Patient Accounts Representative IV Resume Example Company Name

PATIENT ACCOUNTS REPRESENTATIVE IV

Professional Summary

Experienced Patient Accounts Representative from a multi-specialty outpatient medical group looking for a position in San Diego area to start mid-June. Current position requires rotating between all different specialties including Family Medicine, Internal Medicine, Pediatrics, Endocrinology, Cardiology, Neurology, Pulmonary, Dermatology, Allergy and Immunology, Aesthetics, Urology, Orthopedics, Pain Management, Physical Therapy, Radiology, OB/GYN and Urgent Care. Accustomed to working independently and being self-motivated which requires organization, excellent communication and time management.

Skills

CPT, ICD-10, and HCPCS Coding
2021 and 1995 Evaluation and Management Guidelines
Coding Error Resolution
Patient Account Analysis
Insurance Knowledge
Interpretation of explanation of benefits
Medicare and Medicaid process
Medical Records review

Payment Posting
Organization and Time management
Adaptability
Self-motivated professional
Verbal and written communication
Customer Service
Multitasking abilities
MS Office, Epic and Intergy

Work History

October 2017-June 2021Patient Accounts Representative IV | Company Name | City, State

Verified, coded and added modifiers to CPT and ICD-10 codes.
Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Audited provider documentation for accurate coding based on 2021 and 1995 Evaluation and Management guidelines
Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
Provided education to providers of various specialties regarding documentation and coding in accordance with Compliance standards and CMS guidelines.
Communicate with providers, managers, and clinic staff as needed to identify process issues, registration errors and provide support regarding insurance and billing questions.
Act as a liaison between the business office and clinic to create a single point of contact for staff and patients.
Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
Answered questions from patients regarding billing, insurance coverage and cash pay estimates.
Resourcefully used various coding books, procedure manuals and on-line encoders.
Accurately selected proper descriptive code when more than one anatomical location was indicated.

July 2014-December 2015Lead Referral Coordinator | Company Name | City, State

Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
Weighed patient need, provider availability and insurance coverage to determine optimal scheduling.
Called insurance companies to get precertification and other benefits information on behalf of patients.
Coordinated program referrals for community-based resources.
Entered orders into EMR without errors based on treatment schedule monitored by RN and physician.
Offered friendly and efficient service to all customers, handled challenging situations with ease.
Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Interacted effectively with patients, families, staff and other hospital department staff to deliver high level of customer service and teamwork.

December 2011-November 2013Admitting Clerk/Referral Coordinator | Company Name | City, State

Received patient deductibles, co-pay amounts and private cash payments and discussed options to satisfy remainder of patient financial obligations.
Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
Resolved patient financial problems with guidance from documented guidelines and procedures.
Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
Balanced deposits and credit card payments each day.
Assisted patients in filling out check-in and payment paperwork.
Scheduled appointments with specialists on behalf of clients.
Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.

Education

September 2016Associate of Science: Healthcare AdministrationAshworth College, City, State

Certifications

AAPC ID: 01649531

CPC - Certified Professional Coder
CPB - Certified Professional Biller

Resume Overview

School Attended

Ashworth College

Job Titles Held:

Patient Accounts Representative IV
Lead Referral Coordinator
Admitting Clerk/Referral Coordinator

Degrees

Associate of Science : Healthcare Administration

Patient Accounts Representative IV Resume Example

Resume Score: 80%

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