Bobbi Eastman

623-755-1852
SUMMARY OF QUALIFICATIONS
CMBS (Certified Medical Billing Specialist) Kaplan University 2010
Full scope medical claims adjudication, account research and reconciliation, and
collection process.
Resolution of any payment issue requiring high level research and that present a
financial risk.
Knowledge of all healthcare standard codes; CPT, ICD-9, HCPCS and revenue codes.
Medical terminology.
Ability to interpret and process remittance advice, third party responsibility,
UB04, CMS 1500.
Verify electronic submissions, hard copy billing, EMR and EHR documentation.
Software used: Encoder Pro, Facets, IDX, Medical Manager, QMACS, Rehab Manager,
Windows XP.
Leadership skills: account reconciliation analyst, auditor, claims supervisor, c
ollections specialist, compliance consultant, insurance verification, patient ac
counting, prior authorization review.
EMPLOYMENT EXPERIENCE
Osborn Health and Rehabilitation
Skilled Nursing Facility
02/2010 - 05/2010
BILLING OFFICE ASSISTANT/COLLECTIONS REPRESENTATIVE
Handling the collections, denials and appeals of claims to include Government, H
MO, and Commercial.
Review remittance advice forms to verify proper reimbursement.
Insurance company contact to resolve past due accounts.
Input of new patient demographic information.
Prepare the daily bank deposit.
Maintain patient trust accounts.
Effective communication with family members to resolve patient concerns.
Accountants International
10/2009 12/2009
PATIENT FINANCIAL SERVICES REPRESENTATIVE
Daily follow up to include all outstanding patient accounts in an assigned work
list.
Post payments, contractual adjustments, and transfer deductibles to patient acco
unts based of correspondence received from the insurance carriers.
Review accounts that indicate an aged balance.
Perform claims resubmission function.
Follow-up on claims submitted to the AZ, NV, and CA Medicaid programs. Patient
payment follow-up also included.
Handle incoming calls from patients previously contacted regarding claims and pa
tient balance.
St. Josephs Hospital and Medical Center
Childrens Rehabilitation Services Unit
2/2007 - 9/2008
SENIOR CLAIMS REIMBURSEMENT ANALYST
Performs review of healthcare claims utilizing knowledge of current coding guide
lines to determine maximum reimbursement.
Research and perform in-depth review of complex claims requiring an assessment o
f the validity and accuracy of the claim and its billing codes.
Advanced knowledge of specialty coding to analyze patient medical records, helpi
ng to ensure that documentation by providers is accurate with respect to expense
s charged.
Provides research and oversight for all clinical type denials to determine appro
priate action.
Partner with the grievance/appeals administration to present cases at hearing.
Third party liability and fee schedule administration
Ability to read and interpret an EOB, remittance advice, UB04, CMS 1500.
Reimbursement of the following services: pharmacy, home health, durable medical
equipment, ophthalmology, evaluation & management, inpatient, outpatient.
Maricopa Health Plan
12/2003 9/2006
RESEARCH AND RECOVERY ANALYST (Promotion 2006)
Interim Claims Supervisor (Promotion 2006)
Promoted to interim claims supervisor for a period of one year to assist in unit
closing.
Assist in the retrospective review of claims.
Perform focused audits on billing records.
Target overpaid claims and work to recover lost funds.
Perform claims reinsurance and encounter function.
CLAIMS AUDITOR (Promotion 2005)
Perform daily audits on processed claims to ensure payment accuracy.
Compile and report audit findings to the claims department daily.
Experience with managed care reimbursement and contracting.
Monitor claims being processed under Medicaid (AHCCCS AZ. Health Care Cost Conta
inment System) and Medicare guidelines.
Critical knowledge of CPT, ICD-9, HCPCS, revenue codes and modifier use.
ASSISTANT CLAIMS TRAINER (Promotion 2004)
Training of new associates on programs and upgrades.
Retraining of associates in regards to job performance.
Emphasis on ALTCS (Arizona Long Term Care System), acute care, and a Medicare re
placement plan.
Responsible for the maintenance of existing training documentation to include pr
ovider fee schedules, reimbursement methodology, program updates, business polic
y and procedures.
MEDICAL CLAIMS REIMBURSEMENT ANALYST
Adjudication of simple to complex claims including; physician and facility accou
nts.
Reimbursement of the following services: ambulance, ambulatory surgical centers,
occupational therapy, pathology, physical therapy, radiology, transportation, o
utpatient facility.
Third party liability administration