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INTERN
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Experience
Intern07/2017 to 09/2017AscentialLos Angeles , CA
- The meticulous, eager and dedicated individual who brings the understanding of the healthcare revenue cycle, knowledge of reimbursement methodologies, verification of payments and action to processing transactions on customer accounts expect to serve Providence Strategic and Management Services in the capacity of Biller- Physician Billing to perform billing and clerical functions in support of Revenue Cycle.
- Objectives: Biller- Physician Billing Working in the different departments of UMG for understanding and supporting Healthcare Revenue Cycle.
- Front End Processing:.
- Claim runs, reports, Charge Entry, VA Reports and VA choice.
- Bill for professional medical services on 1500 claim forms via paper or direct data entry.
- Prepare billing documents for mailing.
- Return mail.
- Convert paper EOBs to ANSI 835 for posting to billing system by MediStreams.
- Using OneHealth Port, AENTA, MMIS, Noridian, TriZetto, TriWest to verify patients' eligibility.
- Receive, sort and distribute multiple types of source documents.
- Copy, scan, image documents, put it on OnBase if is needed.
- Cash and Credit Resolution:.
- Charge change, insurance credit workflow, steps performed to resolve insurance credits including the refund slip creation.
- Electronic and Manual posting.
- Adjust non-collectible charges.
- Take appropriate action to resolve credit balances - including distributing funds, transferring funds, voiding/reversing transactions, preparing refund checks, and requesting recoupments.
- Follow Up:.
- Process transactions on insurance accounts; ensure the account is set up correctly, problem resolution, appeals and audit transaction activity.
- Communicate professionally with third-party customers including insurance companies to ensure timely and accurate processing of account transactions.
- Review third party claims (i.e.
- MVA settlements, Workers Compensation, Out-Of-State Medicaid, DMAP/CAWEM, Medicare and Commercial claims).
- Trending provider activity and the denials that may arise (i.e., No authorization, Referral shell, Duplicate and Bundled denials.
- During internship completed courses: HIPAA; Modifiers; Fraud Awareness; Integrity Foundations; EpicCare Fundamentals; Respect at the University; POS Payment Posting Training; Resolute Follow-up Workqueues (UMG Staff).
- Performed "Work From Home" project by creating folders for workers who are ready work from home and performed spreadsheets as was assigned.
10/2015Bickford Senior LivingWabash , IN
- Spent time with patients.
- Supervised the activities LIM Warehouse store (Grocery) |Rostov-on-Don Russia.
Supervisor02/1998 to 08/2011
- Maintains inventory and supplies by receiving, storing, and delivering items; securing warehouse; supervising staff.
- Kindergarten "Svetlyachok" #272 |Rostov-on-Don Russia.
Teacher06/1988 to 01/1998
- Design and follow a complete teaching plan.
- Teach alphabet and numeracy along with personal, social and emotional skills.
- Organize learning material and resources.
Languages
Fluent in English and Russian
Education and Training
Certificate Medical Office Specialist - Medical Billing/Claim Analyst. Total 74 credits (September 2017Mt. Hood Community CollegeCity, State
)
Completed Coursework: Medical Terminology; Anatomy & Physiology; Medical Coding: Diagnostic, ICD-10; CPT: Procedural, Evaluation and Management; HCPCS.
Applied Medical Billing and Coding. (Practice filing CMS-1500 and UB04 claim forms, EOB forms, calculating RBRVS; Identify diagnoses/procedures.)
Member of the American Academy of Professional Coders(AAPC); Certified Professional Coder - Apprentice: CPC-A (March 2017
)
AAPC Boot Camp (March 2017
); AAPC Local Chapters Certificates of Attendance.
Bachelor's Degree1994Don Pedagogical CollegeCity, Russia
1985Rostov-on-Don High School
Skills
10-key by touch, Analyst, Anatomy, Attention to detail, Billing, billing system, clerical, CMS, communication skills, CPT, Credit, Critical Thinking, data entry, Fluent in English, filing, forms, funds, ICD-10, image, insurance, Maintains inventory, keyboard, Listening, mailing, Medical Billing, Medical Coding, Medical Terminology, Excel, mail, Microsoft Office Suite, Office, PowerPoint, Word, works, Organizational, Physiology, POS, problem resolution, problem-solving, Coding, receiving, Russian, settlements, shell, spreadsheets, Strategic and Management, supervising, teaching, websites, workflow
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Resume Overview
School Attended
- Mt. Hood Community College
- Don Pedagogical College
- Rostov-on-Don High School
Job Titles Held:
- Intern
- Supervisor
- Teacher
Degrees
- Certificate Medical Office Specialist - Medical Billing/Claim Analyst. Total 74 credits ( September 2017
) Completed Coursework: Medical Terminology; Anatomy & Physiology; Medical Coding: Diagnostic, ICD-10; CPT: Procedural, Evaluation and Management; HCPCS. Applied Medical Billing and Coding. (Practice filing CMS-1500 and UB04 claim forms, EOB forms, calculating RBRVS; Identify diagnoses/procedures.) Member of the American Academy of Professional Coders(AAPC); Certified Professional Coder - Apprentice: CPC-A ( March 2017
) AAPC Boot Camp ( March 2017
); AAPC Local Chapters Certificates of Attendance.
Bachelor's Degree 1994
1985
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