Working knowledge of CPT, HCPCS, ICD-9, ICD-10 coding products. Familiar with commercial and private insurance carriers. Expertise in researching, correcting and follow up on claim errors/rejections in a timely manner. Seeks a position of increased responsibility and authority.
HIPAA Certified
Training on new ICD-10 coding changes
Skilled in preparation of written material; proficient in wide variety of hardware and software application; evaluation of documentation; scientific data collection and quality control; ability to learn complex paradigms in proficient and timely manner; skilled in the use and maintenance of general office equipment and computer literate in Microsoft Works including, but not limited to, Office Word, Excel, Access, PowerPoint, and Publisher; keen ability to understanding and focusing on clients' needs; ability to communicate effectively both verbally and in writing; Maintains strict confidentiality; Knowledge of HMOs, Commercial, Medicare, Medicare Replacement and Medicaid insurance; OB-GYN, surgery, gastro, ENT, ortho, and transplant experience; Extensive anatomy/physiology knowledge; Electronic Medical Record (EMR) software and ICD-9 coding expertise; Quality assessment of coded data; HIPAA compliant; Patient-focused care with strong work ethic; Good written communication skills and exercises good judgment |
Thoroughly investigated past due invoices and minimized number of unpaid accounts.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Strictly followed all federal and state guidelines for release of information.Wrote clear and detailed clinical phone messages for physicians.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Provided administrative support for twenty-five; Resolved and clarified billing issues with patients; Consistently ensured proper coding, sequencing of diagnoses and procedures.Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.Confirmed patient information, collected copays and verified insurance.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.Submitted refund requests for claims paid in error.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Meticulously tracked and resolved underpayments.Performed quality control of the data entry system to verify that claims and payments were posted correctly.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Efficiently performed insurance verification and pre-certification and pre-authorization functions.Performed full-cycle medical billing in a fast-paced medical billing company.
Efficiently performed insurance verification and pre-certification and pre-authorization functions.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Performed full-cycle medical billing in a fast-paced medical billing company.Performed quality control of the data entry system to verify that claims and payments were posted correctly.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Submitted refund requests for claims paid in error.Applied payments, adjustments and denials into NextGen system. Completed appeals and filed and submitted claims. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received. Strictly followed all federal and state guidelines for release of information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Accounts Receivable, advertisements, AR, billing, brochures, hardware, computer literate, conferences, consulting, CPT, CPU, Client 8.3, client, clients, data collection, data entry, data management, documentation, editor, EDI, filing, writer and editor of Focus on the Delta newsletter, front office manager, Gateway software, general office, graphics, Insurance, Medical Management, Access, Access database, Excel, MS Office, Office, Outlook, PowerPoint, Power Point, Publisher, Word, Microsoft Works, Office Automation, outside sales, payment processing, posters, presentations, coding, publication, purchasing, quality control, Research, scheduling, scientific, SOP, supply inventory,
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