Accurate Medical Coding and Billing Specialist with the ability to perform all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Offering 25+ years of experience in working in the healthcare industry to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials. My goal is to obtain a permanent position within a company that offers advancement and incentives for meeting or exceeding the job expectations.
Skills
Basic office skills
Medical Billing
CPT coding
Data entry
Medical terminology
Healthcare claim coding
Documentation oversight
Insurance billing
Medical recordkeeping
Insurance Verification
Database management
Billing procedures
Multitasking
Clerical
Experience
09/2015 to Current
Surgical CoordinatorBeth Israel Deaconess Medical Center – Medford, MA,
Checked patient insurance and collected pre-authorizations from providers.
Contact patient about their financial responsibilities regarding scheduled procedures.
Work closely with lead nurses and surgery center employees regarding patient information, insurance requirements and ICD-10 and CPT coding edits.
Schedule post-operative appointments with referring physicians and generate surgery charge cards and consent forms.
Answered daily phone calls to schedule appointments and address patient inquiries and insurance company inquiries or updates.
03/2013 to 05/2015
Human Resources DirectorColumbus Hospitality – Scottsdale, AZ,
Basic human resource duties of hiring, dismissal, discipline, training, etc…
Maintaining training files on all employees and cross tracking with state and federal agency requirements,
Non-profit organization and maintaining budget guidelines high priority.
Worked with department managers to assess needs.
Conducted exit interviews and recorded employee feedback for use in retention strategy development.
Notified all employees immediately when policies/procedures were updated or changed.
Handled employee conflicts efficiently while following all company procedures.
10/2012 to 03/2013
Coding/Medical Billing SpecialistMain Street Family Practice – City, STATE,
Credentialing for nurse practitioner and oversight physician with most major insurance companies.
Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Reviewed account information to confirm patient and insurance information is accurate and complete.
Post electronic and manual EFTs and EOBs.
Worked monthly aging report and any denials from insurance companies.
03/2005 to 11/2012
Office Manager/Billing Specialist/Certified CoderTri City Radiology – City, STATE,
Managed daily operations within radiology office by supporting continuous delivery of excellent services and care.
Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
Responsible for all workers compensation claims.
Schedule, set up training, overview of timesheets, etc..
Handle patient billing questions or issues.
Review all collections, data entry, charge entry, billing payments etc….
Generated financial reports for management review.
Managed office budget to handle all needs, including inventory, postage and vendor services.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
Prepared billing statements for patients, ensuring correct diagnostic coding.
Maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third-party billing requirements.
Posted charges, payments and adjustments.
Completed appeals and filed and submitted claims.
Submitted refund requests for claims paid in error.
Education and Training
Expected in 2008
Certified Professional Coder: American Academy Of Professional Coders - , GPA:
Willing to become a certified medical coder again if needed for job requirement
Expected in 1988
Honors Diploma: Cherokee High School - Rogersville, TN GPA:
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