CPC-A Seeking an Unique Opportunity in Florida......

Coder_Rick

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Objective:

Motivated Medical Insurance Coding and Billing Specialist, seeking a rewarding, challenging opportunity to utilize my knowledge and application of billing, coding, and collections in a team oriented environment.

Education:
Jan 2009 - Sept 2009 Concorde Career Institute. Miramar, FL
Insurance Coding and Billing Specialist - Diploma
Dec 2005 - Apr 2006 Pro-Dive Academy. Ft. Lauderdale, FL
Master Scuba Diver Instructor - Certificate

Skills:
* Knowledge and use of Misys Tiger PM, Athena, and Medical Manager software.
* Knowledge and use of HIPAA compliance standards.
* Collection calls to patients and third party payers in an effort to resolve unpaid A/R balances.
* Able to initiate the claims process and follow it through to the A/R resolution.
* General knowledge of Medicare, Medicaid, HMO, PPO, and W/C third party guidelines for reimbursement.
* Ability to code from source documents, i.e. Operative reports, History reports, Radiology reports,
Pathology and Lab reports: utilizing CPT, HCPCS and ICD-9CM coding guidelines and methodology.
* Able to review, interpret and process EOB's by posting charges, payments and adjustments to patient accounts.
* Familiar with hospital reimbursement schemes i.e. DRG, APC's and Medicare's OPPS systems.

Employment:
February 2010 – November 2010 Orthopaedics Associates USA, Oakland Park, FL
Certified Coding and Billing Specialist.
* Coding from reports in accordance with CMS, billing charge tickets using computer management
software, creating claims for transmission to payers.
* Communicating with payers regarding denied / rejected claims, correction of required pertinent patient information and CPT/ICD 9 codes, resubmitting corrected claims for reimbursement.
* Collecting, transferring and posting payments into patient accounts.
* Working with assigned physicians, communicating with them on potential claims submission problems, and
trends. Educating on proper code sequencing, modifier usage and ensuring complete documentation.

July 2009 - Sept 2009 Compass Health Systems. North Miami, FL
Insurance Coding and Billing Specialist Externship.
* Updated patient's insurance and account information.
* Performed patient eligibility verification of Medicare, Medicaid, and Managed Care Accounts.
* Communications with payers regarding denied / rejected claims, correcting required codes, resubmission of corrected claims resulting in reimbursement.

Sept 2007 - Jan 2009 Ocean Divers Inc. Key Largo, FL
Sales Associate / Instructor.
* Instructed Scuba , Specialty, and CPR /BLS courses.
* Performed consultations, and booked group and individual dive charter reservations.
* Management of daily operations at north location facility.
* Certified regulator and repair technician.
* Sales of scuba equipment and supplies.
* Lead dive expeditions for pleasure or research.

Aug 2006 – Sept 2007 Atlantis Dive Center. Key Largo, FL
Operations Manager / Instructor.
* Scheduled employee shifts, completion of company payrolls.
* Overseeing daily business operations, including boat and compressor maintenance.
* Equipment sales and air fills.
* Resolved customer complaint issues.
* Worked with vendors, Coast Guard and Law Enforcement officials when requested.


Certifications:
* AAPC Certified Professional Coder A # 01120830
* CPR/BLS certified. PADI #199700
* Certified Master Scuba Diver Trainer. PADI/# 199700

References available upon request.
 
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I am looking for a consultant to hire on an hourly basis, either someone doing consulting now or while the person is looking for full time work. I need some specific scenarios researched and it would help if the person had ED room experience as well as the CPC. If that is you please contact me at "vicki.schweitzer@examworks.com"
Thanks!
 
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