Medical Billing Manager

Angela G Tucker

*** ******** *** *****: 336-***-****

Lexington, NC 27295 Cell: 336-***-****

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

Professional Summary

Certified Medical Billing Specialist with 18 years experience in a fast-paced, multiple client medical billing company. Manager for 11 years; owned my own company for 6 years. Researched and denied claims and submitted appeals. I am a expert with Medicare, Medicaid and other major insurance companies; as well as general business knowledge and collection. Have been a Member of the American Academy of Professional Coders. I am seeking a fast-paced position in an office, hospital or business setting. Medical Billing Specialist - Collector - Administrative Assistant highly efficient Medical Billing with experience in internal medicine, family practice, endocrinology, pediatrics, internal medicine, behavioral health, Hospital, nursing facility and optometry. Excellent multi tasking and demonstrate team player with a positive attitude. Efficient Medical Administrator skilled in tackling administrative and patient-oriented tasks in a medical office or medical billing office fast-paced environment. I am an enthusiastic Administrator with excellent people skills and dedicated work ethic. I have strong attention to detail and extensive knowledge of many different types of business. I have excellent communication with physicians, staff, and patients.

Skill Highlights

• Billing and collection procedures • Medical Manager Software

• Knowledge of HMOs, Medicare and Medicaid • Knowledge of anatomy/physiology

• ICD-10 (International Classification of Disease • Records management

Systems) • Maintains strict confidentiality

• Medical Terminology • Excellent verbal communication

• Deadline-driven • Exercises good judgment

• Strong attention to detail • Office support (phones, faxing, filing)

• Excellent problem solver • Flexible

• Resourceful and reliable • Customer service

• Office management • Good written communication

• Technical expertise • Multi-tasking

• Research and data analysis • Team player with positive attitude

• Medical billing software • Leadership skills

• HIPAA compliance • Strong work ethic

• Understands insurance benefits • Patient-focused care

• Insurance and collections procedures • Strong planning skills

• Behavioral health billing and collections • Composed professional demeanor

• Internal medicine billing • Patient referrals

• CPT and HCPCS coding • Records maintenance

• Patient chart auditing

• Familiar with commercial and private insurance carriers

• HCPCS Coding Guidelines

• ICD-9

• Outpatient surgery coding

• Electronic Medical Record (EMR) software

Professional Experience

President and owner 03/2007 - 12/2012

Organized Billing Solutions, Inc. Winston Salem, NC

Provided administrative support for multiple physicians.

Accurately entered procedure codes, diagnosis codes and patient information into billing software. Researched questions and concerns from providers and provided detailed responses.

Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.

Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Received, organized and maintained all coding and reimbursement periodicals and updates. Initiated, performed and documented quarterly coding audits for physicians.

Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from reports from system.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.

Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.

Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.

Accurately posted and sent out all medical claims. Thoroughly reviewed remittance codes from EOBS/AR's .

Submitted electronic/paper claims documentation for timely filing. Completed appeals and filed and submitted claims.

Responded to correspondence from insurance companies. Posted and adjusted payments from insurance companies. Posted charges, payments and adjustments.

Identified and resolved patient billing and payment issues.

Applied payments, adjustments and denials into medical manager system. Submitted refund requests for claims paid in error.

Confidently and adeptly handled claim denials and/or appeals. Carefully prepared, reviewed and submitted patient statements.

Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.

Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house. Prepared billing correspondence and maintained database to organize billing information. Performed full-cycle medical billing in a fast-paced medical billing company.

Entered orders into the EMR system efficiently and without errors. Consistently ensured proper coding, sequencing of diagnoses and procedures.

Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy. Quickly responded to staff and client inquiries regarding CPT codes.

Maintained strict patient and physician confidentiality. Meticulously tracked and resolved underpayments.

Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.

Office Manager 08/1997 - 02/2007

Medical Data Services, Inc. Winston Salem, NC

Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner. Printed and reviewed monthly patient aging reports.

Thoroughly investigated past due invoices and minimized number of unpaid accounts. Precisely completed appropriate claims paperwork, documentation and system entry. Correctly coded and billed medical claims for various hospital and nursing facilities. Completed registration quickly and cordially for all new patients.

Monitored shared email in-boxes and ensured inquiries were addressed. Provided administrative support for more than 12 physicians.

Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.

Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Received, organized and maintained all coding and reimbursement periodicals and updates.

Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from reports I generated.

Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient or outpatient setting. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.

Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes. Accurately posted and sent out all medical claims.

Thoroughly reviewed remittance codes from EOBS/AR's . Submitted electronic/paper claims documentation for timely filing. Posted charges, payments and adjustments.

Identified and resolved patient billing and payment issues.

Applied payments, adjustments and denials into medical manager system.

Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.

Wrote clear and detailed clinical phone messages for physicians. Diligently filed and followed up on third party claims.

Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy. Maintained strict patient and physician confidentiality.

Admission Representative & Unit Secretary 10/1993 - 11/1999

High Point Regional Hospital High Point, NC

Updated patient financial information to guarantee accuracy.

Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner. Recorded and filed patient data and medical records.

Precisely completed appropriate claims paperwork, documentation and system entry. Strictly followed all federal and state guidelines for release of information.

Prepared patient charts, pre-admissions and consent forms as necessary. Completed registration quickly and cordially for all new patients.

Accurately entered procedure codes, diagnosis codes and patient information into billing software. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Expertly transcribed medical reports for a variety of physicians in a hospital setting.

Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.

Confirmed patient information, collected copays and verified insurance.

Data entry on procedure codes for emergency room, impatient and outpatient services. Wrote clear and detailed clinical phone messages for physicians.

Arranged and assisted with hospital admissions.

Entered orders into the EMR system efficiently and without errors. Ensured compliance with medical/legal requirements, JCAHO standards. Maintained strict patient and physician confidentiality.

Certifications and Credentials

Family Practice Medical Billing

Medical Billing Specialist

Unit Secretary

Education and Training

Associates Degree: Forsyth Technical Community College – College transfer 1998

Winston Salem, NC

Business Administration

Unit Secretary certificate: Forsyth Technical Community College – Unit Secretary 1992

Winston Salem, NC USA

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