Medical billing and coding specialist with 18 years providing administrative and patient support in medical office settings. Advanced knowledge of private insurance processes and codes. Desires a role in a medical office environment.
ICD-10 (International Classification of Disease Systems)
Outpatient surgery coding specialist
Patient chart auditing ability
Office management professional
Excellent problem solver
Resourceful and reliable worker
Close attention to detail
Billing and collection procedures expert
Familiar with commercial and private insurance carriers
Behavioral health billing and collections
Insurance and collections procedures
Understands insurance benefits
Excellent verbal communication
Office support (phones, faxing, filing)
Remote HCC Coder, 02/2016 to 08/2016 Inovalon, Inc – Bowie, MD Reviews, analyzes and codes diagnostic information in a patient's medical record based on client specific guidelines for the project. Ensures compliance with established ICD9/10 CM, DRGs coding guidelines, third party reimbursement policies, regulation and accreditation guidelines.
Team Leader/ Trainer, 04/2007 to 02/2016 Connections: Health*Wellness*Advocacy – Beachwood, OH
Responsible for leading and planning billing operations for a 5 person department. Responsible for designing and implementing and enforcing policies and procedures, as well as streamlining effective billing process. I have the ability to prioritize , plan and direct the department. Responsible for updating and billing client premium statements. Provide customer service with clients and carrier representatives. Analyze enrollments to determine proper eligibility according to the clients' eligibility rules. Balance monthly billing statements for existing clients after changes are entered into billing system and make adjustments as necessary to the statements. Ensures performance guarantees specific to the client are met daily. Upload and submit claims to insurance carriers. Submit claims to MITS, MACSIS, MyCare products. Very familiar with 837s and 835 and Rollup process.
Medical Coder/Biller, 04/2003 to 04/2007 Medical Resources, Inc – Austintown, OH Coded 50 Radiology charts per day. Maintained a 95% accuracy rate. Verified patients' eligibility nd claim stated with insurance companies. Maintained strict patient and physician confidentiality. Actively maintained current working knowledge of CPT and ICD-9 coding principals, government regulation, protocols and third party requirements regarding billing. Submitted electronic/paper claims for timely filing.
CPC- Certified Professional Coder: Coding, 2006 Bryant and Stratton - Cleveland, Ohio
Certified Coding Specialist- CCS: Inpatient Coding, 2016 Code Masters - San Diego, CA