Energetic, Self Starting Seasoned Billing and Coding Manager with over 20 years of experience in Medical and Dental billing and Administrative Management seeking an opportunity which will allow me to apply my knowledge and experience to help exceed the mission and goals of the orgazination. Eager to enhance my knowledge in and to be able to share my expertise that I have learned over the years and gain new ones.
Skills
Bilingual-Fluent in Spanish verbal and written.
Medical and Dental coding and billing/CPT and ICD-10.
Insurance policies and procedure, bundling and unbudling, subrogation and pre-exsisting. MVA and LOP claims.
Entering claims for clearinghouse processing, working rejected and denied claims. Correcting for reprocessing or appeals.
Medical Laws and Ethics/HIPPA Compliance/Billing Cycle.
Medical Terminolgy/Anatomy and Physiology.
Communication and Organizational SKills.
Microsoft Word, Excel, PowerPoint, Piant.
Education and Training
Columbia High SchoolLake City, FLExpected in 05/1994 ā āHigh School Diploma: - GPA:
CMEAtlanta, GA, Expected in 02/2007 ā āMedical Billing And Coding CME Seminar:Continuing Medical Education - GPA:
CMEBoston, MA, Expected in 03/2013 ā āDental Billing And Coding Seminar:Continuing Medical Education/Dental - GPA:
Experience
Tobin Bone And Joint, Inc. - Chief Billing Officer/General Office Manager City, STATE, 08/2014 - 06/2020
Resolved billing issues using knowledge and in-depth research of policies.
Arranged all payment plans with patients. Sent to ouside collections
Improved standard operating procedures to increase billing accuracy of insurance input for increase of correct claims processing.
Conducted insurance verification and pre-authorization, coded all office, DME, in office surgery and out or inpatient surgery procedures and charts.
Trained new hires on company policies and systems to keep team operations productive and efficient.
Prepared monthly and year-end closing statements, financial documents and invoices while working monthly aging reports.
Data input of all office and hospital surgical/consultation charges.
Worked all claims in clearinghouse/corrected any rejections or denials.
Worked front or check out desk as needed which included making appointments, scheduling procedures, precertifications, collection of copays and or deductibles including balances.
Scheduled surgery patients and preformed pre-op consultations.
Assisted in physician credentialing, license renewal and reappointments.
Traveled to satelite office to assist physician with all office aspects including.
Order all DME equiptment and supplies.
Posted all EOB's towards patients accounts including primary and secondary insurances. Processed all electronic credit card payments from insurances.
Assisted physician with castings, fracture treatments and post opertive appointments.
Interpreted for all Spanish speaking patients in each office and for our joined Physical Therapy Office.
Answered phones, scheduled appointments, faxed and phoned prescriptions.
Coastal Pediatric Dentistry - Front Office Administrator/IV Sedation Coordinator City, STATE, 02/2012 - 08/2014
Greeted and checked in all patients for appointments while gathering all insurance and demographic information for billing purposes.
Made all new and return appiontment as well as scheduled patients for inter office procedures.
Verified all insurance policy benefits and collected at time of appointments.
Scheduled IV SEDATION Surgery procedures/discussed treament plans with family along with collection of any benefit fees due for services.
Assisted physician wiht any procedures needed mostly in times to calm down a child in fear or with special needs patients.
Prepared rooms for treatment. Steralized all equiptment and instruments.
Entered all dental claims into clearinghouse for insurance processing.
Answered phones.
Assisted Clinical Supervisor with clinical issues.
CareCore National - Data Intake/Customer Service Supervisor City, STATE, 09/2009 - 01/2011
Trained and mentored new team members to promote productivity, accuracy and friendly customer service.
Handled sensitive customer service complaints and delivered prompt resolution to customer satisfaction.
Assessed team member performances, delivering one-on-one coaching to promote better service.
Established positive rapport with customers, managers and customer service team members to maintain positive and successful work environment.
Coached staff on strategies to enhance performance and improve customer relations in one on one meetings monthly.
Audited agents phone calls as need for coaching and scoring on quarterly basis and advised of audit scores weekly as agents had to keep a audit score of 90% and above.
Met with all other Supervisors monthly reviewing each team along with audit scores.
Neurological Institute Of Savannah - Personal Administrative Secretary/Manager City, STATE, 12/1999 - 08/2009
Answered phones scheduling all appointments along with verifing insurance benefits and advising patients of amounts due at time of services.
Scheduled all surgical procedures and arranged surgical representatives to be prepared for case and any equiptment needed.
Coded and entered into system all office and surgical charges to send through claringhouse for claims processing.
Deligated three seperate schedules including physician, nurse practitioner and physician assistant. Verified all insurance benefits and advise while verfiing appointments.
Sterilized all equiptment and prepared all exam rooms.
Arranged all outpatient radiology and lab procedures.
Assisted with injections and post operative dressing changes.
Assisted in physican credentialing, license renewals and reappointments.
Traveled and assisted physician and physician assistant in satalite office.
Called in presciptions, faxed and maintained all charts.
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School Attended
Columbia High School
CME
CME
Job Titles Held:
Chief Billing Officer/General Office Manager
Front Office Administrator/IV Sedation Coordinator
