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Revenue Cycle Management /Customer Service Medical

Location:
Fort Worth, TX
Posted:
January 06, 2015

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Resume:

VICTORIA DANIEL

**** *****, **** *****, ** ***** (C) 817-***-**** acg9s1@r.postjobfree.com

Professional Summary Sr. Customer Service Rep - Billing with background in billing and collections, records management and maintenance and appointment setting. Desires a role in a medical office environment.

Medical billing and coding specialist with 13 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.

Efficient Medical Administrative Assistant skilled in tackling administrative and patient-oriented tasks in a fast-paced environment.

Patient-oriented Medical Receptionist with strong attention to detail, professional telephone etiquette and organization skills.

Medical Billing Specialist - Collector - Administrative Assistant Skills

Medical terminology expert Billing and collection procedures expert Records management professional Inpatient records coding proficiency Records maintenance professional Office management professional Excellent problem solver Resourceful and reliable worker Close attention to detail Adept multi-tasker Office support (phones, faxing, filing) Excellent verbal communication Work History

Outpatient surgery coding specialist Patient referrals expert HCPCS Coding Guidelines Familiar with commercial and private insurance carriers Insurance and collections procedures DRG and PC grouping Understands insurance benefits Composed and professional demeanor Research and data analysis

Sr. Customer Service Rep 04/2002 to Current Quest Diagnostics – Irving, TX

Correctly coded and billed medical claims for various hospital and nursing facilities. Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge. Submitted electronic/paper claims documentation for timely filing. Accurately posted and sent out all medical claims. Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations. Prepared billing correspondence and maintained database to organize billing information. Printed and reviewed monthly patient aging report and solicited overdue payments. Accurately posted surgeries, hospital visits and payments for assigned carriers. Compiled and tracked outstanding balances owed to medical facilities. Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable. Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house. Confidently and adeptly handled claim denials and/or appeals. Identified and resolved patient billing and payment issues. Posted and adjusted payments from insurance companies. Precisely evaluated and verified benefits and eligibility.

Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms). Maintained updated knowledge of coding requirements, through continuing education and certification renewal. Adeptly managed a multi-line phone system and pleasantly greeted all patients. Entered orders into the EMR system efficiently and without errors. Diligently filed and followed up on third party claims. Assigned appropriate medical codes with a 90 percent accuracy rate. Managed and updated donor information in databases. Accurately selected the proper descriptive code when more than one anatomical location was indicated. Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy. Maintained strict patient and physician confidentiality. Resourcefully used various coding books, procedure manuals and on-line encoders. Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories. Education MBA: Management Information Systems 2009 Dallas Baptist University - Dallas, TX BBA: Accounting 2007 Dallas Baptist University - Dallas, TX Affiliations AHIMA - Member American Health Information Management Association

ISACA - Member Information Systems Audit & Control Association Certifications

American Health Information Management Association Certification (AHIMA)



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