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Reimbursement Specialists Resume Profile

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OBJECTIVE Seeking an administrative/clerical position in a medical facility in Spartanburg

EXPERIENCE

Confidential

  • Billing Insurance Department Manager
  • Manage all employees in the billing / insurance department
  • Keep up Credentialing for all providers
  • Enter new CPT, ICD-9CM, and HCPCS codes into operating system
  • Audited random patient encounters
  • Assist with claim denials after failed attempts
  • Review approve refunds for both patients and insurance
  • Review and approve all EFT/EOBs prior to posting
  • Approve all past due accounts to be sent to outside collections agency
  • Work multiple types of reports upon request

Confidential

Coding / Reimbursement Specialists Level II

  • Explained how to correct denied claims or adjust if needed and why
  • Reviewed electronic medical records to determine if billed claim was correct
  • Acted as a recourse for the Underpayments Dept. for coding questions
  • Reviewed and approved insurance refunds requests

Confidential

  • Billing and Insurance Specialist
  • Updated all encounter forms with new CPT, ICD-9CM, and HCPCS codes
  • Entered new CPT, ICD-9CM, and HCPCS codes into operating system
  • Posted patient/insurance payments/adjustments and medical/cosmetic charges
  • Corrected/re-filed/appealed claims denied by all insurance carriers
  • Filed insurance electronically, worked insurance denials from clearing house
  • Identified and corrected CPT, ICD-9CM, and HCPCS coding errors
  • Audited random patient encounters monthly
  • Explained EOBs and billing questions to patients by phone/ in office
  • Trained all new dept. employees
  • Assisted with transition to 5010

Confidential

Medical/Office Assistant

  • Scheduled office/ referral appointments assisted with answering telephone
  • Escorted patients to exam room took vital signs documented reason for visit
  • Assisted doctor with procedures
  • Gave shots sent/received shot records on patients
  • Consulted doctor on triage calls called patients with recommendation
  • Entered all labs in computer pulled new lab reports for doctor to review
  • Pulled and filed charts requested patients' records from other offices
  • Maintained temperature log for freezer/refrigerator maintained supply list

Confidential

Administrative Assistant

  • Answered telephones requested service calls
  • Typed/prepared correspondence and maintained filing system
  • Coordinated office calendar distributed mail and faxes
  • Coordinated scheduling of closings among all parties involved
  • Oversaw all newspaper advertising
  • Assisted Officer Manger in troubleshooting computer problems

Confidential

Front Desk Receptionist part-time

  • Answered telephones checked patients in and out
  • Filed correspondence and patient records mailed new client letters
  • Made reminder calls for appointments printed/mailed reminder cards
  • Accepted payments filled prescriptions called-in prescriptions
  • Confidential Medical Records Assistant temporary/part-time
  • Sorted, distributed and delivered mail answered telephones
  • Managed petty cash made bank deposits
  • Obtained, faxed and mailed patients' records filed records into charts
  • Traveled to hospital to pick-up paperwork for doctors

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