Medical billing and coding position requiring translation of physician records to properly submit claims to insurance companies for reimbursement.
â€¢Advanced Word processing (Word 2007 for Windows)
â€¢Keyboarding at 70 words per minute
â€¢Spreadsheet generation with Excel
â€¢Electronic Medical Record (Meditech, NaviNet and MediSoft)
â€¢Electronic Claim Submission (Navicure)
â€¢ICD-9, CPT, and HCPCs
â€¢Experienced in Medicare claim submission and appeals processes (TrailBlazer, Noridian, and Palmetto GBA)
â€¢Benefit Verification and Preauthorization Request submission
Associate of Occupational Studies, anticipated graduation in June 2011, Institute of Business and Medical Careers
Emphasis: Medical Billing and Coding
Honors: Deans List and Alpha Beta Kappa National Honor Society
Related Courses and Skills
â€¢Anatomy and Physiology
â€¢Medical Law and Ethics
â€¢Medical Billing and Collections
Foot Surgery Center of Northern Colorado July 2010-March 2011
Surgery Coordinator/Surgery Coding/Surgery Billing
â€¢Schedule all surgery cases to be performed at the Foot Surgery Center and outside facilities (such as Poudre Valley Hospital and the Surgery Center of Fort Collins).
â€¢Verify Insurance benefits (obtaining prior authorization if necessary) for each surgery scheduled, calculate an estimate for the patient utilizing contracted allowed amounts, notifying the patients of their financial responsibility and making financial arrangements if necessary.
â€¢Code for each surgery performed (for both the physician and the facility, when done at FSCNC), verify the coding matches up with the operative report and prepare the patients chart to be sent to the outsourced billing company.
â€¢Track patient and insurance payments, surgery production per surgeon, and monthly totals.
â€¢Research and validate overpayments made by patients and insurance companies, through coordination with the outsourced billing company.
Centers for Gastroenterology August 2008-July 2010
Medicare Follow-Up/Billing/Physician Credentialing/Patient Check-Out
â€¢Follow-Up with Medicare claim denials, appealing when necessary and determining who is responsible for payment.
â€¢Bill Medicare using Medicare specific guidelines regarding coding, patient eligibility and screening, and patient responsibility.
â€¢Created guidelines that are in line with Medicare to create more efficient payments from Medicare and less denials from incorrectly billed claims.
â€¢Complete responsibility for all aspects of Physician Credentialing related to the specialty of Gastroenterology for an office consisting of four physicians. This includes maintaining and renewing state medical licenses, DEA registrations, malpractice liability insurance policies, insurance contracts, hospital privileges, and board certifications.
â€¢Verify patient insurance benefits before seen in the office to determine what pre-requisites are needed, if any, and what kind of financial responsibility the patient will have.
â€¢Check patients out after they have seen the physician, collect any copays or past due balances, and schedule any follow-ups or procedures that the physician has requested.
â€¢Involvement in the collections process that includes calling patients with past due balances to set up payment arrangements and sending patient balances to a Collection Agency when the patient is not able to make a payment within a reasonable amount of time.
Poudre Valley Hospital May 2007-August 2008
Patient Services Representative/Receptionist - Fort Collins, CO
â€¢Register patients for various medical services in the hospital, including laboratory, inpatient/outpatient services, physician or other medical office procedures by obtaining demographic information, validating insurance and receiving payments.
â€¢Using a general understanding of how insurance is billed and obtaining appropriate information from the patient to ensure a payment from the insurance provider and keeping follow-up on the backend minimal.
â€¢Perform bedside registration with all direct admit patients while ensuring the registration is completed accurately and in a timely manner.
â€¢Answers and/or refers questions received from patients, visitors, and staff as appropriate as well as guide them throughout the hospital and direct them to the appropriate departments.
â€¢Coordinate registrations for clerks through scheduled procedures and procedures added on, while monitoring patient wait time and pulling additional resources when necessary while communicating the flow of business to Team Leads.
â€¢Organize and coordinate the daily schedule for most outpatient procedures such as Radiology, Ultrasound, MRI/CT, Nuclear Imaging, Respiratory Therapy, Cardiovascular Lab, Heart Center, and the Center for Gastric and Special Procedures.
â€¢Responsible for answering all calls directed to Admitting and taking information for add on procedures, answering questions from patients or other departments within the hospital, and directing various phone calls to the appropriate person.
â€¢Work closely with the Admission Nurse to ensure prompt placement of patients and provides notification on arrival of all Direct Admits.
Professional Certifications and Associations
â€¢Certified Professional Coder â€“ Apprentice (AAPC), Effective April 16, 2011
â€¢Certified Medical Billing Specialist (MAB), Effective April 15, 2011
â€¢American Academy of Professional Coders (AAPC) Membership, Since February 29, 2011
â€¢Medical Association of Billers (MAB) Membership, Since April 1, 2011