To secure a position that will enable me to utilize my strong organizational skills and experience in reviewing billing data, coding, denial trends, and obtaining authorizations.
Microsoft Office, Word, Excel
*Certified coder Eastern Kentucky University 2001
scheduling appointments, billing, data entry, documentation, verifying insurance eligibility, writing appeal letters, Microsoft Office, Word, Excel, obtaining authorizations, working insurance denials, coding, managing claims, collection of payment, familiar with commercial insurances, HMO's, Medicaid, Medicare, knowledge of medical terminology, ability to manage time effectively, knowledge of ICD-10 codes, excellent written and verbal communication skills
May 2014 to Current
Shriners Hospitals for ChildrenLexington, KYUtilization Review Coordinator/Revenue Cycle Coordinator
Responsible for prior authorizations and retrospective reviews on all inpatient/outpatient surgeries, occupational therapy, physical therapy & radiology services Work collaboratively with case managers, physicians, clinical documentation improvement specialists, claims departments and other medical staff Data entry and processing timely authorization requests to include appropriate coding Processing denial and appeal letters to insurance companies Coordination of peer to peer reviews Present surgery authorizations weekly to clinical staff.
June 2011 to May 2014
Shriners Hospitals for ChildrenLexington, KYRevenue Cycle Liaison Specialist
Responsible for prior authorizations and retrospective reviews including office visits, castings, radiology, Botox medication.
Manage and report on denials.
Designated back-up for the Utilization Management Coordinator.
September 2009 to January 2011
Scott County Family PhysiciansGeorgetown, KYInsurance & Billing Manager
Responsible for coding, billing, office charges, hospital charges, and entering payments Maintain credentialing for three Doctor's and one ARNP Maintain compliance with all state and federal regulations with HIPPA standards Manage claims with commercial insurance carriers, Medicare, and Medicaid Contact insurance companies and patient's for follow ups on denied claims Generate monthly reports reflecting activity for three physicians and one ARNP Experience in telephone triage, scheduling appointments, and taking messages Updated Medicare information for all physicians and ARNP for PECOS Responsible for the collection of unpaid patient debt and financial agreements Filed workers compensation and commercial auto claims.
July 2001 to July 2009
Central Baptist HopsitalLexington, KYOutpatient Coder
Experienced in coding: Cardiology, Vascular, Mammography, Observations, Lab, Radiology, ER, Radiation Oncology, IRA, Robotic Operations, Cyberknife, Physical Therapy, Speech Therapy, Respiratory Therapy, Obstetric Encounters, Pre-Admission Testing, Genetics Testing, EEG's, Surgeries, Fiducial placement, PET Scans and Sleep Studies Trained and evaluated new coders Responsible for compliance issues with each department of the hospital and private practices Updated delinquent charts for administration Responsible weekly for coding delayed claim reports ranging from $63,000 to $620,000.
Education and Training
Eastern Kentucky University Earned a total of 125 college credit hours- 2001