Medical Insurance Billing Accounting 1 & 2 MS PowerPoint
Computerized Billing Medical Law/Ethics
Anatomy and Physiology
Medical Transcription MS Excel
FAMILIAR SOFTWARE: Allscripts- EHR EMRge SMS
Medicare Online System:Hummingbird
Connex: National Government Services
Billing SpecialistMar 2012 to Current The Hospital of Central CT － New Britain, CT
Applies policies and procedures/ Considerable knowledge of office systems and procedures.
Remains current with periodic updates of all medical coding manuals and guidelines in accordance with federal, state, and local regulations.
Manages time schedules, deadlines, multiple requests and priorities, to maintain productivity.
Communicates effectively, orally and in writing, with physician, nurses, and peers (both inter- and intra-) departmentally and with external organizations.
Upholds the standards of confidentiality regarding patients, personnel and physicians.
Ability to input data quickly and accurately.
Exercises judgment with minimal supervision Ensures claims are submitted timely and all filing deadlines are met.
Reviews and resolves claims that are denied daily for edits in the electronic billing files.
Categorizes claims for resolution by other areas as determined by departmental procedures.
Responsible to notify supervisor of electronic claims not received by payers.
Responsible to contact Clinical department and Medical records in order to obtain information relevant to denied claims, working with Collection Specialists and other resources as determined by departmental procedures.
Ensures all correspondence, rejected or denied claims are worked within 48 hours of receipt.
Ensures all primary claims are released or categorized within 24 hours of receipt.
As per governmental or departmental procedures, removes, adds or moves charges on accounts timely and accurately.
Identifies and corrects charging issues to bring resolution to accounts (as determined by department procedures) Ensures all rejected or denied claims related to billing are worked daily in the electronic billing software, Medicare or other online systems.
Keying of primary or adjustment claims into payer online systems where appropriate.
Maintains an active working knowledge of all billing and reimbursement requirements by Payer.
Ensures productivity standards are met daily, weekly and monthly.
Ensures quality standards are met and proper documentation regarding patient accounting records.
Work on special projects as requested.
Performs duties in alignment with HHC pillars of excellence.
Administrative Assistant/Office CoordinatorFeb 2008 to Feb 2012 Cardiology Associates of Derby － Derby, CT
Designed office filing systems, organized and maintained files (including confidential files); maintained, updated and reviewed reference material and manuals.
Checked patients in and out for appointments; scheduled follow up appointments or further testing if necessary.
Ensured providers that all diagnoses and procedures that may impact the facility's reimbursement are identified and attested to by the physical, if appropriate, sequenced correctly and coded in an accurate manner for optimum reimbursement.
Determined correct codes for routine and/or new diagnosis and procedures listed in ICD-9CM and CPT.
Kept abreast of regulatory changes affecting coding information.
Obtained referrals, prior authorizations, and pre-certifications for upcoming testing.
Ability to schedule and prioritize office workflow.
Contacted health insurance companies for payment of claims, submit any additional information if requested.
Secured authorization/documentation requirements specific to payer.
Engaged in employee meetings with the objective of solving problems, brain storming, educating physicians and others as to the coding policies and procedures of the facility, as well as promoting consistency of data collected.
Verified all fee sheets to assure that all charges, appropriate modifiers, dates of injury, E codes as well as referring physicians license numbers (when required) have been documented.
Abstracted information from medical records for special studies and audits, internal and external.
Assisted physicians, administrative and medical personnel with retrieving patient care information for research and reimbursement issues.
Generated reports to retrieve coded and abstracted information from provider's database system.
Charge entry for daily encounter forms and diagnostic testing.
Posted any insurance or patient payments to accounts; whether it be sent via mail or electronically.
Documented data/authorization to online billing system Submit medical records/charges electronically and by paper to other medical offices, insurances and attorneys while following proper HIPAA compliance.
Communicated technical and clinical information concerning patient care and classification systems at different levels i.e.
physicians, medical and administrative personnel.
Read handwritten and transcribed documents in the medical record, interpret information, and enter complete and accurate data into an online computer system.
Used personal computer or other electronic equipment.
Formatted and typed a full range of correspondence, reports, bills, and drafts.
Proofread transcribed notes using knowledge of grammar, punctuation and spelling.
Administrative Assistant/Evening ReceptionistNov 2006 to Jan 2008 Stone Academy － Waterbury, CT
Data entry Transcribed documents for evening instructors Checked students in and out for class start/end Greeted and directed visitors/students; answered telephones and addressed appropriately.
Arranged and coordinated meetings, documented minutes of meetings, lectures, conferences.
Took notes using shorthand, speedwriting or machine transcription.
Copied appropriate documentation needed for staff Scanned correspondence; pulled and attached related materials; reviewed routed and prioritized mail.
Education and Training
High School Diploma2006Cheshire High School － CT
Certificate Awarded Medical Office Professional/Billing and CodingAugust 2007Stone Academy － Waterbury, CTGPA: High Honor GraduateHigh Honor Graduate
Accounting 1, accounting, administrative, Billing, billing system, Business Communications, conferences, CPT, Data entry, database, diagnosis, documentation, EDI, filing, forms, Government, Insurance, Law, notes, materials, Medical Terminology, Medical Transcription, Meditech, meetings, MS Access, MS Excel, mail, Office, MS Outlook, MS PowerPoint, MS Word, Navigator, personnel, policies, Coding, quality, Read, research, shorthand, SMS, supervisor, supervision, telephones, transcription, workflow