kjss49247
Guest
Individual with 12+ years experience in medical setting, performing medical coding, billing and A/R clean up. Worked in large and small hospital in both Michigan and South Carolina, seeking full time remote or travel position as a coder, billing or A/R specialist. Certified CPC coder in 2011 with 2 yrs experience, proven A/R skills with 10 keypad strokes 10k with 98% accuracy. Please email at
kjss49247@yahoo.com
Skills:
Claims Handling and Investigations
Billing all payors
Certified Professional Coder
Oversight of one other employee
Outstanding F/U results
Implantation of policy and procedures
Highly accountable
Experience:
Oaklawn Medical Group- Marshall, MI
Coder/Biller 3/2012- current
ICD- 9 Coding of Cardiology- CCTA, EKG, TTE, TEE, Office visits, Inpt and Observation visits and Holter monitors
CPT coding of procedures
Data entry of all codes and charges for both Family practice office and Cardiologist
Payment posting for both practices
A/R- F/U on outstanding balances for both practices with all payers
Claims correction online using Navicure· Handling patient phone calls regarding billings
Use of Allscripts PM and ERM, Navicure, Cernier and payer websites
Springbrook Behavioral Health – Travelers Rest, SC
A/R Specialist, 6/2010 to 9/2011
Billing Medicare A & B, Sc & Nc Medicaid, VA as well as all commercial payors on UB04, CMS 1500 both manual and electronic
Post payments to patient accounts including figuring the contractual
Contacting payors for outstanding claims
Work denials and ECF's for all payors
Make financial arrangements with patient for self pay accounts
Send statements bi- monthly to patients
Collecting and updating census information for daily room charges
Supervising one other person within the department
Training new individuals
Charge entry of professional fees for both outpatient as well as inpatient
IT support- creating new users in the Sphere system
Handling simple IT issues or arranging for the IT support requests
Sending appeals on denied accounts to insurance carriers
Use of Sphere (NextGen-Spirit), RCM (Healthport- Compu Group), billing on NC Webtools, use of Medicare DDE, BCBS of Sc Stat Chat
Palmetto Health Alliance – Columbia, SC
Patient Account Rep, 1/2009 to 12/2009
Working account in New Follow Up pool as well as Follow up pool
Contacting payer's; Blue Choice, UHC, Beech street, Med Cost, Kaiser Permenate, Fiserv regarding outstanding claim balances
Pulling remits to verify payments, patient responsibility
Correcting adjustments made to accounts due to PCON (automaticAdjustment's made by system due to contract) or the incorrect Adjustment's posted to accounts
Transferring true patient balances to patient
Handled escalated account calls that customer service was not able to handle
Other duties, project as assigned by management
Software used: South Carolina Blues website- stat chat, UHC website,McKesson (HBO or Stars), Solcom, Artiva, Xactimed, GroupWise
National Imagining Association (NIA)
Gallman Professionals – Columbia, SC
Medical A/R Specialist, 8/2008 to 10/2008 (contract position)
Medical AR Specialist for all commercial and Medicaid payers
Ensured that payments and/or adjustments have been posted to accounts correctly· Post payments
Pulling explanation of benefits for review
Contacting insurance companies to discuss outstanding patient balances· Filed appeals with insurance companies
Status accounts that were previously worked. Working denials from insurance payers
Use of Medical Manager, EHS windows based systems, Blue Cross Blue Shield Stat Check
Education:
Lenawee Vocational- Technical Center n Adrian, MI
Medical Services Technology (certificate June 1989)
1500 HCFA Billing (certificate April 2003)
Greenville Technical College n Greenville, SC
CPC- June 2011 2 yrs coding experience
Medical coding and billing (certificate May 2011)
HIPAA I & II (certificate April 2011)
National Medicare (certificate April 2011)
OSHA (certificate April 2011)
kjss49247@yahoo.com
Skills:
Claims Handling and Investigations
Billing all payors
Certified Professional Coder
Oversight of one other employee
Outstanding F/U results
Implantation of policy and procedures
Highly accountable
Experience:
Oaklawn Medical Group- Marshall, MI
Coder/Biller 3/2012- current
ICD- 9 Coding of Cardiology- CCTA, EKG, TTE, TEE, Office visits, Inpt and Observation visits and Holter monitors
CPT coding of procedures
Data entry of all codes and charges for both Family practice office and Cardiologist
Payment posting for both practices
A/R- F/U on outstanding balances for both practices with all payers
Claims correction online using Navicure· Handling patient phone calls regarding billings
Use of Allscripts PM and ERM, Navicure, Cernier and payer websites
Springbrook Behavioral Health – Travelers Rest, SC
A/R Specialist, 6/2010 to 9/2011
Billing Medicare A & B, Sc & Nc Medicaid, VA as well as all commercial payors on UB04, CMS 1500 both manual and electronic
Post payments to patient accounts including figuring the contractual
Contacting payors for outstanding claims
Work denials and ECF's for all payors
Make financial arrangements with patient for self pay accounts
Send statements bi- monthly to patients
Collecting and updating census information for daily room charges
Supervising one other person within the department
Training new individuals
Charge entry of professional fees for both outpatient as well as inpatient
IT support- creating new users in the Sphere system
Handling simple IT issues or arranging for the IT support requests
Sending appeals on denied accounts to insurance carriers
Use of Sphere (NextGen-Spirit), RCM (Healthport- Compu Group), billing on NC Webtools, use of Medicare DDE, BCBS of Sc Stat Chat
Palmetto Health Alliance – Columbia, SC
Patient Account Rep, 1/2009 to 12/2009
Working account in New Follow Up pool as well as Follow up pool
Contacting payer's; Blue Choice, UHC, Beech street, Med Cost, Kaiser Permenate, Fiserv regarding outstanding claim balances
Pulling remits to verify payments, patient responsibility
Correcting adjustments made to accounts due to PCON (automaticAdjustment's made by system due to contract) or the incorrect Adjustment's posted to accounts
Transferring true patient balances to patient
Handled escalated account calls that customer service was not able to handle
Other duties, project as assigned by management
Software used: South Carolina Blues website- stat chat, UHC website,McKesson (HBO or Stars), Solcom, Artiva, Xactimed, GroupWise
National Imagining Association (NIA)
Gallman Professionals – Columbia, SC
Medical A/R Specialist, 8/2008 to 10/2008 (contract position)
Medical AR Specialist for all commercial and Medicaid payers
Ensured that payments and/or adjustments have been posted to accounts correctly· Post payments
Pulling explanation of benefits for review
Contacting insurance companies to discuss outstanding patient balances· Filed appeals with insurance companies
Status accounts that were previously worked. Working denials from insurance payers
Use of Medical Manager, EHS windows based systems, Blue Cross Blue Shield Stat Check
Education:
Lenawee Vocational- Technical Center n Adrian, MI
Medical Services Technology (certificate June 1989)
1500 HCFA Billing (certificate April 2003)
Greenville Technical College n Greenville, SC
CPC- June 2011 2 yrs coding experience
Medical coding and billing (certificate May 2011)
HIPAA I & II (certificate April 2011)
National Medicare (certificate April 2011)
OSHA (certificate April 2011)