Patient-focused Billing Specialist skilled at medical billing, coding and office management. Reliable multi-tasker with internal medicine, dermatology, ENT and ophthalmology experience.
Medical Assistant Certificate
Strong work ethic
Team player with positive attitude
Good written communication
Exercises good judgment
Knowledge of HMOs, Medicare and Medi-Cal
Medical Manager Software
Electronic Medical Record (EMR) software
HHM and Medisoft billing systems
Billing ManagerJan 2006 to Current Alpha Eye Associates, LLC － Smyrna, GAPresently working as a billing manager for an Ophthalmology office in Smyrna, Ga. Essential duties as Billing Manager include but not limited to:Examinig super bills for diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered by the physician. Ensuring timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and Emedeon clearing house. Prepare and attached all required claims documentation including referrals, appeals, treatment plans or other required correspondence to reduce incidence of denials. Remain up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans. Assign additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative. Thoroughly review remittance codes from EOBS/AR's and applying payments, adjustments and denials into our office's medical manager system, Compulink. Act as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy. Perform quality control of the data entry system three times a week to verify that claims and payments were posted correctly. Carefully prepare, review and submit patient statements minimized the number of unpaid accounts. submitting refund requests for claims paid in error. In addition to my billing manager duties, I assistant the front office with recording of patients' medical history, vital statistics and test results in medical records. Collect patients copays, schedule patient appointments, and acquiring insurance authorizations and verification before patients appointment. I scheduled all surgeries and procedures in conjunction with the surgical coordinators at formerly Emory-Adventist Hospital, and now Emory University Midtown Hospital, as well as radiology exams at the various imaging locations throughout Atlanta. I informed all patients of their financial responsibilities prior to any of any outpatient services being rendered and acquire any insurance authorizations for all the surgeries, procedures and tests ordered by the physician. Carefully review medical records for accuracy and completion as required by insurance companies. Serve as a liaison between patients and physicians to assist patients in understanding their treatment plans, medication, and the proper care or any ophthalmic products. Maintained organized records of customer prescriptions, product orders such as contact lens, frames and eyeglass lens and track payments in our Optician manager system. Resolved and clarified issues with patient medications and collaborated with local pharmacies.
Monitor our shared office email and ensured inquiries by patients, vendors, and doctors received are addressed in a timely manner. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Clinical Medical Assistant and FrontJan 2004 to Jan 2005 Ears, Nose, and Throat Institute － Smyrna, GAWorked as a back and front office medical assistant for an ENT office in Smyrna, GA. Essential duties included but not to: Prepared patient rooms prior to their arrival. Directed patient flow during practice hours, minimizing patient wait time. Support duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.Escorted patients to examination rooms and prepared them for physician exams. Assised the physican with minor surgery for example myringotomies, tonsillar abscess removal, and several types of biopsies. Responsible for insurance verification of procedures such as CT scans MRIs, allergy testing, allergy injections and ENG. Kept facility stocked with necessary supplies, equipment and instruments. Familiar and compliant with OSHA blood borne pathogen standards. Served as a liaison between patients and physicians to assist patients in understanding their treatment plans. Educated patients about their treatments.
Scheduled radiology exams for patients. Scheduled surgeries and procedures in conjunction with Surgical Coordinator.
Clinical Medical AssistantJan 2002 to Jan 2004 Dermatology Consultants － Marietta, GA
Assisted physicians with patient care at a Dermatology office in Marietta, GA. My essential duties and responsibilities include, but not limited to:Escorted patients to examination rooms and prepared them for physician exams. Helped physicians examine and treat patients by assisting with instruments, injections and suture removal. Cleaned and sterilized instruments and disposed of contaminated supplies. Recorded patients' medical history, vital statistics and test results in medical records. Performed pregnancy tests and sent specimens for laboratory testing Monitored patient reactions to drugs and carefully documented progress of individual taking Accutane. Prepared specimens for analysis and established proper chronological priorities in testing. Performed lab tests and communicated results.Educated patients about their treatments. Ensured HIPAA compliance. Provided necessary health education training for patients.
Medical AssistantJan 2000 to Jan 2002 Dr. Paula Nelson & Associates － Marietta, GAworking in Dermatology office doing back office work. Duties include working patient's charts as well as putting patient's medical records in the computer. Assisting doctors in rooms at all times with patients. Assisted doctors in minor surgery such as biopsy of irregular pigmented and border nevus and excisions of mild, moderate and severe dysplastic nevus, Squamous Cell and Basal Cell carcinoma skin cancers. Also assisting doctors in major surgeries such as Melanoma and Liposuction, taking viral, bacterial, and fungal cultures. Giving patients injections that contain steroid and cortisone medication for relief of urticaria and certain allergic reactions. Doing phlebotomy work for patients on Accutane, Lamisil and Methrotherate. Calling prescriptions to pharmacy, calling patient with biopsy result which entitled setting up surgery appointments, and doing phone triage as well as answering patient questions about surgical procedures as well as medication usage. Cleaning, stocking, sterilization of rooms and instruments. Explaining of medications usage and different particular condition to patients i.e. Eczema, Acne, Actinic Keratosis, skin cancers etc. Experience in mediate Yag Laser for usage in laser hair removal, facial veins treatments, tattoo removals, and benign pigmented lesions. I also have experience in cosmetic products such as facial, chemical peels, and microdermabrasion.
Medical Assistant (Internship)Jan 1999 to Jan 2000 Dr. Warren Weber － Austell, GAWorked at an Internal Medicine / Geriatrics clinic. Duties involved working patient's charts, doing vital signs, phlebotomy, urinalysis, injections, prepared trays for pap smears, as well as doing in office lab work such as glucose testing.
Education and Training
High School Diploma1997Pebblebrook High School Mableton － Mableton, GA, US1993 - 1997 Pebblebrook High School Mableton, GA High School Diploma
Medical Assistant1999Medix School － Smyrna, GA, US1998 - 1999 Medix School Smyrna, GA Medical Assistant Certificate
2007Kennesaw State University － Kennesaw, GA, US2004- 2007 Kennesaw State University Kennesaw, GA Transferred to GSU
Computer Science2017Georgia State University － Atlanta, GA, US2012- Georgia State University Atlanta, GA Computer Science
Medical Assistant, HIPPA compliance, Office Medical, Medical Billing, Appointment Scheduling, Answering Multi-line phones, Blue Cross Blue Shield, Claims, Billing Clerk, Coding, Front Desk, Healthcare knowledge, Medicaid, Medicare, Outpatient procedures and surgeries, Posting Charges, Receptionist, Electronic Remittance, Clinical Medical Assistant, Infection Control, Medical Terminology, Venipuncture, Radiology Testing Scheduling, Phlebotomy, CPT-4 code, ICD-9, Office Assistant, Medical Records, Pharmacy, Sterilization, Yag Laser, Medical Assistant Certificate, Data Collection, Medisoft, Microbiology, Microsoft Office, Microsoft Office Xp, MS Office, Outpatient Care, Pharmacology, Records Management, Instrument Sterilization knowledge, Toxicology