Customer Service Insurance

Valerie Ramirez, CPC, COSC

**** ******* ****** . ******* ****, IL. 60133 . 773-***-****.

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

Professional Background and Accomplishments

Coding & Appeals Specialist, Certified Professional Coder

. Responsible for the surgical coding, charge entry, and appeals for a

small physician group.

. Extensive knowledge of CPT and ICD-9 coding.

. Specialization in orthopedic coding.

. Ability to communicate effectively and efficiently with doctors and

their staff.

Collections

. Responsible for the reimbursement levels of a large MRI and physical

therapy site.

. Knowledgeable in the application of ICD-9, CPT and HCPCS codes.

. Well versed in the guidelines and conflicts within certain insurance

carriers

. Resolve all insurance and patient non-payment issues.

. Communicate daily with facility sites, insurance companies and

patients.

. Utilize knowledge gained in claims, charge entry and customer service

training.

. Responsible for the training of a few collection staff employees.

Customer Service

. Responsible for reconciling all patient billing inquiries.

. Refiling claims to insurance companies.

. Accepting and forwarding patient payments.

. Utilized claims experience.

. Trained new employees.

Claims Administration

. Responsible for the complete processing of all Workers' Compensation

claims, which includes providing all necessary documentation for

surgeries, office and physical therapy visits.

. Familiar with Medicare and DME claim procedures and processing.

. Responsible for inspecting claims for accuracy and errors prior to

mailing.

. Experienced in dealing with doctors offices and staff regarding claim

issues/discrepancies.

. Familiar with electronic claims processing.

. Trained new employees.

Employment History

. Spine Consultants, LLC, Coding Specialist, May 2010-current.

. Chicago Institute of Neurosurgery & Neuroresearch, Coding Specialist,

October 2008-December 2009.

. Healthcare Information Services, Coding & Appeals Specialist, January

2001-July 2008.

Education

. BA in Psychology and History, Northeastern Illinois University, May

2004, Cum Laude

. Certified Professional Coder (CPC), May 2005

. Certificate in Medical Transcription, March 2009

. Certified Orthopedic Surgery Coder (COSC), September 2010

Computer Skills

. 55 wpm, Windows, Word, Excel, Access, Outlook, Powerpoint, and

Internet

References

. Available upon request

Contact this candidate