# CPC-A Seeking an Unique Opportunity in Florida......



## Coder_Rick (Jan 23, 2011)

Objective: 

Motivated Medical Insurance Coding and Billing Specialist, seeking a rewarding, challenging opportunity to utilize my knowledge and application of billing, coding, and collections in a team oriented environment.

Education: 
Jan 2009 - Sept 2009 Concorde Career Institute. Miramar, FL 
Insurance Coding and Billing Specialist - Diploma 
Dec 2005 - Apr 2006 Pro-Dive Academy. Ft. Lauderdale, FL 
Master Scuba Diver Instructor - Certificate 

Skills: 
* Knowledge and use of Misys Tiger PM, Athena, and Medical Manager software. 
* Knowledge and use of HIPAA compliance standards. 
* Collection calls to patients and third party payers in an effort to resolve unpaid A/R balances. 
* Able to initiate the claims process and follow it through to the A/R resolution. 
* General knowledge of Medicare, Medicaid, HMO, PPO, and W/C third party guidelines for reimbursement. 
* Ability to code from source documents, i.e. Operative reports, History reports, Radiology reports, 
   Pathology and Lab reports: utilizing CPT, HCPCS and ICD-9CM coding guidelines and methodology. 
* Able to review, interpret and process EOB's by posting charges, payments and adjustments to patient accounts. 
* Familiar with hospital reimbursement schemes i.e. DRG, APC's and Medicare's OPPS systems.

Employment: 
February 2010 – November 2010 Orthopaedics Associates USA, Oakland Park, FL 
Certified Coding and Billing Specialist. 
* Coding from reports in accordance with CMS, billing charge tickets using computer management 
software, creating claims for transmission to payers. 
* Communicating with payers regarding denied / rejected claims, correction of required pertinent patient information and CPT/ICD 9 codes, resubmitting corrected claims for reimbursement. 
* Collecting, transferring and posting payments into patient accounts. 
* Working with assigned physicians, communicating with them on potential claims submission problems, and 
trends. Educating on proper code sequencing, modifier usage and ensuring complete documentation.

July 2009 - Sept 2009 Compass Health Systems. North Miami, FL 
Insurance Coding and Billing Specialist Externship. 
* Updated patient's insurance and account information. 
* Performed patient eligibility verification of Medicare, Medicaid, and Managed Care Accounts. 
* Communications with payers regarding denied / rejected claims, correcting required codes, resubmission of  corrected claims resulting in reimbursement. 

Sept 2007 - Jan 2009 Ocean Divers Inc. Key Largo, FL 
Sales Associate / Instructor. 
* Instructed Scuba , Specialty, and CPR /BLS courses. 
* Performed consultations, and booked group and individual dive charter reservations. 
* Management of daily operations at north location facility. 
* Certified regulator and repair technician. 
* Sales of scuba equipment and supplies. 
* Lead dive expeditions for pleasure or research. 

Aug 2006 – Sept 2007 Atlantis Dive Center. Key Largo, FL 
Operations Manager / Instructor. 
* Scheduled employee shifts, completion of company payrolls. 
* Overseeing daily business operations, including boat and compressor maintenance. 
* Equipment sales and air fills. 
* Resolved customer complaint issues. 
* Worked with vendors, Coast Guard and Law Enforcement officials when requested.


Certifications: 
* AAPC Certified Professional Coder A # 01120830 
* CPR/BLS certified. PADI #199700 
* Certified Master Scuba Diver Trainer. PADI/# 199700 

References available upon request.


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## vicki schweitzer (Jun 22, 2011)

I am looking for a consultant to hire on an hourly basis, either someone doing consulting now or while the person is looking for full time work.  I need some specific scenarios researched and it would help if the person had ED room experience as well as the CPC.  If that is you please contact me at "vicki.schweitzer@examworks.com"
Thanks!


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