LaToya Fuller

Experience

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  Per Se Technologies, Inc

  Aug 2003 - Aug 2005

  Accounts Receivable Specialist

  Verified patient demographic, insurance, via the hospital dial-up (IDX system) Responsible for detecting billing and payment errors, and developing & executing plans for resolution

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  Medical Billing Solutions

  Oct 2005 - Feb 2006

  Medical Billing Specialist/Accounts Receivable

  Insurance carrier and patient billing via the MediSoft and PayerpathEntered insurance payments; processed and appealed insurance denialsKeyed charges to be billed utililizing current CPT, ICD-9, and HCPCS guidelines and terminology

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  Per Se Technologies , Inc

  Mar 2006 - Jul 2006

  EDI Claims Specialist

  Electronic claims processing and correctionOnline insurance verification via various carrier websitesClaim management thru the use of claim systems such as RealMed, Halley Detecting billing and payment errors, implemented plans for resolution

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  Liberty Long Term Care, LLC

  Nov 2006 - May 2011

  Accounts Receivable Specialist

  Maintain accurate and timely collection and posting of patient account paymentsFacilitate collaborative team meeting minutes with accurate data entry/record keeping to determine patient eligibility for skilled service provisionThorough patient pre-admission insurance verification and ongoing verification of benefits to ensure maximum reimbursementVerification of Medicare benefits via E-SolutionsRenegotiate customer payment terms, improving cash flow and profitabilitySupport Admissions and Marketing departments respectively via ProviderLink, Proficient, and AllScripts and handling facility tours Show less

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  Carolinas Healthcare System

  Jul 2011 - Nov 2013

  Patient Account Representative

  Maintain accurate and timely follow-up on physician claims filed to Medicare & Medicare Advantage plansDetecting patterns in delays in claim payments, including error and denial tracking; Creating and executing plans for resolution Verification of insurance eligibility and claims tracking via Palmetto GBA’s Online Provider System, Payerlink, Blue-E, and various other payer websitesMaintain a working knowledge of CPT, HCPCS, and ICD-9 terminology and billing for the purpose of claim correction and filingEstablish and maintain rapport with coworkers, management team, and physician sites in order to ensure efficient claims follow-up Show less

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  Carolina Neurosurgery & Spine Associates

  Oct 2013 - Sept 2017

  Accurate and timely follow-up on physician claims filed to Medicare & Medicare Advantage plansDetecting patterns in claim payment delays, including error and denial tracking; Creating and executing plans for resolution Verification of insurance eligibility and claims tracking via Palmetto GBA’s Online Provider System, Navicure, NHXS, Healthtrio, and various other payer websitesMaintain a working knowledge of CPT, HCPCS, and ICD-9 terminology Maintain a current knowledge of Medicare & CMS policies & reimbursement guidelinesCommunicate issues and trends to Billing Dept. supervisor; also maintain a rapport with representatives in various departments including Credentialing, Coding, and Front Desk personnel Show less

  • Patient Representative

    Jul 2015 - Sept 2017

  • Medicare Claims Specialist

    Oct 2013 - Jul 2015
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  OptiMed Hospitalists PLLC

  Sept 2017 - Oct 2021

  Billing Manager
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  The Pines at Davidson

  Jan 2022 - now

  • Sales & Marketing Counselor

    Apr 2024 - now

  • Office Manager

    Jan 2022 - Apr 2024