Medical Billing

Carla J. Ross

Cell 302-***-****

e-mail ab1ygq@r.postjobfree.com

Education Morgan State University Baltimore, Md.

BA Speech Communication

Received health producer license, 2007. License expired

2011.

National certification in Medical Administration and

Billing and Coding specialist; issued by National

Healthcareer Association, 2006

Corporate training provided by Metropolitan Practice

Management for Medisoft medical billing - 2003

Alternate Route teacher training completed in 2000.

2011- 2013 Hospital Billing & Collection Service New

Work Castle, De

Experience Insurance Representative. Utilize three systems in

order to obtain payments for aged claims from major

insurance carriers. Maintain inventory status changes

for moving claims to paid status. Systems used are

Citrix for actual claim and EOB viewing from hospital,

flexible automated collection system and on-line

insurance accounts. Also used automated timekeeping

system(KRONOS). Able to resolve many aged and

outstanding balances before timely-filing periods ran

out. Identified billing problems between facilities and

carriers.

2010-2011 ADP Statewide Insurance Bloomfield,

NJ

Medicare Benefit Consultant. Contact physicians and

other entities to inform them of

new services offered by company. Attend events where

information was provided for eligibles and their

families regarding possible eligibility. Assist

eligibles with application to state assistance programs

and submit. Submit applications to insurance carriers.

2009(6 months) Garden State Science & Technology

Institute Jersey City, NJ

Instructor, Medical Billing and Coding. Implement new

course for adult students at new school. Set-up study

units in anatomy and physiology, medical terminology and

medical administration. Use of several reference tools

to affect complete coverage of each area. Introduction

to coding using CPT and ICD-9 coding manuals. Prepare

review materials and lecture on the practical uses of

such materials in the workplace.

2008 - 2009 Balanced Insurance Advisory Group

Northern, NJ

Medicare Benefit Consultant. Assist Medicare eligible

in locating appropriate Medicare advantage plan for

their needs. Ability to identify and locate correct

plan that will provide best value in terms of PCP,

medication and other plan benefits. Set-up opportunities

for growth and informational meetings for community

organizations. Prepare and submit application to a

variety of health plans.

2007 - 2008 Wellcare Health Plan Newark, New Jersey

Medicare Benefit Consultant. Serve as focal point of

information for Medicare eligible participants. Set-up

meet and greet opportunities for seniors to come out and

learn about Medicare supplemental plan new to New Jersey

market. Explain the benefits of obtaining a

supplemental plan as well as the many benefits new to

the 2008 enrollees. Attended corporate training on

product knowledge, subsequent health insurer producer

trainin

2006 - 2007 (temp assignment) Kessler Institute for

Rehabilitation, W. Orange, New Jersey.

Serve as unit administrator for south wing, spinal cord

injury patients. Assist MD's with appropriate charting

assistance for up to 24 patients in thirteen double and

private rooms. Keep charts complete with urology, lab.,

dietary and consult information. Track patients travel

to ancillary facilities, assist with necessary transport

needs. Supervise three/four rehabilitation aids that

are responsible for patient care, rehabilitation

schedules and feeding when necessary.

2000 - 2005 Dr. Carl S. Ross East Orange, New

Jersey

Serve as office administrator for pediatric practice

with one full-time physician, two part-time physicians

and tow full-time office staff. Processed all medical

claims, handled, billing and collection procedures.

Heavy contact with provider relations counterparts to

insure appropriate payments. Follow-up and correction

of problem claims. Filing of applications with medical

boards, EPA, state agencies and insurances. CPT and ICD

coding and updates followed in order to process claims

using Medisoft practice management system.

1999 - 2000 Russell Academy, Charter School. East

Orange, New Jersey

Teacher.

1998 - 1999 John L. Costley Middle School, East Orange,

New Jersey

Teacher.

Community Health care ministry New Vision Full Gospel Church,

activities 2006.

Montclair Grassroots, Head Counselor during summer

seasons.

Awards

received Received one outstanding evaluation for Alternate Route

Teacher training.

Received exemplary employee recommendation from Blue

Cross & Blue Shield of New Jersey.

Contact this candidate