Medical Billing Quality Assurance

Objective:

Looking for challenging role of medical billing in Hospital / Clinic, where

my skills and knowledge can be utilized to its best, interested to serve

and contribute

. Detail oriented, quality focused, professional trained in medical

administrative support

. Successful track record of handling complicated assignments and

administrative / clerical requests

. Highly experienced in post charges / payments, reconciling accounts

with high degree of accuracy

. Present solid foundation in software applications, database

management, and data entry

. Proven ability to master new technology

. Dedicated to maintaining strict patient confidentiality

. Have good communication and written skills

Certification

1. Certified Coder (2010) by American Association of Professional Coding

2. Certification in Software Quality Assurance

Educational qualification

Bachelor degree in Computer Science (3 year college degree)

Key Administrative Skills:

ICD-9 Medical Terminology Key Boarding

CPT-10 Medical Insurance Medical billing

HCBCS Online claim submission Internet

MS Excel Medical software Perfect care

MS Word 10 Key Confidentiality

Skills Summary

. Experience in medical Billing for more than a year

. In-depth knowledge of coding techniques, follower of medical

guidelines

. Have sound knowledge of medical terminology, physiology and

pharmacology

. Proficient in computer like MS Word, MS Excel and other MS office tool

. Have excellent communication, interpersonal and organizational skills

. Good at record maintenance, proficient with financial records

Professional Experience:

Medical Billing Staff: Jan 2008 - 2009, General surgeon's office, NY

Responsibilities:

Involved in billing for medical and other commercial carriers, did follow

up on unpaid accounts or denying claims for their status, handled data

entry tasking, answering phones, document filing, faxing and copying of

documents

Develop spreads for tracking claim checks for Doctor / physician

Lookup ICD-9 codes and verified that code has been changed and involved in

key-in deposited and updated patients' demographics using Industry standard

Perfect care system

Verified Medicaid statuses using ePACES online system

Involved in seeking authorization from insurance companies for out-patient

surgeries and also for in-patient admissions as well for CT scans and blood

work

Have correctly post payments on patient accounts. Involved in research and

resolved incorrect payments, EOB rejections, and other issues with

outstanding accounts

Reviewed billing edits, provided insurance providers with acceptable

information. Provided tenacious follow-up to ensure proper payments were

fully collected

Used Perfect Care software for all medical billing and coding

Data solutions: Feb 2007-2008, Flemington, NJ

Responsibilities:

Involved in planning, implementing database objects, such as stored

procedures and views

Maintained SQL scripts, complex queries for data analysis and data

extraction

Involved in database coding to support business applications using T-SQL

Performed quality assurance and testing of Windows applications

Worked with business stakeholders, application developers, and production

teams and across functional units to identify business needs and discuss

solution options

Ensure best practices are applied and maintained integrity of data through

security, documentation, and change management

Contact this candidate