DEBRA LYNN STREETER

954-332-8052
blazingin@hotmail.com
BUSINESS EXPERIENCE
Expeditive
Travel position
CAH Facility
Res/Solution
02-09 to present. travel position
Project is over 3-31-09
Travel position: Medical collection
On this project I am working Managed Care and Medicaid: ND & MN. Follow up on un
paid claims, appeal letters, reporting trends that may and can be a problem for
timely payments.
North Cypress Medical Center
Feb-08 to 12-08
Blue Cross Specialist
Here at NCMC there are no contracts with any carriers. I trained co-worker in se
tting up contacts with different Insurance companies to be paid, without having
to bill the patients a huge out of network balance. We now have in place a conta
ct and a working process with all carriers but Blue Cross to be paid per agreed
amount. I have appeal to TDI and research Texas Laws on payment for ER services
to be paid to the Hospital. Blue Cross was sending the payments to the patients.
I got this corrected and NCMC is now in the process of being reimbursed for eve
ry payment that was mailed to the patient that was not sent in by the patient. I
have worked personally with TDI about the reduction that Blue Cross applies to
the claim payments.- temp position
North Broward Radiologist
May-07 to Feb-08
Team Lead
Collections for Doctors who read the reports. Help correct errors with data not
being entered correctly.
Help find errors with payers and answered questions and gave directions. Found w
here the insurance data was not being updated correctly, causing huge delays in
payments. Posting errors being made, money missing, checks not fully being poste
d. Worked the District Charity and Grant programs. This was a temp Job.
Dillingham, Alaska
April-05 to May 07
IHS facility
Blue Cross Specialist Biller and Collector
Work all delinquent claims. Make necessary corrections. Write Appeal letters. Re
view all claims, catch errors before claims are sent out. Errors are mainly inco
rrect coding and missing modifiers. Which in turn cuts down on the turn around t
ime for return payment. When I first came on board with BBAHC a very large amoun
t of the claims were being denied or were outstanding. I have worked very closel
y with our Provider Representative to get these problems handled. Some of the pr
oblems were: too many questionnaires going out for the same diagnosis and relate
d diagnosis. Claims not being processed correctly. Either the professional or th
e facility fee was not paid. Procedures being denied and modifiers not being rec
ognized. At the present time all of the Blue Cross claims that were outstanding
has been corrected and paid. The percentile of outstanding claims is less than i
t has ever been in the History of the Hospital. Which I am very proud of. Proces
s all refunds either for the patient or
Blue Cross. Audit payments. Responsible for electronic filing, reject reports, a
nd filing errors. Found error in claims being written off to the Indian Health P
rogram that was related to questionnaires. Claims being denied to pre-exiting, w
hich there is no such thing with the IHS program, got that corrected and all cla
ims paid. BBAHC had never made over a million in their history before I came on
board. When I left we had over million months as a common occurrence.
July 6,04 thru May 05
Self Employee/Consultant Contracted as an individual. Work short project for dif
ferent companies at different locations. These projects needed clean up on outst
anding claims, aggressive collection, appeals written, and claim correction. Ref
illed claims. Audit payments per contract agreement. Did the necessary steps to
get claims paid and the A/R out of the red. Work under high stress and limited t
ime.
BALYOR COLLEGE OF MEDICINE
HOUSTON, TX
Feb 27-03 to May 14-04
While at Baylor I was responsible for the Breast Care Center. I alone manage all
collections for that group of Doctors. While I was employed at Baylor the Breas
t Care Center's monthly collection was never under 100%. While at Baylor I have
met the goal set by the department every month ($). I also have other work files
that I am responsible for the collection; these are grouped as a whole with my
co-workers, which are called AMS. I am a team player-I share discovery that help
s claims be paid. Ex: Shared knowledge with others concerning appeals and coding
issues. I wrote my own appeals letters: Which is mostly Medicaid. I have appeal
ed all the way to a Washington Office involving a federal employee to get a clai
m paid, and it was. Correct and resubmit claims: correction can be from wrong ad
dress to truncated codes. Corrected all coding issues. Work all refunds due to p
atient or insurance. Corrected contract errors as well as electronic billing (pa
yer). Examples;
*Medicaid HMO not paying per contract
*Doctors listed as anesthesia when it should be radiology.
*Payments being issued for the wrong Doctor that was billed.
*Medicare HMO not paying per contract.
*Medicaid recoup in error.
*Third party insurance paying out of network in error.
*Audit payments per contract
G.S.R. INSURANCE BILLING
FT. LAUDERDALE, FL
May - October 2002
Responsibilities included collections of all insurance claims and legal negotiat
ions of personal injury claims. Auto claims, workman's comp physical rehab, chir
o. Worked with Doctor's personnel on correct usage of ICD-9, CPT coding. Theref
ore avoiding delay and/or non-payments.
CLAIMS REIMBURSEMENT SPECIALIST
1999 - 2002
Contracted on a consulting basis with various hospitals and physicians offices t
o audit past-due account
receivables. Audit payments per contract. As a Consultant, I would review the ac
counts to locate problems and make corrections then resubmit claims. Each locati
on had own type of problems. Including coding issues. Use of my problem solving
skills is up to date. Upon completion of the audit, I would design and recommend
procedures to eliminate future errors.
BROWARD HOUSE
FT. LAUDERDALE, FL
1997 - 1999
Verify Recipient Medicaid eligibility each month. Up date files and Medicaid pro
gram depending upon electronic eligibility confirmations. Assign control number.
Prepare and process monthly Medicaid waiver and chemical dependency billing log
s for electronic invoices. Reconcile monthly Unisys remittance voucher with elec
tronic invoices. Research and verify accuracy of rejected payments. Resubmit rej
ected invoices on any eligible recipients inaccurately denied. Prepare and submi
t monthly write off for all denied payments that are not collectible. Reconcile
each account. Post payments. Prepare and process monthly invoices for Ryan White
Title 1 and Title 11 HOWPA Broward County NPO, and other funding sources. Gener
ate monthly and quarterly demographics reports. Post on master tracking sheet. (
tool-box program). Maintain Broward County data reports/spread sheets for year-e
nd audit. Review all approved grants contracts. Set-up reporting schedules and a
lert manager on
reporting requirements. Coordinate required reports in assuring contract complia
nce. Perform other duties as assigned by Financial supervisor including but not
limited to telephone back up, purchasing of supplies, delivering county reports,
etc.
MEMORIAL DURABLE MEDICAL EQUIPMENT
PEMBROKE PINES, FL 1995 - 1997
Responsible for all claim collection.
LADY OF AMERICA NATIONAL HEADQUARTER
FT. LAUDERDALE, FL
1993 - 1995
Office Manager/ supervisor
EDUCATION
Graduate of Ouachita Parish High School - 1972
Baton Rouge Regional Vo-Tech - Nursing School - 1988
Baton Rouge School of Computers - 1990
Medicaid Seminar - 2000
Medicare Seminar - 2001
Atlantic Coast Institute Medical Insurance CPT & ICD-9 Coding (CE) - 2002
Medicaid Update Seminar 2004
Have experience on all types of billing software.
Examples: IDX 9.0 - TDH 3.0 - HBOC/star - PREMUS - MEDISOFT - SMART TERM E-COMME
RCE-MEDITECH
Update on Word- certification 06-08
Update on Outlook- certification 12-06
Update on Power Point-certification 12-06
Update on Excel-certification 06-08
Continue education: University of Fairbanks
Administrative Medical Health Care
Professionalism in Health Care
Medical Terminology/Recertification of Coding
Letter of Reference from Baylor College of Medicine
Letter of Reference from Bristol Bay Area Health Corporation
Personal References will be provided