Vetra Butler

Experience

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  AXMINSTER MEDICAL GROUP

  Mar 1995 - Jan 2000

  HMO Coordinator

  Reviewed and processed referrals for authorization of office visit, surgeries, and durable medical equipment.

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  PacifiCare Health System

  Feb 2000 - Oct 2004

  Clinical Information Associate II

  • Responsible for reviewing medical bills• Performed moderately complex to advance level of technical and analytical work• Collect and analyzed medical data in order to identify cost savings opportunities• Administered and reviewed claims that were over the claims department limit of forty thousand• Requested Retro-Authorization• Verified eligibility and benefits• Identified financial risk claims• Extensive knowledge on interpretation of contracts• Familiar with HMO, Commercial, Secure Horizon, PPO• HIPAA compliance Show less

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  St Johns Hospital Contracted

  Jan 2005 - Aug 2005

  Medical Collector

  • Responsible for the analysis of patient records• Determined the legitimacy of treatment, diagnostic testing, admissions, etc• Collected on past due claims from several insurance carriers• Experienced with reading Medicare/Medical RA’s, EOB’ s, and Contracts• Requested medical records for strong appeal process• Processed payment’s and adjustment’s according to EOB’s and check’s received from insurance carrier’s• Re-billed and appealed on un-paid, and denied claims• Extensive knowledge with insurance rules and regulations, managed care contracts, POS, HMO, PPO, work comp, and Medi-Care• HIPAA compliance Show less

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  RADNET MANAGEMENT, INC

  Sept 2006 - Apr 2008

  Collector / Brokerage Specialist & Discount Specialist

  Managed special accounts, adhering to specifics determined by established contract rates, billing, and invoices for national leader in high-quality, cost-effective diagnostic imaging services; 200+ outpatient imaging centers. Coordinated traffic for inbound and out call center for radiology billing. Investigated and resolved insurance issues. Filed appeals and grievances according to policy.Administered technical review and documentation for applications concerning discount for self-pay, company employees, professional and financial hardship, and approvals. Show less

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  TEMP UNLIMITED

  Sept 2008 - Jan 2009

  Claims Analyst

  Assigned to Genascis account, processing claims and collections for healthcare facilities, healthcare providers, and medical insurance company.

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  PMG/Genascis

  Jan 2009 - Apr 2011

  AR Administrator

  Provided high levels of technical support and administrative management for surgical billing company providing services for transcription, coding, and specialized billing for in- and out of network claims, claim follow-up, and collections. Held accountability for creating sustained productive team environment, directing work activities, coaching, and coordinating logistics for professional development and training. Worked one-on-one with clients to address payment issues, performed insurance checks, and established payment plans. Supervised 3 staff tracking patient payment records, communications, and collections.Developed subject matter expertise in skip tracing and investigation using TRW / Equifax data to manage severely past due and uncollectable accounts.Key member of Task Force, implementing new Self Pay Program.Worked easily and comfortably with systems to process claims and collections from medical insurance companies for facilities and providers.In role of A/R Administrator, leveraged exceptional time management skills to consistently remain ahead of schedule regarding claims and appeals; rapidly promoted to supervisory role. Show less

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  RONIN Staffing Company

  Jul 2011 - Nov 2011

  Medical Refund Specialist Medical Collector

  Train temp and permanent employees. Medical payment post for labs and process refunds. Post collection agency payments and commission dues from agency. Contact insurance for possible refunds for sending payments wrong providers. Direct contact with collection agency. Performing month end reports and balancing multiple reports. Wrote policy and procedures.

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  LA Care Health Plan

  Feb 2014 - Jan 2016

  Care Management Coordinator

  I have been with the new line business Cal MediConnect from the beginning. CMC Review Health Risk Assessment for new members for triggers for Case Manager RN to further assess and case managed by the Health Plan for dual members of Medi-Care & Medi-Cal. I am the CMC contact person for the Medical Groups for Lows and Moderate Cases. Mail correspondence to members according to their diagnosis. Send referral request forms to the Beacon, Asthma, Diabetic, Social Worker and Educational Referral. Designated person to work on the CMC Hospice Report and contact the Medical Groups and Primary Care for updated Hospice information. Trained new employees within our dept. Show less

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  UnitedHealth Group| UnitedHealthCare

  Jan 2017 - Oct 2020

  Clinical Aministrative Coordinator Telecommute | Credentialing Coordinator Support Coordinator

  Created Work Instructions and updated as needed and trained incoming new hires in person and via WebEx. Place in the role as Acting Supervisor. Monitored auditing process to ensure accuracy and compliance guidelines. Created legal binding contracts with provider and facilities. Managed the recruiting inbox from providers and internal employees. Reports that were due daily and weekly.

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  UCLA Health

  Oct 2020 - now

  Discharge Coordinator for Children’s Health Center for both UCLA Hospitals. I make sure that the patient has hospital follow ups before they are discharged from the hospital. This is processing the hospitalist referrals from the beginning til I get authorization. Hospital rounds with physicians, case managers and social workers. There are weekly reports of the in-patients about possible discharge. Floater through UCLA Health System. Promoted to new position.

  • Administrative Assistant III

    Oct 2021 - now

  • Administrative Assistant II

    Oct 2020 - Oct 2021