Looking for remote coder or billing and coding and a/r position

egarci53

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Local Chapter Officer
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ALLENTOWN
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Evelyn Garcia
1624 W Whitehall St Allentown PA 18102 Cell: (484)809-1255 E-mail: evelyndlove@me.com



Qualifications:

Bilingual (Spanish)
Proficient in Medical Insurance Billing, Medical Terminology, Medical Coding.
Medical software knowledge: Windows XP, Microsoft Word/Excel.
Type 50 wpm Outstanding oral and written communication skills.
Strong ability to multitask, organized, disciplined and detail oriented.

Work experience:

CHS Shared Service Center
Bethlehem, PA
Account Resolution Specialist September 2014 - Present

Manage patient accounts each week, balancing multiple and changing workloads and projects, meeting daily and weekly deadlines, and producing weekly progress reports.
Investigate claim payments for accuracy, addressing underpayments efficiently with calls or written disputes and ensuring claim resubmissions meet the payors’ often-unique billing requirements. Successfully problem-solve claim denials and rejections for wrong patient identification elements, wrong insurance information, eligibility issues, authorization and referral issues, CPT and ICD-9 coding errors, CCI and MUE claim edits, HIPAA 5010 requirements, and federal and state coding requirements.
Write letters of appeal to payors and coordinate supporting documentation when other methods of claims resolution have been exhausted.
Write letters of appeal to payors and coordinate supporting documentation when other methods of claims resolution have been exhausted.
Responsible for interpreting contracts between a multitude of payors and 17 CHS, Inc. hospitals as well as Medicaid Code for Pennsylvania and New Jersey hospitals.
Communicate with hospital departments when flagged claims require further investigation to ensure efficient charge capture and HIPAA compliance.
Have a documented track record of successfully reduced bad debt accounts as a result of thorough claim analysis and diligent and proactive resolution practices.
Discover multiple opportunities for increased revenue through system and process updates.








NCMHC
Philadelphia, PA May 2009 – August 2014
Billing Specialist

Set up new patient accounts as well as update established patient accounts.
Post monies to patient accounts to reflect insurance payments, copays and/or deductibles.
Daily reconciliations of payments & credits pertaining to patients and insurances.
Coding and posting of rendered services to patient for clean claims sumissions to insurance.
Daily review of pre-submissions claims report to ensure clean claims transmission.
Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts.
Responsible for weekly review and completion of "Aged Trial Report" for resolutions and adjustments of claims denials, rejections and possible claims appeals.

Florida Hospital Orlando, FL July 2007- October 2008
Ultrasound Assistant/ Assistant Coordinator

Daily printout of daily schedule for inpatient, outpatients and surgery cases in preperation prior to patient encounters.
Responsible for receiving and directing of all incoming phone calls to correct departments.
Assisted with translation to spanish speaking patients to ensure clear communication between doctors and patients.
Daily calls for appointments confirmations and patient follow-up.
Constant communicate with Radiologists, Physicians, and Nurses for high priority cases.

NCMHC
Philadelphia, PA March 2002 – April 2004
Billing Specialist

Review of daily encounters for proper diagnosis coding.
Responsible for all billing submissions via electronic and paper claims.
Manage all the data entry of new patient and established patient information in system.

Education:
Bachelor of Science in Health Administration , University of Phoenix, (2011 - Present)
Associates Degree in Medical Insurance Billing and Coding, Everest University, Orlando, FL
Certified Professional Coder

References:
Available upon requests.
 
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