Medical Billing Records

Shelene C. Doss CPC

**** ****** ***** ******* **.

Royse City, TX 75189

903-***-**** cell # 1

469-***-**** cell #

2

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

WORK HISTORY:

PROMEDEX PATHOLOGY BILLING, CADDO MILL TX- May 10th, 2010-current

Pathology Coder

Coding correct procedural terminology and ICD-9 for the professional

component of pathology.

HCA HEALTHCARE SERVICES, IRVING TX - Sept. 15th, 2008-Jan. 29th, 2010

Revenue Integrity Analyst

Assisted in resolving billing edits that are holding patient claims from

billing, by reviewing medical records and other applicable documentation.

Assisted in helping with

patient request for internal and external billing audits. Provide monthly

audit results. Review denial trends for documentation or charging issue

opportunities. Review high charge stays/procedures for charging accuracy.

Ensures web tool (unbilled) items are addressed properly and timely. Serve

as primary contact for all charge-related PAS inquiries and issues. While

ensuring correct procedural coding at all times.

Experienced In Resolving Edits for OPPS and OCE

E/M E/D

Surgical Charges Would Care

Pathology Radiology

Modifers NCCI NCD/LCD

SADS

Infusions/IVP's/IM,s

MUEs

Insurance Defense Audit Coordinator

Scheduling and coordinating Insurance defense audits for DFW division for

HCA.

Receiving, logging, calculating and determine if accounts are eligible

for audits. Reviewing contract s for compliance with per diem, stop loss,

DRG payments. Working closely with Third party audit company's and

external auditors as well as our internal auditors in auditing charges..

Maintaining medical records while keeping compliance with HIPPA and PHI.

EMPHYSIS MEDICAL MANAGEMENT (Zotec)-ROCKWALL TX - Apr.19/ 04-Dec 1/ 08

Radiology Coder

In-depth coding for correct procedural terminology and ICD-9 for

professional component of radiology . Experienced in CCI, NCD/LCD of local

and various states. Working with Medicare, Medicaid, Commercial denials

and appeals. Staying within company, state and federal compliance with

continued education in all areas.

PERSE' TECHNOLOGIES, GREENVILL TX(now McKessons) - Apr./01-Apr/ 08

Medical Billing Specialist

Correct billing for professional component of Radiology. Training in

processing clean claims with correct procedural terminology and ICD-9 .

Working with Medicare, Medicaid, Commercial denials and appeals with follow

up . Understanding and assisting with extensive phone communications and

of incoming correspondence(EOB),

with concentration of co-pays, deductibles, MUEs, med. ness., primary,

secondary insurances. Response to Attorney request. Spread sheets and

generated account reports.

My goals are continued Education in Diagnostic Coding and Medical Billing.

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