Medical Insurance

** * * * . *** P H I N # * W C H I C AG O, I L

773-*-*-*-*-*-** C E L L

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

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

MARGARET BLAKE

OBJECTIVE

Seeking a position providing the opportunities to further develop and

apply skills to any business and organization. To work, learn and achieve

success in an environment that offers opportunities with responsibilities.

WORK OF EXPERIENCE

May 2009 to Current Jackson Park Hospital/Group Practice

Medical Biller/Coder

Ÿ Update daily bank transaction and lock box spreadsheet of all

payments received

Ÿ Update daily log of all clinical encounter batches received

Ÿ Update Log of all cash receipts received

Ÿ Submit physician charges for OB/GYN, Orthopedic, Pediatric,

Cardiology, Family Medicine, Nursing Home, Psychiatric and STD

clinics

Ÿ Process physician Inpatient, Surgery and ER billing

Ÿ Follow up on denied claims and submit for reprocessing

Ÿ Research disputes on Medicaid and Harmony claims using IHFS

online

Ÿ Enter all new patient registration and update past information, if

needed

Ÿ Ensure all ICD 9 codes and CPT codes are entered for clean claim

Ÿ Must meet month end deadline and balance batches accurately

Ÿ Work Monthly REQ Report

October 2008 to May 2009 Horizon Financial Management

Second/Third Party Medical Biller

Ÿ Work daily A/R report on open claims

Ÿ Evaluate medical records documentation and charge tickets to

abstract diagnosis on patients being seen outpatient/inpatient by

utilizing ICD 9 and CPT 4 manuals

Ÿ Manage, review and follow up on second and third party claims

previously submitted to insurance for processing

Ÿ Submit hospital claims electronically/HCFA 1500, UB 04 and

UB92 paper claims to Medicaid, Medicare and commercial

carriers

Ÿ Submit appeals to Medicare, Medicaid and other insurance carriers

on claim denied in error

Ÿ Communicate with insurance carrier regarding denials, claim status

and payment information

Ÿ Research denied claims and reprocess, if needed

April 2007 to Sept 2008 Pediatrics and Adolescents Clinic

Dr. Alfred W. Hathorn, MD

Front Office/Billing Office Supervisor

Medical Biller/Coder

Ÿ Evaluate medical records documentation and charge tickets to

abstract diagnosis on patients being seen outpatient/inpatient by

utilizing ICD 9 and CPT 4 manuals

Ÿ Manage, review and follow up on claims previously submitted to

insurance for processing

Ÿ Submit electronic/paper claims to Medicaid and commercial carriers

Ÿ Post charges and payments

Ÿ Complete and submit Kid med exam form to Medicaid for payment

Ÿ Communicate with patient by phone or in person relating to

statements

Ÿ Communicate with insurance carrier regarding denials, claim status

and payment information

Ÿ Research denied claims and reprocess, if needed

Ÿ Work monthly account receivable report

Ÿ Process monthly statements and mail to patient

Ÿ Assist physician with completing FMLA paperwork

Ÿ Facilitate physician enrollment in insurance contracts

Ÿ Enroll premature babies in Home Healthcare Synagis Program

Ÿ Order all office supplies for each department as needed

Ÿ Collect co pays, past due balances and current account balances

due

Ÿ Ensure patient has been completely educated on what their

explanation of benefits shows as well as the coinsurance amount

due

Ÿ Collect all necessary certificates, licenses, and insurance

documents to have credentials updated

Ÿ Submit all current credential information to insurance carriers

before deadline to ensure physician will be apart of network

EDUCATION

January 2008 Louisiana State University Shreveport

Medical Coding

March 2004 to May 2004 Professional Careers Development

Institute

Medical Billing/Claims

August 1993 to May 1996 Southern University

Medical Laboratory Technician

1993 Graduate of Southwood High School Shreveport, LA

SKILLS AND SYSTEMS

Knowledge of the following systems:

Microsoft Windows 98, XP, Vista, Excel, and power point, 10 key by

touch, Microsoft Office, IDX, Bar, TES, C SNAP, ECARE, IHFS

I suite, JDA, HBOC, Medical Management System, CPU Medical

Management System, Green Screen, Credo, Laser Fiche, RAM,

Practice Point Management System, knowledge of Medical

terminology and abbreviations, ICD 9, HCPCS, CPT 4, Knowledge of

HIPAA rules and regulations

SALARY REQUIREMENT :

NEGOTIABLE

REFERENCES * GIVEN UPON REQUEST

Contact this candidate