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OBJECTIVE

It is my objective to obtain a position where the employer can utilize the skills that I have to offer them.

SUMMARY OF SKILLS

I have extensive experience with various types of insurance plans, as well as personal knowledge of Surgical, Radiology, Neurology, Ophthalmology, Anesthesia, Pharmacology procedures and more.

Medical Billing:

InfinEDI, Trailblazer Clearinghouses EDI, AMD, Patient Now, Medisoft, RPMS, HIS systems
Professional Hospital Claims Audit Processing Professional Hospital Audit Adjustments
Professional Hospital Payment Audit Adjudication Professional Hospital Billing Audit Corrections
Physician, Hospital, Outside Insurance Contacts Extensive Knowledge of Workers Compensation
TriCare/CHAMPUS/Commercial Insurance Government/State/County/City Contracts
CPT/HCPCS Code Levels Modifier Knowledge of ICD9 Code Training for ICD10
Audit Resolve Aged Account Reports Payments Extensive Knowledge of Anatomy Physiology
Extensive Knowledge of Medical Terminology Extensive Knowledge of Verification of Insurance
Extensive Knowledge of Health Insurance Process Insurance Appeals Audit Process
Secondary Insurance Guidelines Knowledge of TPL, TPB, EOB
Client Scheduling Resolve Client Dispute Resolution
Organized Analytical
Data Entry, Processing 45 wpm 10 key by touch
Internet Microsoft Office

Employers

Confidential

Third Party Claims Processing /Review, Medicare/NV Medicaid/Medi-Cal Claims Billing Process/Review, Commercial Claims Audit Process and Review, Audit and corrected 61 to 90 Day Report Claims Review and Recovery of None Pays/Adjustments/Denials, audit 91 to 120 Day Report Claims Review and Recovery of None Pays/Adjustments/Denials

Confidential

Plastic Surgery/Dermatological billing coding utilizing AMD electronic billing system PatientNow program, enter payments audit and research denials, work with insurance on audits of appeals including federal government agencies, audited aged account report.

Confidential

Lead in CHAMPUS Claims Audit, Review and Adjustments, Government Claims Audit, Review and Adjustments, Commercial Claims Audit, Review and Adjustments.

Confidential

Supervisor of Workers Compensation Claims Audit, Review, Adjustments, Adjudication and Appeals, Programs used were Medata and EDS, Trained employees on the new EDS program and wrote user friendly manual for it, Audited employees work progress, as well as unit production.

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