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

  1. Default CPC, Looking for Coding Position or Billing Mgr. Position in Richmond, VA
    Medical Coding Books
    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; 05-21-2011 at 07:40 PM.

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