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EVELYN J. ROBERTS
2951 SIENA HEIGHTS DR #2311
HENDERSON NV 89052
702-912-1751
409-457-5224(Cell)
(Email: evelyn.roberts@ymail.com)
PROFESSIONAL EXPERIENCE
ST JOSEPH MEDICAL CENTER, HOUSTON, TX
FINANCIAL COUNSELOR – AUG 2012 – Feb 2013
Performed daily review and contract interpretation, pre-cert/authorization compliance, and upfront
Business to Business collections for all in-house accounts. Assisted with all active participants in
facility Net Revenue and or Discharge Planning meetings. Facilitate the coordination of account follow
up with the Assigned Case Manager.
CHRISTUS DUBUIS HEALTH SYSTEM, HOUSTON, TX
PATIENT ACCOUNT SPECIALIST – Dec 2008 to Aug 2012
Verified insurance and entered data for pre-admissions to fifteen Long Term Acute Care Hospitals along
with appropriate release, safety, security and confidentiality of business records. Perform a variety of
patient account related duties including posting of payments, verification of claims, preparing daily
census of all facilities.
BROOKE ARMY MEDICAL CTR, FT. SAM HOUSTON, TX
(CONTRACTOR – TA CONSULTING & CAREER MANAGEMENT ASSOCIATES)
INSURANCE BILLER – Nov 2006 to Oct 2008
Researched documentation for billing of various patient categories along submission of claims for all
outpatient and inpatient services. Generate monthly reports for all bills as well as reports by fiscal year
and type of account. Assisted with debt management procedures and provided information on general
request through research, copying, billing and filing. Maintained database of all accounts and metric
system of bills produced on a daily basis. Created outpatient bills upon Attorney’s request as required.
Processed interagency billing once a month.
UNIVERSITY HOSPITAL, SAN ANTONIO, TX
SR. FINANCIAL ACCESS SPECIALIST, OCT 2006 TO NOV 2006
Responded to phone inquiries on patients admitted to the facility. Screened patients with Insurance and
verified coverage along with accepting co-pays and deductible from patients being referred to outpatient
facilities as well as being admitted to the Hospital.
UNIVERSITY HEALTH SYSTEM
TEAM LEADER OUT PATIENT CUSTOMER SERV –May 2006 to Oct 2006
Completed performance of para-administrative and clerical duties in support of clinical services which
included; patient reception, answering incoming telephone calls, appointment scheduling, registration,
patient arrival and dismissal, referral coordination, financial screening, patient account inquiry and all
collections. Supervision of Outpatient Customer Service Representatives and Outpatient Pre-
registration Customer Service Representatives. Assisted with scheduling, training and evaluation of
personnel in assigned area(s). Also, ensured that equipment and supply levels are effectively
maintained.
UNIVERSITY OF TEXAS MEDICAL BRANCH, GALVESTON, TX
SR. FINANCIAL COUNSELOR – August 2003 to Feb. 2006
Trained and guided new employees. Assisted manager in procedural development and supervision.
Gathered all patient demographic data required in the hospital Information System and computer
system during patient interview. Screened patient for financial responsibility by using the uniform
financial screening document. Verified patient information, called patients Insurance when necessary to
determine Emergency Room co-pays for services rendered and collected at time of service.
Performed proofing, reviewed processing and verification procedures on account. Adhered to internal
controls established for department. Performed related duties as required.
UNIVERSITY OF TEXAS MEDICAL BRANCH, GALVESTON, TX
PATIENT SERVICE REPRESENTATIVE – April 2002 to August 2003
Completed Insurance follow-up on all (Business to Business) Commercial, Tri-care and Medicare
Claims. Followed up on EOB’S to make sure contractual adjustments taken properly. Provided clerical
and communication support for hospital billing; Performed soft Collections, sent out monthly statements
and submitted delinquent accounts to Hard Core Collections. Reviewed accounts for third party
information; Provided correspondence to patient and providers as needed; Billed patients and refund
insurance companies as needed; Completed monthly reports as required; Trained new employees as
needed.
UCLA DEPT. OF MEDICINE, LOS ANGELES, CA
BILLING & COLLECTIONS SUPV - August 1998 to June 2001
Supervised Ambulatory/Outpatient services. Provided training for staff, delegation of work to insure
maximum efficiency in (Business to Business) billing and collections of Government, Commercial and
Managed care claims along with follow-up and appeals. Reviewed daily production of staff targets on
account receivables in order to maintain A/R Days. Interfaced with patients, health plans, physicians
and other outside agencies regarding outstanding balances. Reviewed claims and assist with coding
for appropriate coordination of CPT and ICD9 codes to insure correct billing and maximum revenue
collections. Assisted management with various special projects as needed.
PRUDENTIAL HEALTH CARE, LOS ANGELES, CA
A/R BILLING SPECIALIST, August 1997 to August 1998
Performed booking and allocating of all payments to assigned accounts and branches. Address
internal/external questions concerning billing, rates and members. Reconciled payments received from
clients. Assist Benefits Administrator/Payroll in regards to billing issues on a monthly basis. Attended
Monthly meetings to enhance knowledge of all medical and dental products provided by Prudential.
Assisted with client contact and follow up within all levels throughout Prudential. Continuously met
and exceeded established deadline and expectations.
PRO-ACC MEDICAL BILLING SERVICE, LOS ANGELES, CA
PRESIDENT/FOUNDER, July 1990 to July 1997
Owner of a Billing Service that serviced twelve physicians. Responsible for data entry, claim generation
and electronic submission of Medicare, Medical, Blue Cross and Blue Shield Claims. Followed up on
all claims, generated monthly reports; send monthly statements, account payables and account
receivables.
HARV PARK DERMATOLOGY, LOS ANGELES, CA
OFFICE MANAGER, April 1983 to June 1990
Performed training of employees in all phases of Insurance Billing and Collections, send monthly
statements, account payables and account receivables. Instrumental in office relocating to new office.
EDUCATION
LA College of Medical Assistants/Front Office – Los Angeles, CA
(Course completed with Certification)
MEDICAL SOFTWARE PROGRAMS
Microsoft Office, Outlook & Excel
REFERENCES
Provided Upon Request

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Evelyns Resume10

  • 1. EVELYN J. ROBERTS 2951 SIENA HEIGHTS DR #2311 HENDERSON NV 89052 702-912-1751 409-457-5224(Cell) (Email: evelyn.roberts@ymail.com) PROFESSIONAL EXPERIENCE ST JOSEPH MEDICAL CENTER, HOUSTON, TX FINANCIAL COUNSELOR – AUG 2012 – Feb 2013 Performed daily review and contract interpretation, pre-cert/authorization compliance, and upfront Business to Business collections for all in-house accounts. Assisted with all active participants in facility Net Revenue and or Discharge Planning meetings. Facilitate the coordination of account follow up with the Assigned Case Manager. CHRISTUS DUBUIS HEALTH SYSTEM, HOUSTON, TX PATIENT ACCOUNT SPECIALIST – Dec 2008 to Aug 2012 Verified insurance and entered data for pre-admissions to fifteen Long Term Acute Care Hospitals along with appropriate release, safety, security and confidentiality of business records. Perform a variety of patient account related duties including posting of payments, verification of claims, preparing daily census of all facilities. BROOKE ARMY MEDICAL CTR, FT. SAM HOUSTON, TX (CONTRACTOR – TA CONSULTING & CAREER MANAGEMENT ASSOCIATES) INSURANCE BILLER – Nov 2006 to Oct 2008 Researched documentation for billing of various patient categories along submission of claims for all outpatient and inpatient services. Generate monthly reports for all bills as well as reports by fiscal year and type of account. Assisted with debt management procedures and provided information on general request through research, copying, billing and filing. Maintained database of all accounts and metric system of bills produced on a daily basis. Created outpatient bills upon Attorney’s request as required. Processed interagency billing once a month. UNIVERSITY HOSPITAL, SAN ANTONIO, TX SR. FINANCIAL ACCESS SPECIALIST, OCT 2006 TO NOV 2006 Responded to phone inquiries on patients admitted to the facility. Screened patients with Insurance and verified coverage along with accepting co-pays and deductible from patients being referred to outpatient facilities as well as being admitted to the Hospital. UNIVERSITY HEALTH SYSTEM TEAM LEADER OUT PATIENT CUSTOMER SERV –May 2006 to Oct 2006 Completed performance of para-administrative and clerical duties in support of clinical services which included; patient reception, answering incoming telephone calls, appointment scheduling, registration, patient arrival and dismissal, referral coordination, financial screening, patient account inquiry and all collections. Supervision of Outpatient Customer Service Representatives and Outpatient Pre- registration Customer Service Representatives. Assisted with scheduling, training and evaluation of personnel in assigned area(s). Also, ensured that equipment and supply levels are effectively maintained.
  • 2. UNIVERSITY OF TEXAS MEDICAL BRANCH, GALVESTON, TX SR. FINANCIAL COUNSELOR – August 2003 to Feb. 2006 Trained and guided new employees. Assisted manager in procedural development and supervision. Gathered all patient demographic data required in the hospital Information System and computer system during patient interview. Screened patient for financial responsibility by using the uniform financial screening document. Verified patient information, called patients Insurance when necessary to determine Emergency Room co-pays for services rendered and collected at time of service. Performed proofing, reviewed processing and verification procedures on account. Adhered to internal controls established for department. Performed related duties as required. UNIVERSITY OF TEXAS MEDICAL BRANCH, GALVESTON, TX PATIENT SERVICE REPRESENTATIVE – April 2002 to August 2003 Completed Insurance follow-up on all (Business to Business) Commercial, Tri-care and Medicare Claims. Followed up on EOB’S to make sure contractual adjustments taken properly. Provided clerical and communication support for hospital billing; Performed soft Collections, sent out monthly statements and submitted delinquent accounts to Hard Core Collections. Reviewed accounts for third party information; Provided correspondence to patient and providers as needed; Billed patients and refund insurance companies as needed; Completed monthly reports as required; Trained new employees as needed. UCLA DEPT. OF MEDICINE, LOS ANGELES, CA BILLING & COLLECTIONS SUPV - August 1998 to June 2001 Supervised Ambulatory/Outpatient services. Provided training for staff, delegation of work to insure maximum efficiency in (Business to Business) billing and collections of Government, Commercial and Managed care claims along with follow-up and appeals. Reviewed daily production of staff targets on account receivables in order to maintain A/R Days. Interfaced with patients, health plans, physicians and other outside agencies regarding outstanding balances. Reviewed claims and assist with coding for appropriate coordination of CPT and ICD9 codes to insure correct billing and maximum revenue collections. Assisted management with various special projects as needed. PRUDENTIAL HEALTH CARE, LOS ANGELES, CA A/R BILLING SPECIALIST, August 1997 to August 1998 Performed booking and allocating of all payments to assigned accounts and branches. Address internal/external questions concerning billing, rates and members. Reconciled payments received from clients. Assist Benefits Administrator/Payroll in regards to billing issues on a monthly basis. Attended Monthly meetings to enhance knowledge of all medical and dental products provided by Prudential. Assisted with client contact and follow up within all levels throughout Prudential. Continuously met and exceeded established deadline and expectations. PRO-ACC MEDICAL BILLING SERVICE, LOS ANGELES, CA PRESIDENT/FOUNDER, July 1990 to July 1997 Owner of a Billing Service that serviced twelve physicians. Responsible for data entry, claim generation and electronic submission of Medicare, Medical, Blue Cross and Blue Shield Claims. Followed up on all claims, generated monthly reports; send monthly statements, account payables and account receivables.
  • 3. HARV PARK DERMATOLOGY, LOS ANGELES, CA OFFICE MANAGER, April 1983 to June 1990 Performed training of employees in all phases of Insurance Billing and Collections, send monthly statements, account payables and account receivables. Instrumental in office relocating to new office. EDUCATION LA College of Medical Assistants/Front Office – Los Angeles, CA (Course completed with Certification) MEDICAL SOFTWARE PROGRAMS Microsoft Office, Outlook & Excel REFERENCES Provided Upon Request