Medical Billing/Coding Resume

Desired Industry: Billing	SpiderID: 17868
Desired Job Location: Atlanta, Georgia	Date Posted: 12/21/2007
Type of Position: Part-Time Permanent	Availability Date: 12/31/2007
Desired Wage: 30,000
	U.S. Work Authorization: Yes
Job Level: New Grad/Entry Level	Willing to Travel: Yes, Less Than 25%
Highest Degree Attained: High School/Equivalent	Willing to Relocate: No

Objective:
Summary of Qualifications:

Over 10 years experience in diverse setting, including Central Business Office and Collection Agency. Comprehensive background in:

• Customer Service
• Account Receivable
• Billing (Medicare A & B,Medicaid, Commerical Insurance, Worker Compensation and Managed Care)
• Admissions and registration
• Cash posting and reconciliation
• Charge entry and charge description master
• Outpatient coding
• Problem Solving: Identify problems and communicates details to management with suggestions for solutions.
• Software experience: Mestamed,Medical Manager,Medisoft,Florida Share Systems,NEIC,Norton,Citrix,AT&T Global,IDX,SSI,Excel,MS Word, Power Point.

Experience:
Professional Experience:

10/2007-Present Healthfield-Gentiva Marietta,GA
Self-Pay Collector

Responsible for collecting on Self-pay accounts and increasing revenue for accounts less than 90 days.

• Maintained accurate file of accumulated balances 30-90 days for Durable Medical Equipment.
• Initiated consumer contact in order to obtain relevant financial and insurance information for payment on DME accounts.
• Pre-set payment arrangement of DME balances for various dollar amount.
• Prepare financial hardship form for patients that are approved.
• Prepare adjustments, requested co-pay balances to be move to insurance.
• Daily productive sheet on Excel.
• Receives and process miscellaneous correspondence from patients.

9/2005-9/2007 Complete Collection Service Fort Lauderdale, FL
Senior Medical Collector/Insurance Follow-up

• Initiated consumer contact in order to obtain relevant financial and insurance information for payment on hospital/physician claims.
• Coordinated large balance accounts with health insurance providers, attorneys, hospital record keeping staff and other third party payers for the purpose of negotiating payments while exercising FDCPA regulations.
• Pre-set payment arrangements on large dollar balances according to consumer’s ability to pay per review of credit report.
• Evaluated financials to determine purpose of forwarding accounts for legal collections.
• Billed claims to insurance companies per verification of coverage per date of service.
• Supervising medical collector
• Handled any dispute calls from the patients.
• Receives and process miscellaneous correspondence from patients, insurance companies and clients.

8/2004-6/2005 Tenet Healthcare Boca Raton, FL
Medicaid Billing Rep/Collector

• Utilized SSI, Florida Share Systems, NEIC and different collection systems to process and refill Medicaid claims, refilled Medicaid claims, electronic billing for several Florida Hospitals.
• Utilized process and refilled Medicaid claims, electronic billing for several Florida Hospitals utilized Medicaid web site to assist with claims processing, completed various spreadsheets on a day to day basis.
• Consisted, timely follow-up on all assigned accounts. Immediate appropriate resolution of all issues preventing timely reimbursement on bill claims.
• A/R follow-up during 0-90 days refilled or appealed for payment.
• Works necessary reports associated with denials. Maintains logs for refunds received by clients.
• Receives and process miscellaneous correspondence from patients, insurance companies and clients.

3/2004-8/2004 Complete Collection Service Fort Lauderdale, Fl
Medical Collector/Bad Debt

• Initiated consumer contact in order to obtain relevant financial and insurance information for payment on hospital/physician claims.
• Coordinated large balance accounts with health insurance providers, attorneys, hospital record keeping staff and other third party payers for the purpose of negotiating payments while exercising FDCPA regulations.
• Pre-set payment arrangements on large dollar balances according to consumer’s ability to pay per review of credit report.
• Evaluated financials to determine purpose of forwarding accounts for legal collections.
• Billed claims to insurance companies per verification of coverage per date of service.
• Receives and process miscellaneous correspondence from patients, insurance companies and clients.

1/2003-10/2003 Team Health Plantation, FL
Coding Specialist

• Codes routine diagnoses and treatment of hospital patients and abstracts information from patient records.
• Reviews the entire medical record of all outpatient services to assign the appropriate ICD-9 code to support medical necessity for all services performed.
• Accurately assigns HCPCS codes to include CPT-4 and modifiers in compliance with Medicare, Medicaid and Third party payer guidelines to ensure the appropriate APC assignment for emergency department.
• Abstracts and enters all required clinical and demographic data into the NEIC electronic billing system.

8/2002-1/2003 Team Health Plantation, FL
Patient Registration

• Utilized IDX and different collections systems to process and refilled medical claims to different insurance companies.
• Submits paper/electronic claims to payor according to payor specifications for all government contracts.
• Enter charge entry and charge description master
• Monitors/traces and corrects billing errors and ensures corrections are processed and correct claims are generated to ensure correct billing.
• Monitors accounts receivable for accounts for which billing is completed. Reviews older accounts and contacts payor/insurance company for status of claims.

07/1998-6/2002 Kemper National Service Plantation, FL
Billing Analyst/Bill Reviewer
• Reviews and investigates claims, matches claim data with the appropriate authorization and determines correct claims payment or denial.
• Analyzes and resolves or refers questionable claims and authorizations or system issues as appropriate.
• Completes special assignments and analyzes provider requests, review plan, eligibility, patient notes, and authorizations to determine appropriate adjudication.
• Reviews electronic claims or enters data as necessary into the claims system, resolves computer generated edit conditions and determines correct payment or denial amounts. Documents notes as appropriate.
• Researches and if necessary, processes claims payment adjustments resulting from customer service referrals, audits or data inaccuracies as detected.
• Researches and, if necessary, processes claims payment adjustments resulting from customer service referrals, audits or data inaccuracies as detected.

Education:
Education:

2000-2001 Medical Billing/Coding II & I Certification; Piper Community School, Tamarac, FL

1988-1989 Unit Secretary Certification, Atlantic Vocational Center, Coconut Creek, FL

1987-1988 Dillard High School, Fort Lauderale, FL

Professional Affiliation:

American Academy of Professional Coders (AAPC)

Affiliations:
Professional Affiliation:

American Academy of Professional Coders (AAPC)

Skills:
• Software experience: Mestamed,Medical Manager,Medisoft,Florida Share Systems,NEIC,Norton,Citrix,AT&T Global,IDX,SSI,Excel,MS Word, Power Point.

Candidate Contact Information:

Name: Cecilia Thompson
Street: -	Phone: -
City: -	Fax: -
State: Georgia
Zip: -
Web Site: