Mary R. Nungesser, CPC, CMCS

Certified Medical Coding Specialist

Cell :703-***-**** Email: adhw07@r.postjobfree.com

Home:703-***-****

CAREER SUMMARY

Certified Medical Coding and Billing Specialist, with extensive hands-on experience, managing many different account specialties. Throughout my career, I have had the opportunity to work in Podiatry, Pathology, Internal Medicine Otolaryngology and Behavioral Health. Comprehensive knowledge of Revenue Cycle Management, EMR, DME, Workmen’s Compensation, CPT, and ICD-10-CM. CPC Certification/AAPC and CMCS Certification /American Medical Billing Association.

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PROFESSIONAL EXPERIENCE

Independent Contractor/ Medical Coding and Billing 07/2018-Present

Certified Medical Coding and Billing Account Specialist

Multispecialty, CPT and ICD-10 Coding for Physicians and Surgical Procedures.

Provides education to the providers to ensure proper completion Of Electronic Health

Records and proper assignment of CPT and ICD-10 codes.

Accurately codes office and surgical procedures for providers to ensure proper reimbursement.

Recommended and changed processes for change, to improve workflow, to enhance billing procedures for rapid reimbursement,

Performs overall revenue management including, timely filing requirements and maximizing billing revenue and collections, and resolution of denied/rejected claims.

Submits claims via Electronic Clearing House. Monitors clean code submissions.

Monitors monthly aging reports and conduct follow-up on unpaid claims and take appropriate action to correct and re-bill for reimbursement.

Identify, researches and resolves system issues through direct contact software vendors and encoder.

Provide technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for billing.

Researches and maintain billing compliance and regulations

Increased profitability of revenue by 90%

Try Remedy Advocate, Auditor/ Independent Contractor 10/2015- 7/2018

Auditing, insurance company data, inpatient, outpatient, and physician, charges (procedure and diagnosis codes) for discrepancies, on the behalf of Remedy Labs.

Patient advocate assessing patient's medical bills, incurred from, physicians, hospitals, and lab bills. Evaluating all charges, to ensure corrective billing (procedures and diagnoses)

Negotiate, significant reductions and payment plans, the behalf of the patients.

Research and negotiate discounts, financial aid for uninsured patients Reviewing payments, and or, underpayments, reimbursed, by the insurance company

Resolve discrepancies on the behalf of client's, insurance company, hospital, and physicians

Herndon Foot Clinic

Office Administrator / Billing Manager 05/1989- 01/2015

Supervise a team of five including, the front desk staff. Managed the day-to-day operations of a medical office, as well as medical billing and coding.

Developed and maintained office policies in conjunction with medical protocols

Implemented medical coding, and billing strategies for maximum profit.

Provided all medical billing, revenue cycle transactions, procedure coding and, ICD-10-CM to ensure the highest level of reimbursements

Use persistence and persuasive communication skills to advocate for physicians and/or patients with their insurance companies.

In-depth knowledge of managing insurance contracts and compliance.

Implementation of Electronic Interchange (EDI) conversion from 4010 to 5010 electronic billing, the establishment of EMR, E-prescribe for patients, as by the request of the physicians.

Executed office operations, workflow, time management, and office staff including recruitment, performance, management and training/development of a specialty practice

Handle all Accounts Payables together with medical and administrative expenses

Reconciliation of monthly bank statements, balance general ledger and prepare year-end reports

Accountable for bi-weekly payroll preparation including quarterly federal and state taxes

Managed employee relations, benefits and retirement accounts

Credentialing for Physician and new associates for all insurance companies and hospital

affiliations; strict adherence to HIPAA laws. Experience with CAQH.

SKILLS:

Proficient knowledge of medical terminology and anatomy. Strong medical coding skills. Knowledge of and ability to work with different medical software. Ability to perform detail-oriented work. Work well with others.

Education

Ocean County College.; AAPC American Academy of Professional Coders, CPC American AMBA American Medical Billing Association, CMCS.

Continuing education throughout my career.

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