Monique Williams
San Diego
Summary
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
16
16
years of professional experience
Work History
FINANCIAL INTAKE SPECIALIST
California Protons Cancer Therapy Center
06.2022 - Current
- Obtain and verify insurance eligibility for services provided and document complete information in system accurately.
- Perform prior authorizations as required by payer source, including procurement of needed documentation by collaborating with physician offices and insurance companies.
- Providing insurance patients clinical information such as labs, diagnosis codes, ICD-10.
- Determine patient’s financial responsibilities as stated by insurance.
- Provide self-pay estimates for services and payment arrangements, including collecting payments from patients and/or family members.
- Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures.
- Coordinate denials and appeal correspondence.
PATIENT ACCOUNTING COLLECTOR
Alvarado Hospital Med. Ctr.
03.2018 - 06.2022
- Processing appeals and DMHC submissions for-PPOs/HMOs/Medicare accounts
- Manage EPIC work que claim denials, underpayments and variances
- Prepare monthly audits of accounts over 25k and present findings to CEO, CFO and Owner on a quarterly basis
- Process payments for patient responsibility
- Provide payers with medical Records for claim review and payment consideration
- Verify patient eligibility via RTE; Payer Portal and by phone
- Hospital Closed
PATIENT ACCES REP. III (Contract)
Rady Children's Hospital
05.2017 - 02.2018
- Provided Support in the Central Authorization Department, with genetic laboratory authorizations.
- Secure and provided appropriate information to patients and their families
- Register, schedule and/or obtain authorizations for inpatient, outpatient, and/or diagnostic services.
- Conducts eligibility reviews on a monthly basis and assists with Hematology, Neurology, and Allergy authorizations when needed.
- Utilization Review Management
BILLING OPERATIONS MANAGER
Therapy Changes
05.2015 - 04.2017
- Manage insurance verifications and authorizations to determine eligibility of services.
- Review accounts receivable and reconcile statements to avoid error.
- Create procedures and train new staff on the process of following up on outstanding claims.
- Communicate billing and insurance information to clients, office staff and therapists.
- Submit claims and research/resolve those found outstanding to avoid future rejections.
- Manage all client transactions including posting payments as well as generating invoices for outstanding balances.
- Prepare and reconcile all generated bi-weekly payroll reports for therapists.
- Assist with the process of contracting and credentialing all new therapists.
- Assisted with the development of systems and procedures that assure a smooth transition as the company grows and resulted in a $122,000 increase in company revenue within nine months.
- Created a new position of A/R Specialist whose goal is to advocate for the therapists by collecting on outstanding funds due.
- I developed a procedure manual, provided extensive training and managed new employees in that position.
MEDICAL COLLECTOR
SPEAR Physical Therapy
08.2012 - 03.2015
- Trained all new employees on medical collection procedures.
- Worked on behalf of multiple physicians to recover payments from Commercial/Government and Worker's Comp insurance carriers for medical services rendered.
- Received payments and posted to patient accounts. Prepared and submitted medical records for claim processing.
- Paper bill and submitted claims electronically.
- Prepared itemized statements and refund requests for patients.
- Created procedure manuals for all medical collectors which included clear direction.
- Created authorization procedures to help ensure fewer denials and extension of patient treatment plans.
BILLING MANAGER
Psychiatric Associate's North County Group, Inc
08.2011 - 06.2012
- Managed all patient accounts, insurance and collections accounts.
- Posted daily charges and payments, follow up on delinquent accounts.
- Ran schedule analysis report, monthly journal and month-end reports.
- Performed daily deposit report and run.
- Assisted staff with receptionist and bookkeeping duties.
OFFICE MANAGER
H&B Escalante Chiropractic
10.2009 - 05.2011
- Served as primary data processing, insurance and spreadsheets maintenance manager.
- Prepared and presented all patient estimate packages.
- With permission from president, prepared new statements allowing financial assistance or extensions for patients.
- Lead in patient account collections, patient traction and physical therapy preparation needed.
- Teamed with the provider during sports physicals.
Education
Bachelor's - Sociology
Cal State San Marcos
San Diego, CA07.2015
Associate - Spanish
San Diego Mesa College
San Diego, CA08.2009
Skills
- Claims processing
- Research and analysis
- Insurance verification
- Charting and clinical documentation
- Intake assessment
- Follow-up skills
- Records maintenance
- Group and individual instruction
- Employee training
- De escalation tactics
- Workflow management
- Report preparation
- Money management assistance
Languages
Spanish
Native or Bilingual
Timeline
FINANCIAL INTAKE SPECIALIST
California Protons Cancer Therapy Center
06.2022 - Current
PATIENT ACCOUNTING COLLECTOR
Alvarado Hospital Med. Ctr.
03.2018 - 06.2022
PATIENT ACCES REP. III (Contract)
Rady Children's Hospital
05.2017 - 02.2018
BILLING OPERATIONS MANAGER
Therapy Changes
05.2015 - 04.2017
MEDICAL COLLECTOR
SPEAR Physical Therapy
08.2012 - 03.2015
BILLING MANAGER
Psychiatric Associate's North County Group, Inc
08.2011 - 06.2012
OFFICE MANAGER
H&B Escalante Chiropractic
10.2009 - 05.2011
Bachelor's - Sociology
Cal State San Marcos
Associate - Spanish
San Diego Mesa College