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Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary

Experienced Patient Accounts Representative from a multi-specialty outpatient medical group. Previous position required 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
Patient Accounts Representative IV, 10/2017 to 06/2021
Amita HealthBuda, TX,
  • 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.
Lead Referral Coordinator, 07/2014 to 12/2015
Swedish Medical CenterCity, 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.
Admitting Clerk/Referral Coordinator, 12/2011 to 11/2013
Hoag Memorial Hospital Presbyterian/Medical GroupCity, 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
Associate of Science: Healthcare Administration, Expected in 09/2016
Ashworth College - Norcross, GA
GPA:
Certifications

AAPC ID: 01649531

  • CPC - Certified Professional Coder
  • CPB - Certified Professional Biller

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Resume Overview

School Attended

  • Ashworth College

Job Titles Held:

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

Degrees

  • Associate of Science

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