Medical Billing

Silvia Simonzadeh

*******@***.***

***** ***** *****, ********* *****, CA 91381 Home: 661-***-**** Cell: 661-***-****

PROFESSIONAL PROFILE

Highly experienced and medical office professional with a diverse background in medical office

management coupled with extensive medical billing and coding expertise, insurance submissions,

medical collections as well as staff and patient relations. Knowledgeable in Microsoft Word, Excell &

Powerpoint. Fluent in both English and Spanish.

CERTIFICATIONS AND AFFILIATIONS

• American Medical Billing Association (AMBA)

• Certified Medical Reimbursement Specialist (CMRS)

• American Academy of Professional Coders (AAPC)

• American Health Information Management Association (AHIMA)

• Medical Assistant

• MD Peel Certificate (Microdermabrasion)

• Skin Rx Certificate in Advanced Chemexfoliation

• QuadraMed Corp. Certificate HIPAA

OPERATIONS AND CORE COMPETENCIES

• • •

Medical Medicare/Medi- Team

Billing/Collections Cal/HMO Leadership/Management

• • •

CPT, ICD9, HCPC Account Policies &

Coding Management Procedures/Contracts

• • •

WC/IPA/Private HIPPA/COLA/OS Inventory/Supplies

Insurance HA/CLIA & Equipment

• • •

Front & Back Submissions/Appe Patient &

Office Management als Employee Relations

• • •

Scheduling Panels Physician Word

Credentials Processing/Data Entry

EXPERIENCE Private Doctors Office- Internal Medicine Practice

Administrative Assistant, 1981- February 2013

• Contracted physicians from various specialties including ENT, General Surgeons, Gastroenterology,

Urology, Neurology, etc.

• Analyzed contracts with IPAs & HMO insurances in order to produce a finalized contract for

hospital patient care

• Ensured that all group physicians were up-to-date on their licenses, triplicates and malpractice

insurance

• Reported and organized malpractice claims, including gathering pertinent information and

completing the malpractice report filing in order to ensure that all of the material was readily available.

• Procured, prepared and mailed records for Medicare audits

• Maintained accreditation requirements by scheduling lab equipment repairs and yearly calibrations

along with preparing for inspections from C.O.L.A. & CLIA

• Accurately transcribed group board meeting minutes

• Coordinated vacation schedules for group physicians as well as reviewed on-call schedules at

multiple hospital ERs for conflicts and implemented changes when necessary.

• Arranged depositions and court dates while relaying this information to the physicians so that they

could testify for on-going cases

Working Office Manager

• Hiring and training proper phone etiquette, HIPAA, OSHA, COLA and Sexual Harassment in the

Work Place seminars along with many additional duties to ensure efficient work flow

• Cross-trained in all departments in order to cover for any absent employee when needed

• Conducted bi-annual reviews of all applicable employees on topics that included strengths,

weaknesses and goals, handling patient-employee, patient-physician and physician-employee complaints to

help reach a resolution for the purpose of improving the work environment

• Ordered all office, medication and lab chemical supplies, ensuring that inventory was never low or

obsolete while being responsible for Drug Room organization including destruction of expired medication

and record keeping of patient sample distribution

• Trained employees on all equipment including EKG, PFT, Holter, Sigmoidoscopy preperations,

autoclaving, diathermy as well as ultrasound therapy

• Prepared refunds for both patients and insurance companies to encourage an adequate response time

while also completing all acute, sub-acute, nursing home and hospice billing

• Implemented data integrity standards by constantly updating, archiving and adding to our insurance

and patient information, which assisted in proper billing and patient record handling

• Reviewed and updated all CPT, ICD9 and HCPC codes yearly

• Set fee schedules, account adjustments, and preparations for collection services

• billed approximately 400 patients per week that were cash, private, HMO, IPA, Worker’s

Compensation, Medicare, Medi-Medi and Medi-Cal

• Designed all forms used in the office per HIPAA regulation

• Implemented methods of keeping up to date on test results by making forms that allowed for follow

up of all out patient testing

• Mail distribution, employee vacation scheduling, APR reports, all level appeals to Medicare & Medi-

Cal, posting payments etc.

• Newspaper Advertising, bulk-mail advertising, designing flyers etc.

• Responsible to maintain office always looking clean and professional by monitoring housekeeping

services, arranging for floor waxing, carpet cleaning and furniture cleaning at regular intervals or as needed

Front Office

• Utilized a patient-focused technique by effectively checking in patients and scheduling their future

appointments while simultaneously answering multiple phone calls to ensure office efficiency

• Completed all necessary forms for nursing homes, hospice and equipment claims that patients

required

• Arranged for visiting nurses along with all necessary tests for complete patient care

• Set up out patient testing such as MRI, x-ray, labs, etc.

• Collecting co-pays, updating patient data in the system such as phone numbers, address, insurance

etc.

Back Office

• Completed all patient vitals, chart preparation, history recordings as well as worker’s compensation

and car accident reports

• Prepared a sterile field for minor surgeries, assist with pelvic exams, autoclaving and

sigmoidoscopies, EKG, 24 hour Holter monitoring, PFT, blood drawing, injections, TB Tine

• The only one doing Microdermabrasions and Glycolic Peels, skin care product sales

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