Cynthia L. Gooch

**** ******* **. *** #*, Houston, TX 77004, 210-***-**** acp9i5@r.postjobfree.com

SKILLS & QUALIFICATIONS

Front Office & Administration, Checking In/Out Patients, Scheduling Appointments

Insurance Verification, Authorization Requests, Referral Coordination

HMO, PPO, WC, Medicare, Medicaid

MS Office (Word, Excel), GE Centricity, Med iSOFT, Versus

Medical Billing & Collections, American Professional Coders Member (Non Certified)

Specialties (Anesthesia, Obstetrics, Rehab, Neurosurgery, Dermatology, OBGYN, Peripheral Vascular, Internal Medicine)

EXPERIENCE

Emergency Groups Office San Dimas, CA 03/2014-05/2015

Medical Lead Chart Coordinator

Gathering/retrieving remotely protected health information (PHI) of all patients treated by Emergency Room physicians.

Responsible for forwarding via secure email, courier, scanning or faxing all patient record documentation of EGO in a timely manner to facilitate timely coding and billing.

Maintain the responsibility of eight data sets (hospitals).

Monitor client’s shortage accounts (no greater than 90 days with target goal of 2%).

Facilitate record completion process.

Responsible for the communication with field chart coordinators

Travel, if necessary, to carry out all responsibilities in accordance with company policies and procedures.

Pain Management & Wellness Center San Antonio, TX 03/2011 - 08/2013

Pre-authorization/Referral Coordinator

Responsible for obtaining preauthorization's for outpatient & surgical care, diagnostic testing & special circumstance requests.

Maintain a working knowledge of insurance policies, coding procedures and changes to ensure authorization and maximum payment for services.

Provide direct support to clinical staff regarding education and questions for eligibility and benefit coverage.

Triage of denials, to research and assist in gathering required documentation needed to resolve and appeal outstanding medical authorizations.

Direct interface between physician, patients & referring physicians.

Assist front office with scheduling clinical and surgery appointments, approximately 30 per day

Dr. Patricia Burden, Dermatologist San Antonio, TX 10/2004 - 03/2011

Office Administrator

Responsible for the organization and management of Dermatology office.

Maintain all front office responsibilities which include but not limited to: Verification of all insurances, new & previous patient scheduling; release of medical information; prior authorization & scheduling follow up examinations & surgical procedures.

Process and transmit daily medical billing to provide maximum payments for services.

Audit appeals & collection accounts.

Provide monthly patient billing statements via electronic & Manuel processing; daily, monthly & yearly reports.

Provide direct support for clinical spa clients during non-medical office hours.

Point of contact for Physician's personal activities and business schedules.

Neurosurgical Associates Of San Antonio San Antonio, TX 03/2003 - 10/2004

Medical Billing Specialist

Quickly evaluate & enter all patient demographics and medical information to determine the appropriate type of medical insurance for proper destination.

Responsible for verification and processing of Physical Therapy insurance claims, accounts receivable, collections & patient billing.

Work closely with Workers Compensation cases and Attorney LOP cases for reimbursement on unresolved balances.

Assist clinical coordinator when necessary.

Anesthesia Practice Management, San Antonio, TX 03/1997 - 03/2003

Medical Billing Coordinator

Manage and coordinate medical billing staff in processing medical claims through electronic & HCFA data processing for Anesthesiologist & Pain Management services.

Coordinate verifications, denials & appeals, adjustments, secondary claims processing & collection accounts.

Maintain monthly, quarterly & yearly reports for Physicians & Accountants.

South Texas OBGYN Associates, San Antonio, TX 06/1996 - 03/1997

Medical Billing/Referral Coordinator

Business Office for eight Obstetricians.

Acquire authorizations & referrals for inpatient & outpatient procedures.

Work closely with referring physician's offices and hospitals to obtain surgical schedules for verification of insurance coverage.

Audit patient accounts & process weekly & monthly statements.

Update & maintain current reports on patient's deliveries.

Assist Office Manager & front office during peak office hours.

San Antonio Gastroenterology Associates, San Antonio, TX 04/1995 - 06/1996

Medical Account Receivable/Data Entry

Input and process health insurance claim payments for multi-physician's office.

Balance & audit patient accounts for twelve physicians.

File and forward secondary claims and process appeals.

Maintain daily & monthly account receivable reports.

Update accounts and collect co-insurances and patient balances prior to surgical procedures.

Provide assistance to incoming patients.

Assist administrator with bank transfers and daily deposits.

Internal Medicine Associates, San Antonio, TX 11/1990 - 04/1995

Medical Insurance Receptionist

Perform duties of medical claim processer for fast pace medical office.

Code and process daily super bills for office visits, laboratory charges, inpatient, outpatient, nursing home, patient home care services.

Post all incoming insurance payments.

Verify insurance benefits & updated all demographics.

Provide services to incoming patients.

Collect copayments, co-insurances & patient balances.

Process monthly statements.

Close out daily transactions and process daily bank deposits.

Lillian Martin Jones, San Antonio, TX 11/1990 - 06/1998

Physician Secretary

Perform duties as Secretary to Physician.

Schedule inpatient and outpatient appointments and surgical procedures.

Process all medical claims and appeals.

Obtain all authorizations with area healthcare facilities.

Process reimbursements, collections, audits and monitor deliveries.

Conduct weekly and monthly staff meetings.

Provide assistance to clerical and nursing staff.

EDUCATION:

Highlands HS, San Antonio, TX (Diploma 1975)

St. Phillip’s College, San Antonio, TX (General Office Certificate)

Texas Southern University, TX (Education – 36SH)

Professional References Available Upon Request

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