mcastro123
New
Michelle Castro
mcastro2216@gmail.com
CERTIFIED PROFESSIONAL CODER/BILLING MANAGER
OBJECTIVE
Seeking a position in which I can utilize my highly skilled, knowledgeable, and proficient medical billing experience. This experience includes extensive, specialized knowledge in management, medical coding, collections, patient accounts, and customer care capacities throughout inpatient/outpatient and independent medical billing environments. I am a highly articulate and effective communicator with demonstrated ability to build new relationships and drive momentum among peers and colleagues.
SKILLS
Medical Coding CPT/ICD9/HCPCS/ICD-10 EDI Transmitting Insurance Verification/Eligibility Authorizations/Pre-certs
A/R Collections/Appeals Pt Letters/Grievances
Payment Posting Monthly Close-outs Customized Reporting HR duties (Payroll, hiring, etc)
Familiar w/ Billing Rules/Regulations in multiple states including but not limited to TX, NY, CA, FL
EMPLOYMENT HISTORY
Surgical Notes, Certified Coder, Remote 12/15-Present
Remote ASC Coder, currently coding for multiple ASCs in different states for a variety of centers who facilitate services to all specialties that include but are not limited to General Surgery, ENT, OBGYN, Pain, etc. Must maintain accuracy, consistency, and timeliness with all cases presented.
Exact Billing Solutions, Billing Manager, Houston, TX 2005-12/2015
Duties have shifted throughout the years, currently the lead coder for the following specialties: Family Medicine, Internal Medicine, General Surgery, Bariatric Surgery, Gastroenterology, Gynecology, Pediatric Infectious Disease, Neurology and Neonatology.
NueMD, Billing/Collections/Posting, Remote 2014-Present
Duties for this position include posting payments and collections for multiple specialties. Previous duty included Pain Management coding.
The Pain Care Center, Houston, TX 2004 – 2005
Ran the back office, duties included: prior-auths for outpatient procedures, surgery scheduling, MA work, and patient counseling.
Bear Creek Wellness Center, Houston, TX 2002 – 2004
Front office coordinator: Responsible for scheduling, pt check-in, collecting copays, insurance verification and referrals.
Oscar De Valle, MD, Houston, TX 1999 - 2002
Back office coordinator: Triaged patients, completed prescription refill requests, helped with procedures, administered injections, phlebotomy, and scheduled procedures.
COMPUTER SKILLS
Microsoft Office LeonardoMD (web-based)
Medisoft NueMD (web-based)
Medical Manager E-Clinical Medicare ERA software Clearinghouses (Availity/Ingenix/Optum/Navicure) Quickbooks typing 50 wpm 10 key by touch Encoder Pro
PROFESSIONAL EXPERIENCE
CODING
Responsible for CPT/ICD-9/HCPCS/ICD-10 coding for multiple specialties including but not limited to internal medicine, general surgery, emergency room, pain management, infectious disease, gastroenterology, colon/rectal, otolaryngology, obstetrics/gynecology and neonatology.
• Primary coder for over 5 accounts at a time for various specialties; both inpatient and outpatient
• Oversee other coders by performing audits and system checks to ensure accuracy
• Keep up to date with current changes and updates regarding codes/bundling
A/R COLLECTIONS/APPEALS
Use online/phone resources to ensure that all claims going out are not only paid in a timely manner, but also that they have been paid at the correct reimbursement rate allowed by contract.
• Extensive experience and understanding of Medicaid and its Commercial plans
• Extensive experience and understanding of Medicare and its Supplement and HMO plans
• Familiar with Texas State Laws that can be used to ensure timely payments for commercial payers
• Work A/R in its entirety monthly with no exception (to avoid PTF issues)
• Experience in helping guide the patients and to help them understand what their rights are recommendations to secure payment from their insurance carrier
H/R DUTIES
Responsible for keeping track of all employees and their daily activities
• Semi-monthly payroll which includes counting up hours, recording time-off, and accessing Quickbooks
• Daily/weekly audits on individual employees and the completion of their daily tasks
• Interviewing/Hiring/Terminating of employees when necessary
• Creation/updating of policy/procedures such as Handbooks as necessary
MONTHLY CLOSE-OUTS
Generate all reports and correspondence that is required to reconcile at month end
• Balance the month end deposit report from the practice management system to the lockbox total
• Run monthly reports to keep track of vital information such as total billed, collected, and outstanding
• Run clean A/Rs for the next months collection work
• Keep track of payer mix reports, procedure analysis, and other customized reporting necessary to project future revenue
EDUCATION
NHMCCD, Associate of Arts – Field of Study, Business, Houston, TX 2007
Jersey Village High School, Houston, TX 2000
Bilingual – Speak, Read, and Write Spanish
CERTIFICATIONS
Certified Outpatient Coder, AAPC awaiting testing
ICD-10 Profecient, AAPC 2015
Certified Professional Coder, AAPC 2011
Certified Medical Coder, PMI (Practice Management Institute) 2010
Dale Carnegie Course: Effective Communications & Human Relations/Skills For Success 2009
REFERENCES UPON REQUEST
mcastro2216@gmail.com
CERTIFIED PROFESSIONAL CODER/BILLING MANAGER
OBJECTIVE
Seeking a position in which I can utilize my highly skilled, knowledgeable, and proficient medical billing experience. This experience includes extensive, specialized knowledge in management, medical coding, collections, patient accounts, and customer care capacities throughout inpatient/outpatient and independent medical billing environments. I am a highly articulate and effective communicator with demonstrated ability to build new relationships and drive momentum among peers and colleagues.
SKILLS
Medical Coding CPT/ICD9/HCPCS/ICD-10 EDI Transmitting Insurance Verification/Eligibility Authorizations/Pre-certs
A/R Collections/Appeals Pt Letters/Grievances
Payment Posting Monthly Close-outs Customized Reporting HR duties (Payroll, hiring, etc)
Familiar w/ Billing Rules/Regulations in multiple states including but not limited to TX, NY, CA, FL
EMPLOYMENT HISTORY
Surgical Notes, Certified Coder, Remote 12/15-Present
Remote ASC Coder, currently coding for multiple ASCs in different states for a variety of centers who facilitate services to all specialties that include but are not limited to General Surgery, ENT, OBGYN, Pain, etc. Must maintain accuracy, consistency, and timeliness with all cases presented.
Exact Billing Solutions, Billing Manager, Houston, TX 2005-12/2015
Duties have shifted throughout the years, currently the lead coder for the following specialties: Family Medicine, Internal Medicine, General Surgery, Bariatric Surgery, Gastroenterology, Gynecology, Pediatric Infectious Disease, Neurology and Neonatology.
NueMD, Billing/Collections/Posting, Remote 2014-Present
Duties for this position include posting payments and collections for multiple specialties. Previous duty included Pain Management coding.
The Pain Care Center, Houston, TX 2004 – 2005
Ran the back office, duties included: prior-auths for outpatient procedures, surgery scheduling, MA work, and patient counseling.
Bear Creek Wellness Center, Houston, TX 2002 – 2004
Front office coordinator: Responsible for scheduling, pt check-in, collecting copays, insurance verification and referrals.
Oscar De Valle, MD, Houston, TX 1999 - 2002
Back office coordinator: Triaged patients, completed prescription refill requests, helped with procedures, administered injections, phlebotomy, and scheduled procedures.
COMPUTER SKILLS
Microsoft Office LeonardoMD (web-based)
Medisoft NueMD (web-based)
Medical Manager E-Clinical Medicare ERA software Clearinghouses (Availity/Ingenix/Optum/Navicure) Quickbooks typing 50 wpm 10 key by touch Encoder Pro
PROFESSIONAL EXPERIENCE
CODING
Responsible for CPT/ICD-9/HCPCS/ICD-10 coding for multiple specialties including but not limited to internal medicine, general surgery, emergency room, pain management, infectious disease, gastroenterology, colon/rectal, otolaryngology, obstetrics/gynecology and neonatology.
• Primary coder for over 5 accounts at a time for various specialties; both inpatient and outpatient
• Oversee other coders by performing audits and system checks to ensure accuracy
• Keep up to date with current changes and updates regarding codes/bundling
A/R COLLECTIONS/APPEALS
Use online/phone resources to ensure that all claims going out are not only paid in a timely manner, but also that they have been paid at the correct reimbursement rate allowed by contract.
• Extensive experience and understanding of Medicaid and its Commercial plans
• Extensive experience and understanding of Medicare and its Supplement and HMO plans
• Familiar with Texas State Laws that can be used to ensure timely payments for commercial payers
• Work A/R in its entirety monthly with no exception (to avoid PTF issues)
• Experience in helping guide the patients and to help them understand what their rights are recommendations to secure payment from their insurance carrier
H/R DUTIES
Responsible for keeping track of all employees and their daily activities
• Semi-monthly payroll which includes counting up hours, recording time-off, and accessing Quickbooks
• Daily/weekly audits on individual employees and the completion of their daily tasks
• Interviewing/Hiring/Terminating of employees when necessary
• Creation/updating of policy/procedures such as Handbooks as necessary
MONTHLY CLOSE-OUTS
Generate all reports and correspondence that is required to reconcile at month end
• Balance the month end deposit report from the practice management system to the lockbox total
• Run monthly reports to keep track of vital information such as total billed, collected, and outstanding
• Run clean A/Rs for the next months collection work
• Keep track of payer mix reports, procedure analysis, and other customized reporting necessary to project future revenue
EDUCATION
NHMCCD, Associate of Arts – Field of Study, Business, Houston, TX 2007
Jersey Village High School, Houston, TX 2000
Bilingual – Speak, Read, and Write Spanish
CERTIFICATIONS
Certified Outpatient Coder, AAPC awaiting testing
ICD-10 Profecient, AAPC 2015
Certified Professional Coder, AAPC 2011
Certified Medical Coder, PMI (Practice Management Institute) 2010
Dale Carnegie Course: Effective Communications & Human Relations/Skills For Success 2009
REFERENCES UPON REQUEST