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Experienced Home Home Representative with a demonstrated history of working in the hospital and health care industry.
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* Coordinate systems and procedures with medical records, data entry, claims review and personnel and human resource functions to ensure efficient and compliant billing and payroll operations.
* Ensure continuous coverage in all administrative areas through appropriate staffing assignments and workload distribution and supervises non clinical staff.
* Ensure appropriate orientation for new staff.
* Screen, interview and make appropriate hiring decisions for non clinical staff and administrative staff.
* Conduct performance appraisals/reviews as necessary and in compliance with company policy and procedures.
* Accountable for ensuring compliance with all new and current documentation required by Human Resources and regulatory agencies for maintaining employment within the organization including, but not limited to, I-9 compliance, professional licensure, background checks and all other documents related to employment.
* Maintain an ongoing evaluation of space, supplies and equipment needs for the care center.
* Directly communicates with the IT Department regarding system problems, repairs and
troubleshooting as needed.
* Ensures efficient, accurate and timely operation of the payroll function and compliance with payroll and timekeeping policies.
* Ensures accurate and timely billing processes by reviewing patient charts for compliance/accuracy with all billing requirements before billing.
- Retrieved, sorted, copied, and filed all documents and paperwork.
- Created or updated records with new files or information.
- Strictly adhered to confidentiality dictations to safeguard information.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Pulled patient records and transferred information to appropriate parties.
- Streamlined day-to-day office processes to meet long-term goals.
- Disseminated information to correct department, individual or outside location.
- Performed basic administrative duties, including answering calls, taking messages, data entry, typing tasks and locating files upon request.
- Partnered with healthcare and administrative staff to create patient-centered, inviting and supportive environment for patients and families.
- Collected forms, copied insurance cards and coordinated patient information for billing and insurance processing.
- Efficiently performed insurance verification and pre-certification and pre-authorization functions.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate effective treatment.
- Used Athena software to process patient payments and update accounts.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Printed and filed examination data records according to HIPAA patient standards.
- Prepared prescription refill requests on behalf of physician to prevent lags.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Responded to coding questions from callers and other internal departments.
- Assigned value codes and modifiers to provide specific information for services provided.
- Specified service dates by assigning occurrence codes, span codes and date information.
- Accurately assigned codes using software and official print copy of code book.
- Collected documentation and clarified ambiguous patient care statements by contacting providers.
- Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
- Assigned procedure and diagnosis codes for insurance billing using Cerner.
- Reviewed clinical data from medical records to assign ICD, CPT and HCPCS codes.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Verified proper coding, sequencing of diagnoses and accuracy of procedures.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
Orangeburg Calhoun Technical College - Orangeburg, SC
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Resume Overview
School Attended
- Orangeburg Calhoun Technical College
Job Titles Held:
- Business Office Manager
- Records Coordinator
- Medical Assistant
- Certified Coder
Degrees
- Associate of Applied Science
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