* ******** ** **** *****-434-***-****

Ruckersville, VA 22968 m3u3r2@r.postjobfree.com

Patricia P. Williams, CPC

EDUCATION:

I graduated from Charlottesville High School

I took a passed a typing class at Braxton College in Richmond, VA

I passed a medical terminology class at MJH given by PVCC. 2002 I took and passed a 6 Month coding class 2002 I took the National Certified Professional Coding Exam given by AAPC and passed to become a Certified Professional Coder.

AWARDS:

In 2008 I received an AIMS award at work for my work with Pricing Estimates and Grant pricing in coordination with UVA Hospital.

WORK EXPERIENCE:

08-22-2005 to 05-19-2009 -Reimbursement Specialist 1, UVA Health Services Foundation Charlottesville, VA I researched posted payment low pay reports looking for claims that were not paid at our “contracted rates”. I Resubmitted claims to Insurance Carriers for payment reconsideration and notified them of the correct payment we should have received. I Identified errors in Carriers’ adjudication processes and notified the Insurance Representatives and got them to update/ or change their system and reprocess claims that were not processed correctly. Identified low fees billed by Departments and gave recommendations of the fee(s) they should implement. Also did pricing estimates and grant pricing with UVA Hospital to give a Patient an estimate of their upcoming charges. I maintained the 8 Payer fee schedules that I was assigned and worked ,and kept up to date Monthly.

11-08-04 to 08-2005 - Assistant Manager/Billing Operations, Gamma knife Neurosurgery-UVA Charlottesville, VA. I was responsible for coding office/consult visits and writing up encounters and billing them in IDX, and for billing all Gamma procedures. I was responsible for running Precision AR reports and working them. I sent requests to Department Supervisors to take appropriate action. I also called Insurance Companies to do my own follow up on high dollar accounts. I did the month end and year end reconsolidations and ran precision reports to verify all charges had been posted. I worked the work file edits daily. I also verified the charges were posted in A2K3 and kept a monthly report of charges posted and payments received and logged them on an excel spreadsheet. I was responsible for Supervising the Students that we had working for us. I worked all of the Department requests and notified them of appropriate action needed.

01-2004 to 11-2004 Billing Office Specialist-MJH Medical Enterprise/Central Billing Office in Charlottesville, VA . I was responsible for Team Leadership and assisting my Co-Workers with any questions concerning follow up on claims. I assisted with the Insurance follow up team with questions on how to appeal and get claims paid and processed. I was a liaison between the patients and their Insurance Companies to help patients with their Insurance claims or questions in resolving their bills and to understand any balances that were owed and why.

08-200*-**-**** OSA II Forest Lakes Family Medicine, Charlottesville, VA. I did multiple tasks from answering the phones, scheduling appointments, coding encounters, posting charges to the system, calling in referrals and pre-authorizations to Insurance Companies. I checked Patients in for their appointments and out at check out. I collected any co-pays and processed credit card payments and did the balancing at the end of the day to make sure the encounters and the payments matched. I pulled charts for appointments and filed them away after the Doctors were finished with them. We had 3 Physicians and 2 Nurse Practitioners.

1999-2003 Reimbursement Specialist-Central Billing Office/MJME, Charlottesville, VA. I did Insurance follow up for all Insurance Carriers for 2 MJH owned practices and 5 specialty practices, including Gynecology, Dermatology Surgery, Pediatric, General Surgery and Orthopedic. I was the contract person for all 7 of these Practices. I ran and worked reports based on the age of the claims and also worked pending reports and appealed incorrect denials such as adding the appropriate modifier, and appealing if the contractual amount was not paid correctly. I refunded the Insurance Companies any overpayments. If the Insurance returned a claim for errors, I contacted the Physicians Office for the correct information and refilled or appealed the claims with the corrected information. I called Insurance Companies for claims 60 days and over and refilled any claims that were not on file. I helped my Supervisor train new Reimbursement Specialists and other duties asked of me. I helped my colleagues with many questions and answers so they knew the appropriate action required.

1998-1999-Insurance Biller-Patient Accounting, Martha Jefferson Hospital in Charlottesville, VA. I did Insurance billing for all Insurance carriers for Patient last names that began with A-D. I would edit all of the claims on a work bench on the computer and correct any errors and make sure the claims were correct before we billed them to the Insurance Companies. I billed all secondary claims to the Secondary Insurance Co. with the primary Insurance co. explanation of benefits.

1977-1991 Insurance Follow Up and Biller, Patient Accounts, Martha Jefferson Hospital in Charlottesville, VA.I started out answering the phones in 1977 after graduating from High School. I transferred to billing in 1979. I transferred to Insurance follow up in 1981.. I resigned in 1991 to stay at home with my two sons.

I have volunteered for the American Heart Association and walked to raise money.

Last year I volunteered for the RAM(Remote Area Medical) Clinic held every July in Wise VA .I was the Team Lead and made sure the Registrars were given the next available Patient in the order they arrived. I also registered Patients for free care. We stayed for 3 days and worked 12 hours a day for 2 of the days and 7 hours the last day.

In 2005 I was elected by the PAC members, to be the Piedmont Association of Coders Secretary for the 2006 Calendar Year term.

REFERENCES:

Madeline (Lynne) Slonaker

Senior Reimbursement Specialist-UVA Health Services Foundation

Phone: 434-***-****

Linda Gibbons

MJME-Central Billing Office

Phone: 434-***-****

Melisa Chisholm

Financial Analyst-UVA, Neurosurgery Dept.

Phone: 434-***-****

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