MSCALLIE79
Networker
I am currently looking for a beginning remote coding position I am located in the Charlotte, NC Area.
Organized and detailed-oriented medical professional with more than 13-years? experience in all aspects of the medical revenue cycle and keen ability to analyze, evaluate and interpret information while making sound judgments based on data obtained. Seeking to continue stellar career with a progressive healthcare organization.
Computer program proficiencies include: Microsoft Office 2010, NextGen EPM and EHR, Care tracker, Insight, Navicure, Encoder Pro and Enterprise Registration.
Strongly understands medical revenue cycle, including precertification, registration and insurance follow up on claim processing and cash receipts processing of patients accounts (insurance/self-payments).
Able to determine proper codes/modifiers for all billable services utilizing CPT-4 and ICD-9 coding publications.
Effectively applies ICD9CM, ICD-10 CM, CPT4 and HCPCS coding guidelines to surgical and outpatient diagnoses and procedures.
KEY MEDICAL QUALIFICATIONS
Anatomy & Physiology ~ Government Payers ~ Medicare & Medicaid ~ TRICARE ~ Elec. Medical Records
Third-Party Payers ~ Worker?s Compensation ~ Managed Care (HMO, PPO, and POS) ~ Office Management
Typing/Filing Documents ~ Co-Payments and Deductibles ~ Scheduling Appointments ~ Answering Phones
ICD-9-CM, HCPCS, CPT ~ Introduction to ICD-10-CM ~ Medical Terminology ~ HIPAA ~ UB-04
Insurance Claim Processing ~ EOB ~ Insurance Billing Procedures ~ Data Entry
MEDICAL WORK HISTORY
Horizon Eye Care ? Charlotte, NC
Patient Account Specialist 12/2012 ? Present
Implement new-hire training on various medical heath systems/health records, handle patient complaints about fees/billing and promote disposition of complaints and ensure billing and collection activities adhere to Medicare, Medicaid and other insurance regulations, rules, and laws.
Monitor vision plan accounts receivable and solve corresponding issues to exceed goals and timeliness.
Horizon Eye Care ? Charlotte, NC
Patient Service Representative (Float) 7/2011 ? 11/2012
Completed numerous administrative duties, including: Patient check-in/out, updating patient data base, accepting/post co-payments, deductibles, co-insurances and payments to patient accounts, scheduling patient appointments and accurately/timely post insurance and self-payments to patient accounts.
Manage various miscellaneous revenue and A.R reports in company CBO office, verify insurance coverage and get in network and out-of-network benefits.
ProMedica Health System ? Toledo, OH
Billing Specialist 2/2009 ? 5/2011
Processed all electronic billing claims by using UB92 and 1500, provided extensive follow-up with external clients to research accounts/ensure proper claim processing and revamped entire billing process to streamline quality control.
Partnered with external clients to identify timely solutions for outstanding accounts.
Maintained monthly and weekly reports to track/ensure corporate quality standards and trained new employees on all daily responsibilities/procedures.
ProMedica Health System ? Toledo, OH
Cash Receipts Processor 3/2005 ? 2/2009
ProMedica Health System ? Toledo, OH
Pre-Registrations Specialist 9/2003 ? 3/2005
Medical Records Reviewer 6/2001 ? 9/2003
EDUCATION OVERVIEW
Ultimate Medical Academy ? Tampa, FL
Associate in Science Degree - Medical Billing & Coding (GPA: 3.52) 12/2013
Pursuing National CPC-A certification
Certifications include: CMS 1500; Medicare Fraud and Abuse Prevention, Detection and Reporting; Uniform Billing (UB)-4.
Davis College ? Toledo, OH
Associate Degree in Business - Accounting & Human Resource Management (GPA: 3.2) 5/2010
Organized and detailed-oriented medical professional with more than 13-years? experience in all aspects of the medical revenue cycle and keen ability to analyze, evaluate and interpret information while making sound judgments based on data obtained. Seeking to continue stellar career with a progressive healthcare organization.
Computer program proficiencies include: Microsoft Office 2010, NextGen EPM and EHR, Care tracker, Insight, Navicure, Encoder Pro and Enterprise Registration.
Strongly understands medical revenue cycle, including precertification, registration and insurance follow up on claim processing and cash receipts processing of patients accounts (insurance/self-payments).
Able to determine proper codes/modifiers for all billable services utilizing CPT-4 and ICD-9 coding publications.
Effectively applies ICD9CM, ICD-10 CM, CPT4 and HCPCS coding guidelines to surgical and outpatient diagnoses and procedures.
KEY MEDICAL QUALIFICATIONS
Anatomy & Physiology ~ Government Payers ~ Medicare & Medicaid ~ TRICARE ~ Elec. Medical Records
Third-Party Payers ~ Worker?s Compensation ~ Managed Care (HMO, PPO, and POS) ~ Office Management
Typing/Filing Documents ~ Co-Payments and Deductibles ~ Scheduling Appointments ~ Answering Phones
ICD-9-CM, HCPCS, CPT ~ Introduction to ICD-10-CM ~ Medical Terminology ~ HIPAA ~ UB-04
Insurance Claim Processing ~ EOB ~ Insurance Billing Procedures ~ Data Entry
MEDICAL WORK HISTORY
Horizon Eye Care ? Charlotte, NC
Patient Account Specialist 12/2012 ? Present
Implement new-hire training on various medical heath systems/health records, handle patient complaints about fees/billing and promote disposition of complaints and ensure billing and collection activities adhere to Medicare, Medicaid and other insurance regulations, rules, and laws.
Monitor vision plan accounts receivable and solve corresponding issues to exceed goals and timeliness.
Horizon Eye Care ? Charlotte, NC
Patient Service Representative (Float) 7/2011 ? 11/2012
Completed numerous administrative duties, including: Patient check-in/out, updating patient data base, accepting/post co-payments, deductibles, co-insurances and payments to patient accounts, scheduling patient appointments and accurately/timely post insurance and self-payments to patient accounts.
Manage various miscellaneous revenue and A.R reports in company CBO office, verify insurance coverage and get in network and out-of-network benefits.
ProMedica Health System ? Toledo, OH
Billing Specialist 2/2009 ? 5/2011
Processed all electronic billing claims by using UB92 and 1500, provided extensive follow-up with external clients to research accounts/ensure proper claim processing and revamped entire billing process to streamline quality control.
Partnered with external clients to identify timely solutions for outstanding accounts.
Maintained monthly and weekly reports to track/ensure corporate quality standards and trained new employees on all daily responsibilities/procedures.
ProMedica Health System ? Toledo, OH
Cash Receipts Processor 3/2005 ? 2/2009
ProMedica Health System ? Toledo, OH
Pre-Registrations Specialist 9/2003 ? 3/2005
Medical Records Reviewer 6/2001 ? 9/2003
EDUCATION OVERVIEW
Ultimate Medical Academy ? Tampa, FL
Associate in Science Degree - Medical Billing & Coding (GPA: 3.52) 12/2013
Pursuing National CPC-A certification
Certifications include: CMS 1500; Medicare Fraud and Abuse Prevention, Detection and Reporting; Uniform Billing (UB)-4.
Davis College ? Toledo, OH
Associate Degree in Business - Accounting & Human Resource Management (GPA: 3.2) 5/2010