AllisonMorani
Contributor
OBJECTIVE
Highly motivated EXPERIENCED Certified Professional Coder - seeking a challenging position in the health care industry where I can apply my knowledge and skills to the growth of the company.
QUALIFICATIONS
Highly Knowledgeable in ICD-9, CPT & HCPCSS Level II. 1995 & 1997 CMS guidelines, Medicare NHIC, Medicaid and commercial third party insurance carriers. Proficient in Microsoft Office 2003, 2007 & 2010 (Outlook, Word, Excel, PowerPoint & Access). Trained in client services; Outstanding analytical, and interpersonal, written, and verbal communication skills. Honest, Hard working team member/leader. Can work effectively with people of all levels. Used various software: MedFx PM, LMR Electronic Medical Records, Epic, 3M, and Encoder Pro.
WORK EXPERIENCE
Advanced Pain Management/Northeast Ambulatory Center, Stoneham, MA 4/2011-Present
MEDICAL BILLING/PRACTICE MANAGER: Supervise and managed the billing team. Interview prospective employees Implement new strategies to increase work flow within the medical office. Trained new and existing employees on new policies and procedures pertaining to the compliance of billing, payment entry and new patients. Create new encounter forms and update with new ICD-9 and CPT when needed or on a yearly basis. Knowledge of CAQH database for physician Credentialing. Charge entry, insurance and patient payment posting in practice management (PM) software. Speak to patients regarding inquiries and resolve issues to patient's satisfaction. Check for claim denial trends and make corrections. Educate myself and staff on the ever changing policies and procedures using the CMS website and other commercial insurance company portals. Check Clearing house for rejected claims, correct all errors and resubmit. Appeal all rejected claims, send letter of medical necessity as needed. Research and Follow up on un-paid claims. Send Precertification to insurance companies for approval of procedures. Create daily deposit and reports for medical director. DME, ASC & Anesthesia, interventional/surgical pain management coding as well as E/M coding & billing. Educate physicians on proper documentation for each evaluation and management code. I act as the compliance officer for the practice with this title the responsibility is to make sure that the practice remains compliant with all billing of codes and record documentation due to a contract with Office of the Inspector General (OIG). I compile a yearly chart review for an outside auditor each year and prepare a written report yearly for OIG regarding audit results. The practice is correctly coding and billing. The past 2 years we have been found to have an error rate of < 5%, which is OIG's requirement. Physician also had a cosmetic practice (Center for Laser and Cosmetics). I did laser hair removal, microdermabrasion, chemical peels, and assisted the physician with botox and juvederm patients.
Belmont Medical Associates, Cambridge, MA 9/09-4/2011
MEDICAL BILLING SPECIALIST: Experienced in Surgical, E/M, Laboratory, In-patient hospital & Technical Coding Medical billing/coding for a 21 physician multi-specialty group practice to include Internal Medicine, Ophthalmology, Dermatology, Neurology, Gynecology, & Endocrinology. Increased revenue for practice by correcting the coding and the billing of procedures and modifiers. Responsibilities include payment posting, accounts receivable management, patient collections, appeal processes to include letters of medical necessity, correct credit & debits, check patient's eligibility. Submit primary and secondary claims electronically and/or manually. Check Clearing house for rejected claims, correct all errors and resubmit. Research and Follow up on un-paid claims. Speak to patients inquiring about their accounts and resolve issues. Communicate effectively with Insurance companies. Special projects as assigned by Business Manager & direct supervisor. Create encounter forms for physicians and other word documents for practice as needed.
General Chemical Corporation, Framingham, MA 08/04-5/08
SALES ADMINISTRATIVE ASSISTANT: Administrative support for sales and management team. Researched internet for projects & Obtain RFP documents from public solicitations. Prepared professional proposals for state and federal projects. Compile & Prepare bid packages. Created and updated quote & bid reporting spreadsheet. Created & Maintained ACT database. Office supply inventory and purchasing. Maintained postage and fax machine & direct Contact for office equipment vendors. Create company marketing mailers. Process professional Documents, letters & memos. Opened, date stamped and distributed incoming mail. Created and maintained on line fed-ex account. Maintain employee phone list. Updates master “On Call” Document for 24-hour answering service. Waste receiving paperwork & Invoicing. Assisted with billing. Resolved customer service issues and complaints. Specialized in caring for each clients direct needs specified for there company.
EDUCATION
Salter School, Malden, MA 2008--2009
Health Claims Specialist Certification
Concentration -Medical Billing and Coding)
American Academy of Professional coders – (AAPC)
Certified Professional Coder (CPC) credentialed through the AAPC. 2012
Highly motivated EXPERIENCED Certified Professional Coder - seeking a challenging position in the health care industry where I can apply my knowledge and skills to the growth of the company.
QUALIFICATIONS
Highly Knowledgeable in ICD-9, CPT & HCPCSS Level II. 1995 & 1997 CMS guidelines, Medicare NHIC, Medicaid and commercial third party insurance carriers. Proficient in Microsoft Office 2003, 2007 & 2010 (Outlook, Word, Excel, PowerPoint & Access). Trained in client services; Outstanding analytical, and interpersonal, written, and verbal communication skills. Honest, Hard working team member/leader. Can work effectively with people of all levels. Used various software: MedFx PM, LMR Electronic Medical Records, Epic, 3M, and Encoder Pro.
WORK EXPERIENCE
Advanced Pain Management/Northeast Ambulatory Center, Stoneham, MA 4/2011-Present
MEDICAL BILLING/PRACTICE MANAGER: Supervise and managed the billing team. Interview prospective employees Implement new strategies to increase work flow within the medical office. Trained new and existing employees on new policies and procedures pertaining to the compliance of billing, payment entry and new patients. Create new encounter forms and update with new ICD-9 and CPT when needed or on a yearly basis. Knowledge of CAQH database for physician Credentialing. Charge entry, insurance and patient payment posting in practice management (PM) software. Speak to patients regarding inquiries and resolve issues to patient's satisfaction. Check for claim denial trends and make corrections. Educate myself and staff on the ever changing policies and procedures using the CMS website and other commercial insurance company portals. Check Clearing house for rejected claims, correct all errors and resubmit. Appeal all rejected claims, send letter of medical necessity as needed. Research and Follow up on un-paid claims. Send Precertification to insurance companies for approval of procedures. Create daily deposit and reports for medical director. DME, ASC & Anesthesia, interventional/surgical pain management coding as well as E/M coding & billing. Educate physicians on proper documentation for each evaluation and management code. I act as the compliance officer for the practice with this title the responsibility is to make sure that the practice remains compliant with all billing of codes and record documentation due to a contract with Office of the Inspector General (OIG). I compile a yearly chart review for an outside auditor each year and prepare a written report yearly for OIG regarding audit results. The practice is correctly coding and billing. The past 2 years we have been found to have an error rate of < 5%, which is OIG's requirement. Physician also had a cosmetic practice (Center for Laser and Cosmetics). I did laser hair removal, microdermabrasion, chemical peels, and assisted the physician with botox and juvederm patients.
Belmont Medical Associates, Cambridge, MA 9/09-4/2011
MEDICAL BILLING SPECIALIST: Experienced in Surgical, E/M, Laboratory, In-patient hospital & Technical Coding Medical billing/coding for a 21 physician multi-specialty group practice to include Internal Medicine, Ophthalmology, Dermatology, Neurology, Gynecology, & Endocrinology. Increased revenue for practice by correcting the coding and the billing of procedures and modifiers. Responsibilities include payment posting, accounts receivable management, patient collections, appeal processes to include letters of medical necessity, correct credit & debits, check patient's eligibility. Submit primary and secondary claims electronically and/or manually. Check Clearing house for rejected claims, correct all errors and resubmit. Research and Follow up on un-paid claims. Speak to patients inquiring about their accounts and resolve issues. Communicate effectively with Insurance companies. Special projects as assigned by Business Manager & direct supervisor. Create encounter forms for physicians and other word documents for practice as needed.
General Chemical Corporation, Framingham, MA 08/04-5/08
SALES ADMINISTRATIVE ASSISTANT: Administrative support for sales and management team. Researched internet for projects & Obtain RFP documents from public solicitations. Prepared professional proposals for state and federal projects. Compile & Prepare bid packages. Created and updated quote & bid reporting spreadsheet. Created & Maintained ACT database. Office supply inventory and purchasing. Maintained postage and fax machine & direct Contact for office equipment vendors. Create company marketing mailers. Process professional Documents, letters & memos. Opened, date stamped and distributed incoming mail. Created and maintained on line fed-ex account. Maintain employee phone list. Updates master “On Call” Document for 24-hour answering service. Waste receiving paperwork & Invoicing. Assisted with billing. Resolved customer service issues and complaints. Specialized in caring for each clients direct needs specified for there company.
EDUCATION
Salter School, Malden, MA 2008--2009
Health Claims Specialist Certification
Concentration -Medical Billing and Coding)
American Academy of Professional coders – (AAPC)
Certified Professional Coder (CPC) credentialed through the AAPC. 2012