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Thread: CPC, Looking for Coding Position or Billing Mgr. Position in Richmond, VA

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    Default CPC, Looking for Coding Position or Billing Mgr. Position in Richmond, VA

    AAPC: Back to School
    I’m knowledgeable of third party rules and regulations including Medicare, Medicaid, and BCBS. Customer focused, providing service consistently exceeding expectations to both internal and external customers. I communicate clearly and concisely both verbal and written. I’m also proactive, assertive, articulating knowledge and understanding of payer claims processing philosophies. I have more than ten years of experience as a Medical Billing Specialist. I am skilled on various computer systems which include Caremedic, Obr, Gpms, Misys, SMS, Emdeon, Premis, Healthport and billed UB04’s and HCFA 1500 forms. I have knowledge of CPT, ICD-9 and CPC certified. I’m knowledgeable in Physician and Hospital Billing. I’m dynamic, detailed oriented, hardworking, leader and a team player. I’m also people-oriented with strong inter-professional skills and the ability to build lasting relationships and an entrepreneurial spirit; and enjoy reaping the rewards of my efforts. The enclosed provides a more detailed description of my skills.


    • May 2010 Practice Integrity
    Richmond, VA
    AAPC Certification

    • January 1999 High Hopes Medical Billing & Coding
    Paterson, NJ
    Medical Billing Certification

    Professional Experience:

    06/07 – Present Billing Specialist - Universal Health Services Inc.

    • Completes all third party electronic and manual billing timely and accurately in accordance with appropriate rules and regulations.
    • Completes all payer specific edits identified through billing system.
    • Resolves issues associated with incomplete claims including follow up on non-transmitted claims.
    • Submit adjustment claims to Medicare/Medicaid through use of online systems.
    • Attaches appropriate documents when billing manual claims including ER reports, itemized bills, implant invoices and other medical reports.
    • Work daily assigned reports.
    • Records daily productivity of claims billed and assures proper documentation in the notes of the patient accounting systems.
    • Completes all monthly required in-services and educational training as required.
    • Worked special projects to increase revenue and reduce debt.
    • Proficient knowledge of value codes, condition codes and modifiers

    11/06 – 04/07 Patient Representative - Southside Regional Medical Center

    • Assist patients in applying for county program (SLH & Medicaid).
    • Reviewed patient files to determine who meets the requirements for discounts -work with patients and guarantors to secure payment on outstanding account balances.
    • Communicated with patients and insurance companies regarding payment delays.
    • Possess verifiable knowledge of managed care protocols for coverage, based on illness/injury and whether provider is in or out of network.
    • Possess in-depth understanding of claim denials and actions required for insurance payment/resolution.
    • Filling claims, working follow up, posting payments, working denials and appeals.

    02/2000 - 02/2006 Advanced Receivables Strategies - Madison, Tennessee
    Project Manager
    • Determine the frequency and content of status reports from the project team, analyze results, and troubleshoot problem areas.
    • Direct and manage project development from beginning to end.
    • Estimate the resources and participants needed to achieve project goals.
    • Negotiated with other department managers for the acquisition of required personnel from within the company.
    • Compute monthly unpaid claim liabilities and retrospective refund liabilities and write offs.
    • Direct and manage project development from beginning to end.
    • Maintained superb customer relations by responding to clients’ needs and requests.
    • Identify and resolve issues and conflicts within the project team.
    • Coach, mentor, motivate and supervise project team members and contractors, and influence them to take positive action and accountability for their assigned work.
    • Traveled from assigned projects in the U.S. to produce accelerated revenue.
    • Identify and manage project dependencies and critical path.
    • Develop and deliver progress reports, proposals, requirements documentation, and presentations.
    Last edited by raquel.tharpe@uhs.com; 05-21-2011 at 07:40 PM.

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