Customer Service with background in billing and collections, records management and maintenance and appointment setting. Desires a role in a productive office environment. Medical billing and coding specialist with six years providing administrative and patient support in insurance based office settings. Advanced knowledge of private insurance processes and codes. Efficient Medical Administrative Assistant skilled in tackling administrative and patient-oriented tasks in a fast-paced environment.
Medical terminology expert
Billing and collection procedures expert
Records management professional
Inpatient records coding proficiency
Outpatient surgery coding specialist
OASIS billing and coding
Insurance and collections procedures
Composed and professional demeanor
Excellent problem solver
Resourceful and reliable worker
Office support (phones, faxing, filing)
Records management professional
Understands insurance benefits
04/2014 to Current
A/R Billing RepresentativeGenova Diagnostics Inc – Norcross, GA
Triage customer voicemails within the ARBO Call Center (ACC) and respond within 1 business day Use an effective approach to handle special telephone tasks like call transfers, taking messages, call backs, holds, interruptions, and unintentional disconnects Maintain clear, concise and collegiate communication with all customers Process refund requests/verify payments applied Identify, research, and resolve customer issues using the computer system - also utilize the QA System to report issues as necessary Research and review patient files for accuracy and proper medical coding Proficiently utilize internal database and coding systems Enter refund transaction detail into the appropriate system to accurately reflect approved transaction.
Correctly coded and billed medical claims for various hospital and nursing facilities.
Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
01/2013 to 04/2014
Benefits/Claims RepresenativeDentegra Insurance Company – Alpharetta, GA
Benefits/Enrollment/Claims Interact directly with doctors and nurses to provide patients with excellent care and service Patient enrollment including initial payments via credit card Communicate with dental patients to ensure clarity of services and fees/verification of enrollment/EOB's Direct liaison of escalation to counterparts at high-profile EarthLink partners HIPPA compliant/NPF (National Provider File) experience Serve as a liaison between the Provider Enrollment (Credentialing) group and new dental professionals.
Precisely completed appropriate claims paperwork, documentation and system entry.
Verified patients' eligibility and claims status with insurance agencies.
Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.
01/2008 to 01/2014
Level II Customer Care RepresentativeDelta Dental Insurance Company – Alpharetta, GA
Maintain clear, concise and collegiate communication with all customers Interact directly with doctors and nurses to provide patients with excellent care and service Research and review patient files for accuracy and proper medical coding Proficiently utilize internal database and coding systems/eob explanation Update dental provider tax id and other credentialing Dentrix experience/HIPPA compliant/NPF (National Provider File) experience.
Responsible for handling escalated issues with customers.
Create reports and presentations to recap.
Demonstrated analytical and research skills.
Daily communications with brother vendors regarding products issued.
Complied annual recommendations for end of fiscal year budgets.
Met or exceeded service and quality standards every review period.
Referred unresolved customer grievances to designated departments for further investigation.
Addressed and resolved customer product complaints empathetically and professionally.
Bachelor of Arts: Child Psychology Morris Brown College - Atlanta, GA
Coursework in Business, Accounting and Healthcare Administration
Coursework in Healthcare Management
Microsoft Office (Excel, Word, Power Point, Access)
Terminals, Maax Statistics Database, MACESS.exp, National Provider Files, CITRIX, Check Registries: Educational Psychology Oneonta State College - Oneonta Atlanta, NY Georgia Educational Psychology
approach, Benefits, Call Center, CITRIX, concise, credit, Database, Access)
Database, Excel, Microsoft Office, Power Point, Word, presentations, coding, QA, Research, Statistics, tax, telephone
The Atlanta Union Mission
Bachelor of Arts : Child Psychology Microsoft Office (Excel, Word, Power Point, Access)
Terminals, Maax Statistics Database, MACESS.exp, National Provider Files, CITRIX, Check Registries : Educational Psychology
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