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Loytia Scott, CPC, CRC
9609 DePorres Lane Breckenridge Hills, MO 63114
Phone: (314) 764-2941 or (314) 397-8988
EDUCATION
Vatterott College Berkeley, MO
Diploma: Medical Office Assistant Graduation: 10/2009
AOS: Medical Coding and Billing Graduation:05/2010
APPC: Certified Risk Coder Since: 2015
SKILLS
Medical Billing
Claims Follow-up
ICD-9/CPT
ICD-10
Medicare Risk Adjustment
HCC Coding Auditing
Healthcare reimbursement
WORK HISTORY
ADVANCED MEDICAL ASSOCIATES St. Louis, MO
MEDICAL BILLER/CODER 03/16-CURRENT
Submit Inpatient and Dialysis billing for the doctor.
Follow-up on submitted claims regarding payments.
Work denial/and additional information letters from the insurance companies.
ROBERT HALF/ESSENCE HEALTHCARE St. Louis, MO
MEDICAL CODER 02/15-02/16
Review enhanced Medicare encounters to insure the documentation is provided for the ICD 9/10 codes that are being submitted for reimbursement from Medicare.
Perform audits of the providers to insure they are capturing all diagnosis for that encounter as well as any other diagnosis that the patient may have so that Medicare can accurately calculate the amount of funds that will need to be provided for the patient’s care for the upcoming year.
Follow the guidelines of Medicare to ensure that all processes are followed for Medicare Advantage plans.
WHEELCHAIR PROFESSIONALS St. Louis, MO
MEDICAL CODER- 06/13-1/15
Code claims to be submitted to the insurance company for reimbursement while following Medicare
guidelines.
Contact the Associate Providers for missing information.
CLAIMS REPRESENTATIVE- 6/12-06/13
Work with third party payers to ensure proper reimbursement on patient accounts, identifying and preparing adjustments and write*offs as appropriate
Followed up on daily correspondence (denials, low pays) to appropriately work patient accounts.
Interfacing with insurance companies via telephone to check claim status, written correspondence to
payers and patients.
Submit medical records for review
Submitted corrected claims for reprocessing
BARNES JEWISH HOSPITAL St. Louis, MO
PATIENT ACCOUNTS SPECIALIST 07/10-12/2011
Worked off aged trial balance to ensure all claims were followed up on within a timely fashion
Followed up on daily correspondence (denials, low pays) to appropriately work patient accounts.
Interfacing with insurance companies via telephone to check claim status, written correspondence to
payers and patients.
Corrected CPT and/or diagnosis codes on a rejected claim.
Enter payment information from online or off of paper EOB’s
Magellan St. Louis, MO
AUTHORIZATION SPECIALIST 03/09 – 07/2010
Authorized doctors to conduct special procedures requiring nuclear medicine
Expert knowledge of diagnosis and procedure codes
Express Scripts St. Louis, MO
PHARMACY TECH 09/08 – 3/09
Prepared and verified new prescription orders and refill orders
Selected and retrieved appropriate medications, compound and dispense medical prescriptions, verified
quantities, and prepared labels for bottles
United Healthcare St. Louis, MO
CUSTOMER CARE COORDINATOR 03/06 – 4/08
Fielded questions from public regarding services provided
Submitted medical claims for reprocessing
References furnished upon request
9609 DePorres Lane Breckenridge Hills, MO 63114
Phone: (314) 764-2941 or (314) 397-8988
EDUCATION
Vatterott College Berkeley, MO
Diploma: Medical Office Assistant Graduation: 10/2009
AOS: Medical Coding and Billing Graduation:05/2010
APPC: Certified Risk Coder Since: 2015
SKILLS
Medical Billing
Claims Follow-up
ICD-9/CPT
ICD-10
Medicare Risk Adjustment
HCC Coding Auditing
Healthcare reimbursement
WORK HISTORY
ADVANCED MEDICAL ASSOCIATES St. Louis, MO
MEDICAL BILLER/CODER 03/16-CURRENT
Submit Inpatient and Dialysis billing for the doctor.
Follow-up on submitted claims regarding payments.
Work denial/and additional information letters from the insurance companies.
ROBERT HALF/ESSENCE HEALTHCARE St. Louis, MO
MEDICAL CODER 02/15-02/16
Review enhanced Medicare encounters to insure the documentation is provided for the ICD 9/10 codes that are being submitted for reimbursement from Medicare.
Perform audits of the providers to insure they are capturing all diagnosis for that encounter as well as any other diagnosis that the patient may have so that Medicare can accurately calculate the amount of funds that will need to be provided for the patient’s care for the upcoming year.
Follow the guidelines of Medicare to ensure that all processes are followed for Medicare Advantage plans.
WHEELCHAIR PROFESSIONALS St. Louis, MO
MEDICAL CODER- 06/13-1/15
Code claims to be submitted to the insurance company for reimbursement while following Medicare
guidelines.
Contact the Associate Providers for missing information.
CLAIMS REPRESENTATIVE- 6/12-06/13
Work with third party payers to ensure proper reimbursement on patient accounts, identifying and preparing adjustments and write*offs as appropriate
Followed up on daily correspondence (denials, low pays) to appropriately work patient accounts.
Interfacing with insurance companies via telephone to check claim status, written correspondence to
payers and patients.
Submit medical records for review
Submitted corrected claims for reprocessing
BARNES JEWISH HOSPITAL St. Louis, MO
PATIENT ACCOUNTS SPECIALIST 07/10-12/2011
Worked off aged trial balance to ensure all claims were followed up on within a timely fashion
Followed up on daily correspondence (denials, low pays) to appropriately work patient accounts.
Interfacing with insurance companies via telephone to check claim status, written correspondence to
payers and patients.
Corrected CPT and/or diagnosis codes on a rejected claim.
Enter payment information from online or off of paper EOB’s
Magellan St. Louis, MO
AUTHORIZATION SPECIALIST 03/09 – 07/2010
Authorized doctors to conduct special procedures requiring nuclear medicine
Expert knowledge of diagnosis and procedure codes
Express Scripts St. Louis, MO
PHARMACY TECH 09/08 – 3/09
Prepared and verified new prescription orders and refill orders
Selected and retrieved appropriate medications, compound and dispense medical prescriptions, verified
quantities, and prepared labels for bottles
United Healthcare St. Louis, MO
CUSTOMER CARE COORDINATOR 03/06 – 4/08
Fielded questions from public regarding services provided
Submitted medical claims for reprocessing
References furnished upon request