cdschmitz9
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My name is Denise Schmitz; in the spring of 2016 I started online CPC classes through AAPC. In December 2016, I took my first CPC exam and passed it! I am now classified as a CPC and would like to find a job as a Medical Coder. I worked at a Medicare Contractor’s office for twenty years prior to obtaining my CPC certification.
Processed Medicare Part B claims:
•This included entering the claim detail charges from the paper claims, working system edits to allow the claims to process, requesting information from the provider either in writing or by telephone.
•Worked system edits on claims that were submitted electronically by the provider office or their clearinghouse.
•Attended Part B training for all provider types including those listed above.
•Trained in HIPPA and Program Compliance
Answered Part B phone inquiries from the provider’s office to assist in the following:
•Medicare beneficiary eligibility status.
•Provider financial information.
•Explanation of denial on claim.
•Guideline explanation and referrals to Medicare publications on the CMS website and the Medicare contractor’s website.
Responded to Part B written and phone appeal requests from the provider’s office to assist in the following:
•Favorable review of denied charges that allowed the claim to be reprocessed with the documented information that was provided by the caller.
•Unfavorable review of denied charges that allowed the claim to be moved on to the next level of appeal.
•Appeals that shifted the responsibility of the denied charges to the other party depending on whether there was a valid ABN signed by the beneficiary prior to service.
Provided technical support for the Part A and B phone staff and their management. Here are the key functions that I performed:
•Attended Part A Medicare training for all aspects of the Part A program.
•Participated in Part A and B technical support staff calls for tracking problems in the processing of the Part A and B claims.
•Provided reports for management to track system issues and workload numbers.
•Did monthly reports for workload numbers for Part A and B that were submitted to CMS for our funding.
•Attended monthly CMS calls for training and discussion of ongoing issues.
•Participated in special workgroups for upper management.
If you are interested, please contact me at cdschmitz1@gmail.com
Thanks!
Processed Medicare Part B claims:
•This included entering the claim detail charges from the paper claims, working system edits to allow the claims to process, requesting information from the provider either in writing or by telephone.
•Worked system edits on claims that were submitted electronically by the provider office or their clearinghouse.
•Attended Part B training for all provider types including those listed above.
•Trained in HIPPA and Program Compliance
Answered Part B phone inquiries from the provider’s office to assist in the following:
•Medicare beneficiary eligibility status.
•Provider financial information.
•Explanation of denial on claim.
•Guideline explanation and referrals to Medicare publications on the CMS website and the Medicare contractor’s website.
Responded to Part B written and phone appeal requests from the provider’s office to assist in the following:
•Favorable review of denied charges that allowed the claim to be reprocessed with the documented information that was provided by the caller.
•Unfavorable review of denied charges that allowed the claim to be moved on to the next level of appeal.
•Appeals that shifted the responsibility of the denied charges to the other party depending on whether there was a valid ABN signed by the beneficiary prior to service.
Provided technical support for the Part A and B phone staff and their management. Here are the key functions that I performed:
•Attended Part A Medicare training for all aspects of the Part A program.
•Participated in Part A and B technical support staff calls for tracking problems in the processing of the Part A and B claims.
•Provided reports for management to track system issues and workload numbers.
•Did monthly reports for workload numbers for Part A and B that were submitted to CMS for our funding.
•Attended monthly CMS calls for training and discussion of ongoing issues.
•Participated in special workgroups for upper management.
If you are interested, please contact me at cdschmitz1@gmail.com
Thanks!