TataniaAvalon
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Medical Biller and Coder –CPC
EDUCATION
Diploma – Medical Billing and Coding 01/01/2016
Eagle Gate College, Murray, UT
SKILLS AND KNOWLEDGE
ICD-10-CM Anatomy Data Entry
CPT/HCPCS EPIC EHR Microsoft Office Suite
Medical Terminology Medical billing Customer Service
EMPLOYMENT HISTORY
UNIVERSITY MEDICAL BILLING 2016-PRESENT
MEDICAL BILLING ACCOUNT SPECIALIST
• Assigned Medicaid claims and resolve denials.
• Interpret medical records such as diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10 codes.
• Provides feedback to management regarding any new patterns of payer behaviors or repetitive insurance verification, coding, or billing errors.
• Analyze claim edits and charge review rejections for correct and compliant coding to ensure optimal reimbursement.
• Exceeded departmental production goals by reducing work queue from initial 600 claims to a daily 50 claims in approximately 30 days.
• Achieve and maintain an accuracy for claims resolution at 95% or above.
ACCOUNT RESOLUTION SPECIALIST
• Researched, crafted and submitted appeals to multiple (a wide variety of) commercial and government payers for bundling code denials.
• Audited patient registration for coordination of benefit accuracy to maintain one-time claim submission standards
• Negotiated claim reimbursements with out-of-network and third party liability insurance companies.
• Determined appropriate resolution path (not excited about the word path but couldn’t think of a better one) claims for non-insurance payers including: Indian Health Services, Crime Victims, Utah State Prison, etc.
• Created and led presentation members regarding common denials related to registration errors for a group of 30 co-workers. I was chosen to present this training based on my consistently high proficiency of claim resolution.
• Developed and implemented a streamlined process to assist team members on appealing denials, locating digitally stored records and other billing duties.
TOWER ADVERTISING-Midvale, UT 2015-2016
MEDICAL BILLING TEAM LEADER
• Held position of Team Leader for medical billing company managing account receivables for 5 DME companies located across the United States.
• Lead team by providing direction to ensure timely and accurate submission of initial claims.
• Provided direction and monitored workflows of team members regarding all claim assignments and ensuring timely follow-up of aging claims.
• Identified operational practices and coding trends creating barriers to claim payments and collaboratively worked with team to resolve them.
• Worked with management to develop and implement training on any issues identified within the team to ensure best practices were being utilized
• Provided patients with exceptional customer service
EDUCATION
Diploma – Medical Billing and Coding 01/01/2016
Eagle Gate College, Murray, UT
SKILLS AND KNOWLEDGE
ICD-10-CM Anatomy Data Entry
CPT/HCPCS EPIC EHR Microsoft Office Suite
Medical Terminology Medical billing Customer Service
EMPLOYMENT HISTORY
UNIVERSITY MEDICAL BILLING 2016-PRESENT
MEDICAL BILLING ACCOUNT SPECIALIST
• Assigned Medicaid claims and resolve denials.
• Interpret medical records such as diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10 codes.
• Provides feedback to management regarding any new patterns of payer behaviors or repetitive insurance verification, coding, or billing errors.
• Analyze claim edits and charge review rejections for correct and compliant coding to ensure optimal reimbursement.
• Exceeded departmental production goals by reducing work queue from initial 600 claims to a daily 50 claims in approximately 30 days.
• Achieve and maintain an accuracy for claims resolution at 95% or above.
ACCOUNT RESOLUTION SPECIALIST
• Researched, crafted and submitted appeals to multiple (a wide variety of) commercial and government payers for bundling code denials.
• Audited patient registration for coordination of benefit accuracy to maintain one-time claim submission standards
• Negotiated claim reimbursements with out-of-network and third party liability insurance companies.
• Determined appropriate resolution path (not excited about the word path but couldn’t think of a better one) claims for non-insurance payers including: Indian Health Services, Crime Victims, Utah State Prison, etc.
• Created and led presentation members regarding common denials related to registration errors for a group of 30 co-workers. I was chosen to present this training based on my consistently high proficiency of claim resolution.
• Developed and implemented a streamlined process to assist team members on appealing denials, locating digitally stored records and other billing duties.
TOWER ADVERTISING-Midvale, UT 2015-2016
MEDICAL BILLING TEAM LEADER
• Held position of Team Leader for medical billing company managing account receivables for 5 DME companies located across the United States.
• Lead team by providing direction to ensure timely and accurate submission of initial claims.
• Provided direction and monitored workflows of team members regarding all claim assignments and ensuring timely follow-up of aging claims.
• Identified operational practices and coding trends creating barriers to claim payments and collaboratively worked with team to resolve them.
• Worked with management to develop and implement training on any issues identified within the team to ensure best practices were being utilized
• Provided patients with exceptional customer service