Posted charges, payments and adjustments. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Consistently informed patients of their financial responsibilities prior to services being rendered. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans. Carefully prepared, reviewed and submitted patient statements. Monitored staffing patterns and therapists' worked hours for efficiency and made changes when necessary. Carefully selected, developed, and retained qualified staff, as well as trained new staff.
Generated new accounts by implementing effective networking and content marketing strategies. Managed budget forecasting, goal setting and performance reporting. Identified strategic partnerships and gathered market information to gain a competitive advantage. Carefully identified warning signs of emotional and developmental problems in children. Created and implemented developmentally appropriate curriculum. Sustained ideal staff-to-student ratio for children aged 0-12 years. Administered medication and minor first aid to sick and injured children. Maintained accurate daily records of children's individual activities, behaviors, meals, and naps.
Served as liaison between management, clinical staff and the community. Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed. Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature. Thoroughly reviewed remittance codes from EOBS/AR's. Confirmed patient information, collected copays and verified insurance. Completed appeals and filed and submitted claims. Posted charges, payments and adjustments.
Performed full-cycle medical billing in a fast-paced Infusion Pharmacy. Average collections;127% of projected goal. Regularly completed paperwork and entered prescription and insurance billing information into patient profiles. Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Completed appeals and filed and submitted claims. Worked closely with pharmacists and used medication input software to safely and accurately dispense medication. Accurately recorded compounded products and prepared appropriate labels. Maintained drug inventory levels by ordering necessary medications and supplies and verifying deliveries against purchase orders. Managed pharmacy inventory through proper medication ordering, returns and inter-store transfers.
Provided accurate and appropriate information in response to customer inquiries. Conducted interviews, gathered detailed information and completed claim investigations. Investigated any potentially fraudulent claims with a focus on thoroughness, quality and cost control. Communicated with floor managers to determine merchandise placement. Verified and recorded the count and condition of located cargo. Recommended settlement offers and negotiated payment arrangements. Cleared damaged items for disposal. Monitored the storage of merchandise in accordance with product handling standards. Met and surpassed productivity targets and quality standards. Provided detailed monthly departmental reports and updates to senior management.
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