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Medical Insurance

Location:
Lexington, South Carolina, 29073, United States
Posted:
March 30, 2011

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*** ******* **** ***** 803.***.****

Lexington, SC

29073.8717 Cell phone 803.

***.****

Fax 803. ***.****

E-mail

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

Phyllis 'Nickie' R. ******, CC&BS - P-H - I.C.

Objective To use my knowledge of medical insurance, Medicare and Medicaid

billing and coding procedures and certifications.

Functional Experienced in processing medical and dental claims. Extensive

summary knowledge of Medicare, Medicaid and "other carrier liability"

coordination of benefits. HIPPA compliant and certified.

Employment 08.2010 - Present Medical Advocates of SC

Goose Creek, SC

Medical Advocate

Review medical bills, medical records and insurance documents for

errors.

Code medical bills in question or dispute by patient.

Write letters to providers about services received by patients.

Negotiate with providers after submitting justification for reduced

fees.

07.2009 - 07.2010 Lexington Medical Center

West Columbia, SC

Physician Support Specialist (PRN)

Responsible for all patient account functions including billing,

collections, follow up and posting of charges and

money in a timely and accurate manner.

Posted payments from EOB's (Explanation of Benefits), EOMB's

(Explanation of Medicare Benefits) as well as

EFT's (Electronic Fund Transfers).

Coded encounter forms with diagnosis, procedure and revenue codes on

UB92 and HICFA claim forms.

Proficient using MYSIS, Varian, Allscripts and Systock Operating

Systems.

Used PayerPath and other software to insure proper billing.

Worked regularly with information that is restricted to specific

persons.

Returned phone inquiries about bills to patients after researching

their concerns.

Worked insurance buckets, which included regular contact with all

insurance companies accepted by LMC,

Medicaid and Medicare.

Employment 02.1989 - 06.2009 Blue Cross & Blue Shield of SC

Columbia, SC

Offsite Dedicated Claims Processor

Reviewed medical records, coded procedures, diagnosis and revenue

codes on UB92 and HICFA claim forms. Processed Medicare, Medicaid

and other carrier liability benefits primary and secondary.

Summary of Knowledge of account benefits, payment policies Comprehensive and/or

qualifications Dental business.

Thorough knowledge of health and/or dental coding, CPT4, ADA, and

ICD9.

Ability to read medical reports and operative notes available to

process claims.

Proficient in interpreting EOB and EOMB's both primary and secondary.

Accreditations Certified coding and billing specialist. HIPAA certified 2010.

Professional American Association of Professional Coders.

memberships

Outside Being a wife, nana, mom, mom-in-law and friend. Member Zion Lutheran

Activities Church. Team captain RFL. Love to garden, walk, read, take photos,

decorate, and cook.



Contact this candidate