Manager Customer Service

Qualifications:

. Certified Professional Coder: AAPC - CPC (12/27/08).

. Member of the American Academy of Professional Coders: Member #

01084523.

. Acknowledges the differences of OPPS vs. PPS payment systems.

. In depth understanding of billing requirements for Medicare, Medicaid,

and commercial payers'.

. Coding Technical skills- extensive regulatory coding from

International Classification of Disease (ICD-9-CM), Physicians Current

Procedural Terminology (CPT), and HCPCS (Healthcare Common Procedure

Coding System).

. Articulate individual with strong analytical and problem-solving

abilities, alongside a talent for dealing with people of different

backgrounds and temperaments.

. Detail oriented, with solid organizational and time management

abilities in coordinating multiple projects.

. Proficient with Microsoft Office System (including Word, Excel,

PowerPoint, Access, and Outlook).

. Maintain strict confidentiality; adhere to all HIPAA

guidelines/regulations.

Experience:

American Healthcare Billing Services

April 2008 - Present

Billing/Coding

Dallas, Texas

. Remote Coding.

. Nationwide Podiatry billing service.

. Analyze and interpret medical records to ascertain complete and

accurate information for coding and abstracting to determine first

listed and principle diagnosis.

. Enters diagnostic and procedure codes into the coding/abstracting

system and billing system as appropriate for outpatient/inpatient

surgical centers, hospitals, hospice, nursing homes, home care,

skilled nursing, and assisted living.

. Nationwide insurances(Medicare, Medicaid, BCBS, Aetna, United

Healthcare, Secure Horizons, Private Pay, Workers Compensation).

. Responsible for collecting, posting, and managing account payments.

. Prepare and submit clean claims to various insurance companies either

electronically or by paper as well as following up with insurance

companies.

. Review all insurance payments and remittance advice documents to

ensure proper processing and payment of each claim.

. Corrects all data errors and resubmit all unprocessed or returned

claims.

. Updating of patient demographics and insurance cards.

. Perform daily Audits to ensure pretreatment authorizations have been

received and entered into the billing and transaction records.

. Audits comparing provider documentation with codes assigned.

Maternity Leave August

2004 - April 2008

Ernie's of Dallas

May 1997 - August 2004

Manager

Addison, Texas

. Rapidly advanced to positions of increasing responsibility,

culminating in a management role with complete oversight for a full-

service upscale restaurant and bar.

. Promoted to manager position in order to oversee end-end operations of

the entire facility, to include direct management of 14 employees,

customer service, sales strategies, inventory control, time

management, payroll staff schedule, and performance assessment.

. Lead by example to ensure the execution of all safety, security,

sanitation, quality and operations policies.

. Developed a self-directed management philosophy in order to facilitate

progressive change and foster an environment supporting earnest

collaboration and innovation amongst employees.

. Strived to foster an environment in which guests enjoy high levels of

service and employees are motivated to deliver top performance.

. Enhanced employee performance and attendance through daily mentoring,

one-on-one discussions and motivational strategies that directly

contributed to significant improvements in guest satisfaction and

sales.

. Played key role in significantly reducing labor costs by recommending

staff scheduling changes to provide service that is more efficient and

meet payroll budget.

Education:

Certified Coding Specialist Exam Review

February 27, 2010

UT Southwestern Medical Center

Dallas,

Texas

Insurance Claims Coding for the Medical Office

June 2007 - December 2007

Richland Community College

Dallas, Texas

Certificates Obtained - Medical Terminology, Human Disease &

Pathology, Health Insurance Billing & Medical Coding, Advanced Medical

Coding, Medical Manager Software, and Medical Law & Ethics

Criminal Justice - 90 Hrs of Bachelor of Science

August 1994 - May 1999

University of North Texas

Denton, Texas

Contact this candidate