Medical Insurance
Resume:
*** ******* **** ***** 803-***-****
Lexington, SC
29073.8717 Cell phone 803.
319.2106
Fax 803. 957.9019
******@**.**.***
Phyllis 'Nickie' R. Knauff, 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