Wiki East Texas CPC/Business Office Manager/10 yrs exp.

mitzekelley

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Mitze M. Kelley, CPC
4265 FM 1990
Palestine, Texas 75801
(903) 724-3197
mitzemkelley@hotmail.com


SKILLS PROFILE

•Certified Professional Coder obtained through the American Academy of Professional Coders.
•Great knowledge of ICD-9, CPT and HCPCS coding.
•Five years of office supervisory experience.
•Skilled in developing successful office procedures.
•Experienced in establishing collection plans and monitoring collection activity.
•Accustomed to working in a fast-paced environment and successfully handling several responsibilities simultaneously.
•Proficient in 10-Key, Microsoft Word, Microsoft Excel and Allscripts medical software.

EXPERIENCE:

EAST TEXAS PHYSICAN'S ALLIANCE, L.L.P/MAGNOLIA HEALTH SYSTEMS
Palestine, TX
August 2007 to Present
Business Office Manager/Certified Coder

•Maintain the billing for nineteen physicians and seven mid-level providers. Intermediate-advanced knowledge of Medicare, BCBS including but not limited to Texas, and numerous commercial carriers to include charge posting, receipt posting, appeals processes and coordination of benefits. I am responsible for staying up to date on Medicare, BCBS and Medicaid billing guidelines and updates such as Limited Coverage Determination, Physical Therapy Caps, Medicare Deductibles and BCBS alpha prefix changes per changes in employee group coverage.
•Oversee twenty employees in daily duties such as following medical claims, appealing problem claims, and patient contact to resolve issues such as coordination of benefit updates and obtaining new insurance information. Insure accurate charge posting for cleaner claims and quicker reimbursement turn around time. Responsible for employee reviews and disciplinary actions within the billing office. Maintain a time off calendar via Google Calendar. Approval of time off requests for all twenty employees. Initialize and maintain online website access for claim status checks and explanation of benefit printing for all employees to use in conjunction with contacting insurance carriers via telephone.
•Responsible for scheduling and participating in quarterly meetings with thirteen physician office managers to keep them informed of any governmental and/or commercial carrier policy changes. I am also responsible for notifying the office managers of repeated posting errors within the clinic setting including charge posting and accurate demographic data entry.

•Communication with IT specialist and Allscripts project managers on system updates and issues.
•Creation of new users, adding new insurance companies, referring physicians and adding and updating procedure and diagnosis codes in Allscripts Practice Management. I also create the physician schedules and make changes when necessary.
•Updating of current fees and following procedures for establishing a standard group fee and self pay fee for E&M, lab, radiology, MRI, CT, Mammography, Nuclear Medicine, Ultrasound and other miscellaneous ancillaries.
•Responsible for creating packets at the beginning of each year notifying the physicians of any CPT additions/deletions/revisions that will affect our multi-speciality group.

EAST TEXAS PHYSICAN'S ALLIANCE, L.L.P/MAGNOLIA HEALTH SYSTEMS
Palestine, TX
September 2000 to May 2005
Account Representative

•Worked for the billing office for seventeen doctors in and around the Palestine area.
•Responsible for charge posting of all cardiology procedures, inpatient services, Cardiac Rehabilitation, and Medical Physiology for numerous physicians.
•In charge of the Nuclear Medicine Department scheduling as well as charge posting of Nuclear Medicine procedures.
•Designated as personal account manager for Dr. Wayne L. Brown.

CERTIFICATIONS:

AMERICAN ACADEMY OF PROFESSIONAL CODERS-CERTIFIED PROFESSIONAL CODER

EDUCATION:

TRINITY VALLEY COMMUNITY COLLEGE
Palestine, Texas
6 hours Legal Ethics

WESTWOOD HIGH SCHOOL
Palestine, Texas
Graduated in 1990

REFERENCES:
Available upon request.
 
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