OBJECTIVE: To obtain a remote position which will fully utilize background experience, training, and skills.
PROFESSIONAL ATTRIBUTES: Over 15 years experience medical billing, current member of AAPC-American Academy of Professional Coders, proven strong work ethic, self starter, problem solver, excellent communication skills.
Medical Careers Institute (LPN program); Richmond, Virginia April-June 2010-Courses completed to include: Anatomy & Physiology I & II, Pharmacology I & II
University of Maryland University College; Heidelberg, Germany 2001.
PERTINENT COURSES: March 2007 Completed Seminar for UB04-VA Medicaid Billing Guidelines. May 2006 Completed "The Cahaba All Day Workshop" for Traveling the Hospice Highway given by Virginia Association for Hospices. September 2005 Certificate of Completion for participation in the course Coding And Billing For Therapy and Rehab-Cross Country University; March 2002 Advance Excel 2000 and Advance Word 2000; August 2001 Introduction to Word 2000 and Introduction to Excel 2000; June 2001 Completion of National Enrollment Database (NED) Course; March 2001 Completed Composite Health Care System (CHCS) Managed Care Program Functionality course; Knowledge of Mysis, Mestamed, Medic computer system, Accura and Medisoft.
September 2007-Present-Account Manager
Develop standard billing and collections procedures; training programs for billing and collections personnel using HCHB software systems; act as liaison between staff and insurance companies to prevent or resolve authorization, billing and collections issues. Negotiate rates with provider contracts. Review/audit clinical information to ensure accuracy and medical necessity for home health services.
Medi Home Health & Hospice
February 2006-March 2007-Billing Manager
Ensures daily operations are completed in accordance to agency and HIPAA guidelines. Reviews billing process for home health and hospice to make recommendations to streamline operations. Complete all agency financial reports. Assist with monthly, quarterly, and fiscal year-end reports. Monitors accounts receivable; investigates and resolves all non-coverage and/or non-payment issues with manager. Meets with manager and staff to address billing problems and to assess productivity. Develops spreadsheets to monitor financial adjustments and write offs. File claims (UB92 & CMS1500) electronically; handle all billing inquiries; follow-up on all outstanding claims and check status on Medicare patient's using Direct Data Entry System; enter add/edit charges as needed and enter all insurance payments. Keep each administrator updated with new and important insurance issues and federal regulations. Review all registrations for accuracy and verify eligibility on all patient's. Consistently facilitates positive interpersonal and team building relations with staff.
Spineworks Physical Therapy
February 2005-December 2005-Billing Coordinator
Responsible for all billing issues. Answer all patient billing questions for physical therapy practice and clinical psychologist; review accounts and financial agreements with patients;work all denial, collection, and aging reports using Medisoft billing system;follow up on all litigation cases;post payments and run claims on a weekly basis.
June 2004-January 2005-Patient Account Representative-ACSEL Corporation
Responsible for insurance follow-up for approximately 7-10 clients, work appeals, patient collection, and refunds. Answer all billing questions for all client accounts. Work denial and reconciliation reports using Emedsys and AcSel Software billing system. Post insurance payments and adjustments.
February 2003-January 2004-Insurance Specialist-Vascular & Transplant Specialists
Enter insurance payments and adjustments. Perform backup for main frame billing computer. Answer billing inquires from patients and insurance companies. Enter requested insurance information/changes in patients' accounts. Post EOB denials along with researching collection write-offs using PMG billing software system. Work unpaid claims report by contacting insurance companies to resolve outstanding claims. Process month end reports. Handle patient collection and bankruptcy reports.
March 2001-August 2002-Medical Service Coordinator-SAIC/TRICARE
Provide customer and technical systems operation support within the Mannheim
Tricare Service Center for a population of over 13,000 active duty, family members, retirees and DOD civilians; provide educational and technical assistance to eligible beneficiaries regarding specific Tricare benefits and services; perform enrollment and disenrollment procedures using NED and DOES computer software system; administer enrollment portability procedures; assign Primary Care Managers to beneficiaries and provide detailed explanations of the responsibilities of the Primary Care Manager; run reconciliation reports on a monthly basis to resolve data inconsistencies; public presentation of Tricare
benefits and enrollment procedures through available media or group
A complete set of references will be furnished upon request
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