13 years experienced Medical Auditing/Coding/Billing/AR- Seeking Management Position


Salem, OR
Best answers
Looking for a Medical Billing Manager position in the Salem/Portland Oregon Area. Please email me if you are interested.


Dear Provider,

I would like to provide to you, a complete analysis of my experience, skills, goals, accomplishments and overall work ethics.

I started my career on a remote basis, in 2004 and worked for a company called Medical Billing Management. The company was based in Santa Barbara, California. During the time I worked remote, I learned the basics of Medical Billing, and the importance of accurate and timely billing. During that period, I progressed my skills in the aspect of billing, with regards to payment posting, charge entry; follow up on unpaid claims, and patient collections. Within 4 months, the President of the company, contacted me, and offered me a more advanced position in the office which I so graciously accepted.

With relocation assistance, I was afforded the opportunity to move to Santa Barbara, California, and begin a more advanced position within the company. I began billing for specialty practice sites, which included but not limited to, Urology, Psychiatric, Orthopedic, Pulmonary, Inpatient and Outpatient professional services, and OBGYN. I also developed into the accounting side which included month end reporting that was forwarded to the practice sites along with the invoicing. My skills sharpened, and I was honored a very generous incentive, which included a base salary, plus bonuses.

I continued my employ at Medical Billing Management, and maintained an Accounts Receivable status of fewer than 10% for the 120+ day reporting for over 4 years. I helped transition new employees that joined the business, and worked extensively after-hours when required, to ensure the company maintained a highly respected status in the community.

In 2009, I moved to the Central Valley, and began my employment at Urology Associates of Central California. I quickly excelled within 2 months, to Medicare Expert. I was responsible for the entire Medicare AR for both the physicians, and the Ambulatory Surgical Center, which was adjacent to the main building. I was responsible for credentialing of new physicians and physician extenders, revalidations, RAC audits, internal pre-payment audits of paper charts, patient collections in-house, and coding two of the physician’s encounters, and surgeries.

When I first joined the practice, I was able to recover over $450,000 in lost Medicare revenue within 150 days. I implemented a tracking system, to ensure all claims, denials, correspondence from Medicare were solely directed to me, for development and resolutions. I tracked write off’s, and addressed any under-payments that were posted to accounts. I collected patient balances, in-house before turning over the ones that were not collectable, to an outside agency. I assisted patients with all Medicare related questions, concerns, or otherwise sought assistance with their benefits. I worked closely with the physicians to educate on correct documentation of services they provide.

I transitioned in 2013 to a Surgical Coder at Central California Faculty Medical Group. I worked at Community Regional Medical Center in Fresno, coding surgeries for Trauma, Burns, Critical Care, and Gastrointestinal. I developed an account receivable tracking system, correlating with the hospital’s EMR, to collect all missing surgical cases, and code them for claim submission. I assisted the Accounts Receivable Department on formatting appeals when required and requested.

At the beginning of 2014, I was offered a position at Foundation for Medical Care of Tulare and Kings Counties. The Foundation had purchased a NCCI edit software system, and required a Certified Coder/Auditor to oversee it. All claims that are billed with a higher Evaluation and Management Service code, level 4 and above are placed in a pending status, and I review those claims for correct documentation, under CMS Evaluation and Management Documentation Guidelines. I review all claims that are denied, and review them against the National Correct Coding Policy Manual to ensure all claims are processed according to CMS guidelines.

Additionally, I educate physicians and staff on coding, documenting, compliance, and any other medical billing related issues that the provider’s practice may have. I demonstrate correct coding methodologies, and visit the practice sites, to educate coders on Evaluation and Management Documentation Guidelines. I occasionally meet with physicians and physician extenders to educate on incident to services, and any other services which may be required at that time.

My passion is the complex, yet rewarding career of Medical Billing. The industry has provided me with the skills, and knowledge I need to excel my career. My total satisfaction is when I can educate staff and physicians and see the progress they are making, and see the outcome of my educational sessions are positive.

To become a key lead role in a medical office environment is a passion I have, and an ability to lead a team, into success. While working in a patient typesetting, such as a physician office, I demonstrate the priority that our patients come first!

Below are some bullet points of my work ethics and guidelines when I occupy the position of Office Manager.

• Patients will be greeted with eye contact, and a friendly smile. If you are on the telephone, and you are the only one in the office at the time the patient comes in, acknowledge that patient, with a smile, a friendly hello, something to show that patient you acknowledge them. A new patient will decided in less than 30 seconds if they will be coming back to this practice or not. We want them to be 100% comfortable and knowing they are important.
• You will conduct yourself in a professional manner at all time, whether or not there are patients present.
• Remember to present yourself the same way you would want to see staff members if you were visiting a physician office for your own personal health, or you were accompanying a family or friend.
• I will review reports on a weekly basis, concerning A/R and revenue returns. Any write off’s, will be periodically reviewed to ensure claims are not denied for erroneous reasons.
• I will review the payments that are incoming. Are we receiving the maximum reimbursement the provider is entitled to?
• I will review and either updates, and/or enforces the physician office compliance program. Address any compliance issues I may find.
• I will review the billing. Are claims being coded and billed correctly? Address any error patterns that I may find.

This is only a sampling of the detailed guidelines in which I adhere to. After reviewing this letter, I am confident you will find I am a perfect match for your practice, and I look forward to becoming part of your team where I can make a difference, and reassure you that you’re hard earned practice is in good, reliable, and able hands.