payer changes and contracts
 Providing updates to Patient Access on payer requirements
 Running reports to capturedenial trends
 Assist in builds, implementations, and testing of new systems (i.e. Meditech,)
 Resubmission of corrected claims via electronic trading partners
 Creating Policies
2001-2006 Revenue Cycle Analyst, Mercy Health System
 Conduct registration and admission audits
 Organize and conduct education classes for registration staff
 Assist patient access management with reports and monitoring staff’s productivity and accuracy
 Assist in builds, implementations, and testing of new systems (i.e, AHIQA system, Medical Necessity
system, HDX auto plan assignment, Invision, MSP enhancement)
 Maintain the accuracy of insurance help guides and the registration guideline on Mercy intranet
 Assist in theimplementation of Invision
1998-2001 Patient Account Follow up representative – Mercy Health System
 Calling payers or status of claim submission
 Calling payers to have claims reprocessed as corrected information provided
 Reviewing denials and determining next steps to reconcile accounts
 Speaking with patients about their billing
 Resubmitting claims through our electronic claims system, Premis.
1995-1998 Enviromental Services, Unit Clerical and Transport – Mercy Fitzgerald Hospital
 Greeting patients
 Obtaining demographic and insurance information
 Placing Dr orders
 Verify insurance via HDX system
 Calling insurance for authorization of treatment
 Food server
 Cleaning patient rooms
 Transportingpatient’s from one department to the next
EDUCATION
1988 Graduated, John Bartram HighSchool
COMPUTERSKILLS Siemens, Unity, Invision, Meditech, HDX, Navinet, Internet, KRONOS, 3M, AHIQA, Document Imaging, Express
Query, Passport and Premis
References Available upon request
235 Carre Ave
Essington,Pa 19029
Home Phone (610) 521-1836
Mvalverde862@gmail.com
Michele Valverde Resume

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Michele Valverde Resume

  • 1. MicheleValverde WORKHISTORY 2006-present Patient Accounts CBO Supervisor, Mercy Health System  Supervise staff numbering between 7-10  Monitor high dollar claims  Hold continuing education session for staff  Manage staff payrollvia Kronos  Payers responsible for assisting in billing and follow up: IBC , MCR ADVANTAGEPAYERS  Completing Audits on staff  Conduct meetings with Payers  Conduct meetings with internal colleagues  Education staff on payer changes and contracts  Providing updates to Patient Access on payer requirements  Running reports to capturedenial trends  Assist in builds, implementations, and testing of new systems (i.e. Meditech,)  Resubmission of corrected claims via electronic trading partners  Creating Policies 2001-2006 Revenue Cycle Analyst, Mercy Health System  Conduct registration and admission audits  Organize and conduct education classes for registration staff  Assist patient access management with reports and monitoring staff’s productivity and accuracy  Assist in builds, implementations, and testing of new systems (i.e, AHIQA system, Medical Necessity system, HDX auto plan assignment, Invision, MSP enhancement)  Maintain the accuracy of insurance help guides and the registration guideline on Mercy intranet  Assist in theimplementation of Invision 1998-2001 Patient Account Follow up representative – Mercy Health System  Calling payers or status of claim submission  Calling payers to have claims reprocessed as corrected information provided  Reviewing denials and determining next steps to reconcile accounts  Speaking with patients about their billing  Resubmitting claims through our electronic claims system, Premis. 1995-1998 Enviromental Services, Unit Clerical and Transport – Mercy Fitzgerald Hospital  Greeting patients  Obtaining demographic and insurance information  Placing Dr orders  Verify insurance via HDX system  Calling insurance for authorization of treatment  Food server  Cleaning patient rooms  Transportingpatient’s from one department to the next EDUCATION 1988 Graduated, John Bartram HighSchool COMPUTERSKILLS Siemens, Unity, Invision, Meditech, HDX, Navinet, Internet, KRONOS, 3M, AHIQA, Document Imaging, Express Query, Passport and Premis References Available upon request 235 Carre Ave Essington,Pa 19029 Home Phone (610) 521-1836 Mvalverde862@gmail.com