Summary

• Committed and motivated specialist certified iMedical Billing and Coding and have experience working ia medical office environment.
• A reliable and competent Medical Billing professional with proficient data entry and customer service skills.
• A Highly organized and meticulous individual with experience both withia corporate office setting, as well as, ia doctor's office setting.

Skills Highlights

Experience

Confidential

Lead Certified Medical Claims Analyst NRCCS

• Assures compliance with applicable laws and regulations related to billing
• Assists Billing Manager and Director with performing billing analysis to ensure that the Billing Department is
• maximizing cash receipts
• Assists with analyzing and monitoring denial trends amongst various payers
• Opetickets with Success EHS to troubleshoot issues
• Assists the Billing Manager with implementing processes and procedures to improve staff efficiency
• Assists with ongoing training of Billing staff as well as Front staff as directed by Billing Manager and /or

Director

Confidential

Certified Medical Claims Analyst NRCCS

• Withi90 days iBilling Department brought iover a total of 100,000.00 and continual monetary flow for
• claims worked
• Processed oaaverage of 60 claims daily
• Claim follow up to ensure continual payment flow and claim and coding corrections
• Process secondary claims for all insurances
• Charge Entry backup prepare claims before claim transmissiovia EHS
• Key Medicaid claims via Medicaid Web tool
• Process commercial insurance
• Proficient iMedicaid HMO insurance plans and processes Select Health, Well Care , United Community
• Plaand Blue Choice Medicaid, Absolute Total Care, Molina
• Claim follow up for payment after withi10-15 days after nonpayment
• Post Medicaid payments via EHS system
• Process and prepare claims for the Cooperative Special Contracts DHEC Sterilizations, Best Chance ,
• Healthy Learners, Fathers and Families and SCPHA Migrant Workers Program

Confidential

Team lead OBGYClinic

• Assisted Practice Manager at Waverly Women's Center with any and all tasks that was requested as Team lead
• Ensure proper patient flow from pt check ito check out
• Checked patients iand out daily
• Assisted Doctors with their productivity as well as any issues with personal schedule blocking
• Assisted Doctors and Medical staff with basic Clinic Console issues and or contacted IT support to ensure
• efficient patient flow
• Provided assistance to any patient questions and or addressed any concerns
• Called patients back to assist with scheduling and any other needed requests
• Trained current PSR to take my positioafter being transitioned to Billing Department
• Very effective communicator

Confidential

Policy Holder Services

• Reviewed and explained insurance plans to pt to guarantee full understanding of payment policies and procedures
• Successfully resolved 60-65 of customers issues daily by corresponding to policyholders via phone, fax, and emails
• Processed simple claims via Fast Pay
• Advised of payment for services rendered, obtained payment, processed via billing system
• Met or exceeded departmental quotas relating to calls, and quality service

Confidential

SR. Customer Service Representative

• Promoted to Senior Customer Service Rep and hand- picked to work with special projects and escalated calls
• Handled customers effectively by identifying needs, quickly gaining trust, approaching complex situations and resolving problems to maximize efficiency

Performed technical troubleshooting

• Change pricing plans and add features promoting products and services
• Contributed with assistance of New Hires iboth the classroom and othe floor
• Effectively promoted products and services that met the customer current and future needs
• Consistently praised by management for the quality and timeliness of assisting customers, attentioto detail, and a team-player attitude

Experience

Confidential

Site Supervisor

• Supervised and oversaw daily site operations for staff of 3-5 adults and 40-55 children
• Collected weekly tuitiopayments and ensured accurate informatioof account balance
• Increased customer loyalty by providing constant feedback ochild's progress and acceleratioieducational activities

Confidential

Medical Office Assistant

• Assisted ibilling department with filing and mailing CMS1500 forms
• Handled, processed and distributed confidential patient information
• Accurately verified insurance information, got authorizatiocodes and referrals
• Prepared folders and maintained records of newly admitted patients and accessed patients' chart for next day duties
• Precisely copied physician-dictated reports and processed requests for copies of patients records
• Managed front desk duties during needed times

Confidential

Lead Certified Medical Claims Specialist NRCCS

• Assures compliance with applicable laws and regulations related to billing
• Assists Billing Manager and Director with performing billing analysis to ensure that the Billing Department is
• maximizing cash receipts
• Assists with analyzing and monitoring denial trends amongst various payers
• Opetickets with Success EHS Greenway Systems to troubleshoot issues
• Assists the Billing Manager with implementing processes and procedures to improve staff efficiency
• Assists with ongoing training of Billing staff as well as Front staff as directed by Billing Manager and /or

Director

Confidential

Certified Medical Claims Specialist NRCCS

• Withi90 days iBilling Department brought iover a total of 100,000.00 and continual monetary flow for
• claims worked
• Processed oaaverage of 60 claims daily
• Claim follow up to ensure continual payment flow and claim and coding corrections
• Process secondary claims for all insurances
• Charge Entry backup prepare claims before claim transmissiovia EHS
• Key Medicaid claims via Medicaid Web tool
• Process commercial insurance
• Proficient iMedicaid HMO insurance plans and processes Select Health, Well Care , United Community
• Plaand Blue Choice Medicaid, Absolute Total Care, Molina
• Claim follow up for payment after withi10-15 days after nonpayment