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Suzanne Livingstone

Expertise In: Oncology

Name : Suzanne Livingstone
Experience : 15
Specialty : Oncology
Location : Roseville,CA
Description :

Suzanne Livingstone wishes to obtain a position as a medical biller where she can utilize her acquired skills.  She started off as an entry level person and her most current experience was as a Hospital Billing Analyst leading nearly 14 billers.

Suzanne has over 15 years of experience in the field of medical billing and also has experience of dealing with all major insurance payers including Medicare, managed health care plans, Medicaid, Blue Shield, Blue Cross, commercial insurances and third party billing. She has 7.5 years experience of working with hospital based Medicare and one year experience of working with physician based Medicare including compliance daily reporting (overlap/72hr), 3 years experience working with chemotherapy hospital billing, 1 year of oncology physician billing, and 1 year working with home infusion billing.

She is currently looking for telecommuting work; where she can perform a variety of roles including billing analyst, instructor, etc.

Skills:

Suzanne is familiar with most major payers and understands each state's payers vary to some extent especially based on contracts and more so with their state Medicaid assistance program. She is also familiar with EOBs, standard abbreviations used, RAC, OIG and CMS and she has frequently in the past worked on special projects and/or research items involving these areas. Suzanne has the requisite knowledge of HCPCS, CPT4, and ICD9 codes

Program used:

  • MS Excel, MS Word, Outlook, MS PowerPoint, MS Vizio
  • EPIC, MediTech, Phamis, SSI, Emdeon, Premis

Experience:

Hospital Billing Analyst

  • Assisted with the implementation of new business office including-developing and writing policies and procedures, interviewing staff, training of new staff
  • Billing Lead for 10-14 billers- assisted in monitoring of work load and work queues; ensured productivity and deadlines are met; interviewed and trained new billers; created job aids and billing procedures; provided ongoing training to the current staff. Provided support to billing staff


Regulatory Specialist on Medicare accounts

  • Billing of initial and secondary claims to Medicare
  • Worked on denial of Medicare claims
  • Worked on corrections of Medicare claims in provider location
  • Followed up with Medicare on pending claims in various locations and claims issues
  • Sent written correspondence to patients as and when required
  • Continuously worked on accounts to ensure low total AR days
  • Assisting in training new employees, special facility requests (usually OIG requests) and
  • Assisted co-workers with Medicare related questions as requests came up
  • Notified manager of any possible issues resulting from either Medicare billing or facility affecting claims payments
  • Constantly procured updates on Medicare regulations

Medicare Specialist

  • Worked onsite at client’s office for billing and following up on accounts that have Medicare coverage, on hospital claims
  • Billed Medicare supplemental claims
  • Interacted with insurance payers for status and eligibility 
  • Appealed claims and ensured claims accuracy
  • Other duties as assigned including working Medicaid claims as well various commercials and third party claims

Insurance Follow up Representative Lead

  • Lead in physician billing department of 10-30 employees, handled over two oncology conversion projects with AR worth over 30 million
  • Contacted clients on a regular basis regarding concerns such as  insurance payer contracts, medical records, system questions, handling of special accounts, and procedures
  • Prepared various reports and updates on AR completed and outstanding; worked on high dollar and special handled accounts; worked and resolved AR for Medicare claims including first level appeals (review request forms), second level appeals (phone hearings, written appeals) and fair hearing appeals

Patient Account Representative

  • Responsible for the billing of reoccurring visits for chemotherapy patients, cardiac rehab, speech therapy, and home infusion patients 
  • Primary insurance billing, secondary insurance billing, insurance and patient follow-up, patient billing, daily Medicare 72 hour reports, entering Home Infusion charges, insurance verification and other miscellaneous reports and assigned tasks, including helping post insurance and patient payments to accounts
  • Handled 1400+ accounts with multiple claims on accounts

Medical Biller

  • Responsible for working two facility’s old AR accounts - for chemical dependency and mental health--both outpatient and inpatient claims
  • Reviewed all old accounts, insurance billing and follow-up as well as patient billing and follow-up

Data Entry/Clerical

  • Helped with various clerical duties such as filing and pulling of EOBs
  • Responsibilities included secondary billings, data entry, copying, faxing and completing PIR forms

Education:

  • Certified in EPIC HB Administration & EPIC SBO Administration
  • CPAT Certification
  • Certificate of Proficiency in secretarial skills
  • Associates Degree in Arts and Science
  • High School Diploma

Speciality:

  • Medicare and Oncology