JAMES P. SANFORD

*** ****** ** *******, ** ***** 832-***-**** hiu5x1@r.postjobfree.com

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NTERPRISING, HARD-WORKING AND TECHNICALLY SKILLED ACCOUNTS PAYABLE/RECEIVABLE SPECIALIST known for accuracy, attention to detail and timeliness in claims processing for Healthcare-industry employers. A/R career spans 5 years of experience in insurance claim follow-up, applying appropriate adjustment types, insurance verification, appeals process,Explantion of Benefits including allowed amounts, discounts, in and out-of-network benefit levels, deductibles, coinsurances, and copays,Electronic and paper claims processing, ICD9 and CPT code knowledge, working knowledge of Special Instructions for carriers and practices.

KEY SKILLS

• Accounts Receivable Processes & Management

• Invoices/Expense Reports/Payment Transactions

• MS Windows, Excel, Power Point

• Medisoft Medical Software

• Centricity Medical Software • Medicare, Medicaid, BCBS and Tricare

• CMS 1500, UB-04

• Verification and Eligibility Benefits

• CPT, ICD-9, HCPCS Codes

• Reconciliation A/R

EDUCATION

Remington College, Houston, TX

Diploma in Medical Billing & Coding, 2010

Compsystems, Inc, New York, NY

Certificate in Medical Billing & Coding, 1994

AFFILIATIONS

Member, AAPC (American Association of Professional coders), 2010 to Present

TECHNOLOGY SUMMARY

MS Office (Word, Excel, PowerPoint) Medical Manager Medisoft Centricity IDX Windows (all)

PROFESSIONAL EXPERIENCE

eCardio Diagnostics, L.L.C., Houston, TX

Medical Collections, 5/11 To Present

• Daily follow-up of insurance claims

• Insurance Verification

• Explanation of Benefits

• Electronic and Paper claims processing

Big Jays Home Repair, Suffolk, VA & Houston, TX

Owner & Carpenter, 11/02 to 5/11

• Build or repair cabinets, doors, frameworks, floors, and other wooden fixtures used in buildings, using woodworking machines, carpenter's hand tools, and power tools

• Prepare cost estimates for clients or employers; maintain records, document actions and present written progress reports.

Sentara Health Systems Services, Norfolk, VA

Medical Biller/Insurance Verification, 5/97 to 11/02

• Billed commercial insurance claims; resolved customer inquiries concerning medical coverage or claim status

• Assign primary care physicians; reconciliation, A/R and retrieval of monies from patients or insurance companies for unpaid claims

• Billed Medicaid, Medicare, BCBS and private insurance on a timely and efficient basis

• Submitted electronic and paper claims as well as manually on the HFCA 1500 form

• Applied CPT and ICD-9 coding when creating new patients charts and inputting data into system concerning their medical coverage.

Accuhealth, Inc, Bronx, NY

Medical Biller, 4/94 to 5/97

• Used proper CPT and ICD-9 coding for accurate payment posting

• Utilized HCFA 1500 and UB92 forms to submit electronic and manual claims

• Billed Medicaid, Medicare, BCBS and private insurance on a timely and efficient basis

• Billed commercial insurance claims; resolved customer inquiries concerning medical coverage or claim status

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