Medical Practice Administrator/ Medical Practice Manager
Resume:
Paterson, NJ ***** *******@*****.***
Joseph D. Williams
Education 1990-1992 Passaic County Community College Paterson, NJ
Business Administration
Professional 11/2003- 11/2009 Medical Billing Services M.B.S
Experience Senior Reimbursement Specialist
Medical collections and intensive follow up on high dollar managed care, Medicaid, Medicare, and commercial insurance accounts.
Oral and written communications with insurance companies (appeals) with 85% of denied appeals overturned and adjudicated.
Hospital and Physician Billing procedures.
Daily and Monthly Closing procedures including submitting EDI and hardcopy claims ( CMS 1500 and UB92).
1/2001- 5/2003 Health Plus
Medical Claims Processor/ Analyst
Process, review, and adjudicate all medical claims submitted for payment.
Heavy phone interaction with healthcare specialist providers and members regarding claims, coverage, and qualifications.
Review claims submitted for second level appeal and forward findings to accounts receivable for resolution.
6/1997- 12/2000 Newark Beth Israel Hospital
Experience Patient Account Collection Representative
Inpatient and outpatient managed care hospital billing procedures.
Patient account review/ qualifications
2nd and 3rd party billing procedures.
Skills • Extensive knowledge of the following medical programs SMS/RUMBA, Medical Manager, Affinity, SSI simed, and Facets.
Extracurricular Riverside Terrace Dancing Angels Choreographer
Activities
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