CPC Looking for employment in Augusta GA


Columbia, SC,Augusta GA
Best answers
Vania James CPC

OBJECTIVE; I would like to obtain employment with a company that will utilize my skills and degree to the organization and my progression.

Certificate, Medical Coder, Associate Degree, Human Services, 6/1998
Certificate, Healthcare Coordinator, 9/1995
Bachelor Degree, Arts Psychology, 09/2009

2/2008 – Present, Accountant/Fiscal Analyst, , Columbia, South Carolina
Serve as trainer and facilitator to seventeen mental health centers. Provides technical assistance to agencies and helps agencies to resolve billing issues. Prepare financial and reimbursement analyses, conduct research and analyze trends to optimize coding and reimbursement, and lead education for all facets of the revenue cycle. Assist with development of policies and procedures related to departmental operations. Responsible for coding diagnoses and operative procedures using ICD-9-CM, DRG, and CPT/HCPCS coding systems as a means of classification for use in research, statistical studies, and cost reimbursement. Perform random audits on charts to ensure accurate. Work with various agencies and departments for resolution of concerns that affect collections.

4/2007-02/2008, Collection Specialist, Camden SC
Responsible for coordinating collections of bad debts for all patient types and any activities associated with collection of Self Pay accounts. Establish payment arrangements within guidelines established by departmental policy for self pay accounts. Ensure that the appropriate CPT codes, ICD-9 and HCPS codes was billed. Review all accounts to insure insurance has paid on all accounts. Maintain all LTC and private pay billing is current. Assist and educate all nursing home patients and family member on insurance and facility protocols.

9/2005-9/2006, Billing Manager, Hopkins, SC
Manage business office staff with daily operations, medical billing and all revenue cycle. Ensure planning, staffing, directing and controlling the activities and operations of the business office. Educate and train providers and clinical staff on new and revised insurance protocol and medical codes. Perform accurate reports for Medicare such as Balance Credit reports, Bad Debt reports and other report. Maintain accounts payable and subsidiary documentation, maintain staffing schedules, overseeing daily balancing and deposits, and acting as liaison between staff, administration and physician. Ensure that the appropriate CPT codes, ICD-9 and HCPS codes was billed.

1/2003-5/2005, Insurance Analyst/Admission Specialist, Columbia SC
Perform daily medical billing via Internet and electronically, conduct appeals and denials in a timely manner as well as post daily charges and payments. Prepares and participates in project planning, analysis, specification development, and implementation, of billing and insurance system. Obtain and conduct per-certification and utilization review. Interface with HMO, Medicare, Medicaid, worker's compensation and managed care companies. Ensure that all providers are credentialed with appropriate insurance companies and facilities. Medical terminology, ICD-9 and CPT-4 coding was vital to my job performance in keeping the patients informed about their accounts. Assist patients and family in admissions and placement of hospitals and other facilities.

6/2000-8/2002, Managed Care Specialist, Columbia SC
Ensure that all insurance benefit is pre-certified prior to all procedures being performed by any of the thirty-nine cardiologists. Obtain all information for admissions and pre-cert. for hospital and other facilities. Educate and train providers and clinical staff on new and revised insurance protocol. Counsel patients appropriately in situations where insurance companies deny benefits by explaining waiver to patient and answering questions. Manage and conduct utilization review and case management with HMO, managed care companies, and worker's compensation. Perform liaison functions with hospitals and outreach offices.

SALARY; Negotiable
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