Patricia Ituen

770-***-**** - aca7vd@r.postjobfree.com

QUALIFICATION PROFILE

. Hardworking, motivated, energetic, dedicated, and professional

individual able to serve clients in a conscientious and pleasant

manner

. Possess high degree of accuracy in reviewing medical records to

determine whether or not the documentation substantiates the coding of

the claims submitted for reimbursement

. Experienced Medicare and Third Party claims processor with billing,

posting deposits/payments, collections, and reconciling accounts in

accordance with company guidelines

. Ability to work in a fast paced environment and handle multiple tasks

at the same time

. Outstanding oral and written communication skills.

EDUCATION

Ashford University, Clinton, Iowa

M.A. Healthcare Management June 2010

Clark Atlanta University, Atlanta, Georgia

B.A. Business Administration/Management May 28, 1998

Richland College, Dallas, Texas

Associates of Science/Computer Information Systems May 1990

COMPUTER SKILLS: All Microsoft Applications, Citrix, GE Centricity,

Greenway Medical, Fortis, eCSO, DMS Data Management Services.

PROFESSIONAL BACKGROUND

Chartis

3650 Brookside Pkwy

Alpharetta, GA 30350

Examiner/Claims set up 08/13/2009-08/2012

Responsible for processing specified medical claims in accordance with

contract provisions using established policies and procedures. Meet

accuracy and productivity goals in order to maintain and exceed

performance standards. Read and interpret insurance policies prior to

claim set up for accurate payment processing. Examined and processed

paper claims and/or electronic claims or make the determination to

proceed with the adjudication process. Followed established departmental

policies and procedures, operating memos and corporate policies to

resolve claims and claims issues. Settled claims with claimants in

accordance with policy provisions. Compared claim application and/or

provider statement with policy file and other records to evaluate

completeness and validity of claim. Interacted daily, with agents and

claimants by mail or phone to correct claim form errors and investigate

questionable entries.

Health Systems

1100 Johnson Ferry Rd #220

Atlanta, Georgia 30342 10/2007-03/02/2009

MEDICAL BILLING ADMINISTRATOR

Responsible for reviewing medical records to determine whether the

documentation substantiates the coding of the claims submitted for

reimbursements. Recorded the results of reviews in company database, and

referred claims to nurses and physicians for further review when

necessary. Performed daily Deposits, posted payments read EOB'S to

determine true and correct payment has been received Via Contract

guidelines. Electronically submitted charge(s) to Medicare, Medicaid

commercial carriers and hospital charges for Cardiologists and Internal

Medicine Doctors. Executed reports and reviewed and corrected electronic

billing errors. Updated patient accounts and demographic information

daily. Posted and adjusted charges daily. Reviewed and executed

financial month-end and aging reports daily. Researched and resolved

incorrect payments, EOB rejections, and other issues with denied claims.

Reviewed billing edits and provided insurance providers with correct

information. Closed and balanced batches daily.

Medical Staffing Resources

9755 Dogwood Rd., # 200

Roswell, Georgia 30075 03/2007-09/2007

PATIENT ACCOUNT MANAGER

Managed high-volume patient accounts/issues while providing resolutions

to claims. Continually maintained open communication with customers and

insurance companies to resolve billing issues. Collected past due

payments from patient's and insurance companies. Appealed denied charges

for payments and billed patients for balance due daily. Generated

delinquent account reports for 190+ to collection agencies monthly.

Posted and adjusted charges daily. Executed financial reports for month-

end and aging reports over 90+ for review. Created and entered patient

demographic data as well as insurance data ensuring accuracy and

attention to detail.

Cardiovascular Physicians of North Atlanta

1285 Upper Hembree Rd.

Roswell, Georgia 30076 03/2004-03/2006

MEDICAL REPRESENTATIVE

Executed all aspects of medical billing to ensure every charge was

captured and submitted to various insurance companies and subsequent

payments were received. Created and entered patient geographic data as

well as insurance data, while ensuring accuracy and attention to detail.

Efficiently managed telephone and in-person inquiries related to billing,

insurance, pre-certification and general information. Collected and

processed patient information from private insurance and

Medicare/Medicaid for use by collection agencies, physicians, and

business managers. Posted and adjusted charges daily. Executed month-end

reports to determine whether the documentation substantiates accurate

reimbursement.

Promoted to Billing Manager, May 2005. Management of billing department

duties included the training of billing department employees in addition

to providing direct assistance to all aspects of the billing department

and resolution of departmental/ customer service issues.

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