Medical Billing
Resume:
Peggy P Hersey
**** ******** **** **, ********** GA 30052
Tel: 678-***-****
abl08v@r.postjobfree.com
CARRIER OBJECTIVE:
To obtain the position as an Medical Receptionist/Insurance Billing Representative in order to
achieve progress in my medical Billing career. In addition, I will give in return my excellent
performance by making use of my extensive experience within the healthcare business
environment.
PROFESSIONAL EXPERIENCE:
4/2005-Present Cardiology associates of Fairfield County Norwalk, CT
Billing Account Representative/Medical receptionist /Pre-Certification
Responsible for verification of insurance companies.
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Verifying of insurances eligibility throughout web sites as well as the automatic
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service.
Responsible to obtain and request authorization and referrals from various
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insurance via online.
Experienced with Carecore National, Aim, and Medsolutions.
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Experienced with Athena Net and NexGen software systems.
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Post payments received from insurance carriers
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Continuous follow up on all claims
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Maintain, negotiate and update current fee schedules
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Print month end production reports and outstanding A/R
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Knowledgeable with Medicare PQRI rule.
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Skillful in Creating individual claims which are professionally prepared, accurately coded and
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electronically submitted everyday
Capable to identify secondary or tertiary insurance information efficiently.
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Proficient to review the EOB form to determine exactly which medical records
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have been requested from payers.
Patient Billing questions answered efficiently Knowledge on how to handle
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Denials/Appeals.
Able to review and reprocess claims when insurance payers have rejected claims.
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Able to resolve claims on HOLD efficiently and in a timely manner.
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Apply policies and procedures on health-record documentation and coding that
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are consistent with official coding guidelines
Answering multiple phone line system, internal and external calls.
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New patient pre registration, includes
Scheduling appointments and hospital procedures.
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patient demographic input, mailing a new patient packet and insurance verification
Serving patients with the appropriate confidentiality for each of their accounts.
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Talented in identifying patients’ specific needs.
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Skillful in assisting doctors with any projects they may have.
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5/2003-8/2004 Comprehensive Women’s Health Care
Wayne, NJ
Medical Receptionist
Responsible for scheduling appointments.
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Responsible for maintaining doctor’s scheduling.
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Verification of insurances eligibility throughout web sites
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Assisted the doctors with the pulling and filling of charts and information
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Prepared lab specimens for pick up
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EDUCATION:
05/2010 Norwalk Community College Norwalk, CT
General Studies Associates Degree
2004-2005 Allied Medical & Technical Institute Wayne, NJ
Certified Medical Billing and Coding
An intensive 520- hour course comprised of the theoretical and practical applications of essential
Medical Billing and computer skills including, but not limited to: Proficiency in diagnostic ( ICD-9)
and procedural ( CPT-4) coding, and HCPCS. Able to verify DRG assignment based on Prospective
Payment System (PPS) definitions. Accurate, ethical and compliant coding and electronic processing of
medical claims. Medical Terminology, Anatomy and Physiology, Medisoft, AthenaNet. Computerized
medical manager software, Knowledge of various types of medical insurance including government,
private and managed care plans, processing and review of medical insurance claim forms and
remittances. In addition to a comprehensive medical records maintenance course with medical ethical
and practices.
5/2006-5/2006 Norwalk Community College Norwalk, Connecticut
Customer Services
• Customer Services for Health Professionals
• Professional qualities that characterize a professional.
• Proper telephone etiquette.
• Patient bill of right.
• Verbal and non verbal communication skills.
• Interpersonal communication.
SPECIAL SKILLS:
Exceptional organizational skills and computer skills, proficient in Microsoft Word, Microsoft Excel, Microsoft
Outlook, & Internet Explorer. Great knowledge in ICD-9, CPT and HCPCS codes. Experience with several major
private insurance, including but not limited to Medicaid and Medicare plans. Skillful in creating electronic claims. I’m
intensely trained to handle heavy multiple incoming phone calls.
Peggy P Hersey
1973 Temple Park Drive, Loganville GA 30053
Tel: 203-***-****
abl08v@r.postjobfree.com
PROFESSIONAL REFERENCE:
Sylvia Villarreal MBA, CMPE
Billing Supervisor
Donna Lentini APRN, NP
Manager Nurse Practitioner for Cardiology Associates of Fairfield County
Dr. Robert Moskowitz MD, FACC
Cardiologist at Norwalk Hospital &
Cardiology Associates of Fairfield County
Contact this candidate