Medical Insurance

SHERRY A. SUGAR

*** **** *******

Norcross, GA **093

Cell: 678-***-****

QUALIFICATIONS

. More than 5 years experience as a Medical Biller/Coder.

. Extremely knowledgeable with regard to Medical Coding guidelines and

coding techniques (ICD-9, CPT-4, HCPCS, and DRG's).

. Proficient in physician coding, inpatient hospital coding, outpatient

coding, and facility coding.

. Very sound knowledge of medical terminology, physiology and

pharmacology.

. Production driven with the ability to produce 45 accounts per day.

. Effective communication and interpersonal skills.

EDUCATION:

9/05-7/06 Central Florida College Orlando, Florida

Health Information Technology Diploma

. Course-work Highlights: Medical Terminology, Medical Billing, ICD-

9/CPT Coding, Surgical Coding

PROFESSIONAL MEDICIAL EXPERIENCE

10/08-Present HCA Patient Account Services

Atlanta, Georgia

Clinical Appeals Analyst

. Monitor insurance claims by running appropriate reports and contacting

insurance companies to resolve claims that are not paid in timely

manner

. Identify coding or billing problems from EOBs and work to correct the

errors in a timely manner

. Identify problem accounts and escalate as appropriate

. Update the patient account record to identify actions taken on the

account

10/07-08/08 Moffitt Cancer Center & Research Institute Tampa,

Florida

Scheduling Specialist

. Responsible for all medications, procedures, and order entry of lab

work.

. Scheduling flu applications in Out-Patient setting.

. Knowledgeable in Infusion, Bone Marrow Treatment, and Chemotherapy

Drugs.

. Interact with patients in a caring & professional matter to ensure all

state laws, state and federal HIPPA regulations

9/06-9/07 Florida Physician Medical Group Orlando,

Florida

Claim Resolution Specialist

. Claim Representative in a team responsible for approximately 300-350

accounts and report directly to a Supervisor.

. Contact with insurance carriers and work through payment issues to

obtain proper payment on claims.

. Developed and implemented EOB's, appeals, and reductions as well as

timely filing.

. Managed patient confidentially while ensuring fast accurate

documentation for a secure environment.

- CONTINUE -

6/03-7/05 Consultants in Pain Medicine San Antonio,

Texas

Scheduling Coordinator

. Personal scheduler for pain management physician, Stephanie S. Jones,

M.D. at two outpatient facilities and hospitals.

. Insurance verifications online and electronic medical records online.

. Surgery scheduling for injections, spinal stimulator trials, permanent

and intrathecal pumps.

. Scheduled for 200-500 patients per month.

5/00-6/03 Peachtree Orthopedic Clinic Atlanta,

Georgia

Appointment Coordinator

. Managed appointments for five physicians.

. Verifications of insurance of all orthopedic evaluations.

. Modifying of schedules to meet patients/physicians needs in a customer

service environment.

. Handled all surgery scheduling at participation hospitals in a timely

manner.

5/98-5/00 Piedmont Physician's Group Atlanta, Georgia

Scheduling Coordinator

. Scheduling and rescheduling of appointments for five offices.

. Confirmation of eligibility, verification and Worker's Compensation

claims.

. Able to troubleshoot and meet deadlines.

. Adhered to company policies, procedures and programs and interacted

with internal and external patients.

5/80-6/95 University Hospital San Antonio, Texas

Critical Care Secretary

. Input data into patients' charts

. Managed census sheets, bed control board and unit fields.

. Transcribed written physician's orders and scheduled appointments for

EKGs.

. Cardiology and medical services.

COMPUTER PROFICIENCES

Capstone Flex Package Menu

Power chart EMD system

Medical Manager Appointments-Pro Windows 2000

Logician Medical Online Power Point

Contact this candidate