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Insurance Manager

Location:
Alton, IL
Posted:
September 29, 2014

Contact this candidate

Resume:

Tami L. Austin PO Box *** Highland Il *****

MEDICAL OUTSOURCING Phone (618)654-

3800

www.linkedin.com/in/TamiAustin

acf6ro@r.postjobfree.com

Highlights of Qualifications:

. Nearly 20 years of experience in ICD9, CPT, HCPCS coding and billing.

. Knowledge in EMR

. 17 years of inpatient, outpatient, and surgical hospital coding and

guidelines

. Medical Records for office and hospital

. Inpatient and Outpatient coding using CPT and ICD9 for Shepherd Center

and Piedmont Hospital both in Atlanta, Georgia

. I have thorough understanding in inpatient ICD9 and CPT guidelines.

. Highly skilled in coding and abstracting medical records by adhering

to present policies and guidelines.

. Proficient in carrying out the business use of computer and hardware

and software to ensure quality of processing.

Special Skills:

. Extensive knowledge with inpatient hospital coding.

. Knowledge and experience with EMR

. Strong understanding of Private Insurance, Medicare, and Medicaid

programs.

. Extensive knowledge in Medical Terminology.

. Excellent communication skills

. In depth knowledge of preparing appropriate claims document.

. Proficient in assigning appropriate medical codes to diagnosis and

services

. Surgical Authorization and surgical scheduling

Accomplishments:

. Voted employee of the year for minimum coding or billing errors.

. Obtained honors for on the job training for medical coding

Experience:

ChiChi Berhane M.D./ Independent Contractor

PRACTICE MANAGER of CODING AND BILLING

August 2013-Present

ChiChi Berhane MD - 404-***-****

Scheduling, Billing, Coding, and Collection Manager:

. Code inpatient, outpatient, surgical, and consult claims using the CPT

book and ICD9 and reviewing the use of ICD10 book before sending them

to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Scheduling daily office appointments

. Scheduling inpatient consult visits

. Scheduling Surgery Room procedures

. Obtaining authorization for surgery via insurance companies

. In charges of Surgery schedule for the provider

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Shepherd Center-Spinal Cord/Brain Injury

BILLING SPECIALIST

August 4, 2014 - Present

Jennifer Dennard - 404-***-****

. Review codes billed for inpatient consult claims using the CPT book

and ICD9 and reviewing the use of ICD10 book before following up with

them to various insurance companies. Medical Computer Programs used

daily and affiliated with Shepherd: Nextgen, SMS, Touch Chart, Lotus,

HIM Portal, and Clinical Portal

. Called and answered phones to assist insurance companies with account

questions or requests.

. Follow up on all outstanding claims

. Send out daily billings to insurance companies at their request

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Handle all of the physician's insurance contract negotiations.

. Send medical records or any requested information to insurance

companies

. Research refund request from insurance companies

Arthur J. Simon, M.D./ Independent Contractor

PRACTICE MANAGER

August 1998- August 2014

Arthur Simon MD - 404/694-6158

Office Manager / RN - Jane Norman - 404-***-****

Human Resources - Pamila Glowacki - 678/358-4589

Scheduling, Billing, Coding, and Collection Manager:

. Case management

. Code inpatient, outpatient, surgical, and consult claims using the CPT

book and ICD9 and reviewing the use of ICD10 book before sending them

to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Scheduling daily office appointments

. Scheduling inpatient consult visits

. Scheduling Surgery Room procedures

. Obtaining authorization for surgery via insurance companies

. In charges of Surgery schedule for the provider

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Core Physicians Group / Independent Contractor

May 2013 -June 2014

Jordan Vickery DC - 618/654-3000

Billing, Coding, and Collection Manager:

. Code all claims using the CPT book and ICD10 book before sending them

to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Metro East Surgical Specialty / Independent Contractor

November 2007-August 2011

Keith Thomae MD - 618/654-8100

Billing, Coding, and Collection Manager:

. Code outpatient ambulatory surgical center claims using the CPT book

and ICD10 book before sending them to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Xerex Anesthesia / Independent Contractor

March 2010-August 2011

Keith Thomae MD - 618/654-8100

Billing and Collection Manager:

. Code all anesthesia using the CPT, HCPCS, and ICD9 book before sending

them to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Highland Ambulatory Surgical Center / Independent Contractor

March 2010-August 2011

Keith Thomae MD - 618/654-8100

Billing, Coding, and Collection Manager:

. Code all facility claims on the UB04 forms using the CPT book and ICD9

book before sending them to various insurance companies.

. Answer phones and assist patients and insurance companies with account

questions or requests.

. Send out daily billings to insurance companies and patients.

. Keep track in daily receivables.

. Collections and Receivables Desk included calls on all accounts after

30 days to collect payment.

. Set up negotiated fees with attorney's offices and insurance

companies.

. Physician's credentialing:

. Handle all of the physician's insurance contract negotiations.

. Transcription Manager: Convert voice transcribed office notes,

operative reports, facility notes, history and physical reports,

admission reports, inpatient consults, discharge notes, letters of

medical necessity, Independent Medical Evaluations, durable medical

equipment reports, and documentation after medical records review in

to typed reports using transcriber and/or dragon. Experience with

EMR system. Use of digital dictation and real time speech to text.

Center for Pain Management / Independent Contractor

Oct 2003-May 2004

Doctor Kabakibou - 404/603-9090

Collections Desk:

. Temporary help on seriously aged claims.

. Collected payments for seriously past due services, which was not

collected by his previous employees.

. Posted payments as they came in

. Followed up with insurance companies via phone or email.

. Printed claims mailed and faxed claims upon the request of various

insurance companies.

South Trust Bank / Independent Contractor

May 1999-September 2000

Michael Haber - 404/815-3500

Collections Desk:

. Temporary help on seriously aged claims for a physician who closed his

office.

. Collected payments for seriously past due services, which was not

collected by his previous employees.

. Posted payments as they came in

. Followed up with insurance companies via phone or email.

. Printed claims mailed and faxed claims upon the request of various

insurance companies

. This was help for medical provider whom went bankrupt to help the

doctor and bank clear their account was reason for such a short and

quick period.

. Transcription: Convert voice transcribed medical necessity reports

using transcriber and/or dragon into written form. Created medically

necessary reports to insurance companies as needed.

Wound One Inc.,/ Independent Contractor

February 2000-September 2000

Roger Norman / Closed

Daily Duties:

. Credentialing contracts for the new Durable Medical Equipment Company.

California Emergency Physicians/Modesto, CA

March 1995 - August 1998

Mike Wells / Relocated

Daily Duties:

. Daily coding using the CPT, ICD9, and HCPCS books. After reviewing

the emergency room record I would determine the appropriate codes to

bill to each insurance company.

. Send bills to all insurance companies daily.

. Follow up with all insurance companies on outstanding and unpaid

bills.

. Post payments

Education:

Al-Med Academy, St. Louis, MO Certified Medical Assistant

Belleville Area College, Belleville, IL General Courses

AAPC Member

Billing/Coding Specialist

BOTH PERSONAL AND PROFESSIONAL REFERENCES AVAILABLE UPON REQUEST



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