Customer Service Medical Billing

Cynthia Hush

Email: abozta@r.postjobfree.com

Address:

City: Plainfield

State: NJ

Zip: 07060

Country: USA

Phone: 908-***-****

Skill Level: Any

Salary Range:

Primary Skills/Experience:

I am detail oriented quality focused professional billing specialist. I have a successful track record handling complicated assignments. Highly experienced in reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications; I am dedicated to maintaining strict patient confidentiality. I currently looking for my next challenge and I want to bring the skills that I now possess and l am looking forward to joining a team of professional. Summary

I am detail oriented quality focused professional billing specialist. I have a successful track record handling complicated assignments. Highly experienced in reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications; I am dedicated to maintaining strict patient confidentiality. I currently looking for my next challenge and I want to bring the skills that I now possess and l am looking forward to joining a team of professional.

Educational Background:

High School Dipolma from Lincoln Technical Institute formerly Cittone, Edison NJ 1/2001 to 6/2002 (Medical Administrative Assistant)

Job History / Details:

Professional Overview

Dedicated Medical Billing professional with refined computer skills and strong ability to assist in efficient company operations. I am driven, mature, ambitious, energetic and focused professional with motivation to perform beyond expectations. I also am reliable and competent professional with exceptional data entry and customer service skills.

Summary of Skills

Claims appeal procedures

Insurance processing

HIPAA compliance

International Classification of Diseases (ICD.9CM)

Medisoft proficient

Online claim submission

Internet Research

Filing, Faxing, Copying

Email

Minute Taking

Microsoft Office

Microsoft Excel

Microsoft Word

Data Entry

Typing 70 WPM

Computer Proficient

Customer Service Skills

Time Management

Letters and Memorandum

Work Experience

October 2003 to May 2011

Foot And Ankle Care Associates, LLC Piscataway, NJ

Medical Billing Coordinator

Updated patient financial information to guarantee accuracy.

Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.

Accurately posted surgeries, office visits and payments for assigned carriers.

Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.

Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.

Communicated with medical transcriptionist regarding patient medical records.

Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables system and clearing house.

Submitted refund requests for claims paid in error.

Performed full-cycle medical billing in a fast-paced medical billing company.

Verified patients' eligibility and claims status with insurance agencies.

Entered orders into the EMR system efficiently and without errors.

Diligently filed and followed up on third party claims.

Maintained strict patient and physician confidentiality.

Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.

Provided accurate and appropriate information in response to customer inquiries.

Trained staff on Insurance Payment Posting, Collections, Data Entry.

September 1998 to June 2002

One Health/Great West Health Insurance Piscataway, NJ

Medical Provider Credentialer and Provider Maintenance

One Health Plan/Great West Healthcare1998-2002

Credentialing Analyst and Provider Maintenance Analyst

GREAT-WEST HEALTHCARE (PREVIOUSLY ONE-HEALTH PLAN) 8525 Orchard Road, #3Englewood, CO 80111-5022 800-***-****

www.csog.net GREATWEST-HEALTHCARE--

Updating and maintaining provider data (hospital, physician, and ancillary), loading newly credentialed providers and updating providers and updating provider demographics for web searching capabilities. Maintaining providers' contracts and payment schedules for accurate claims processing. Answered all incoming telephone calls from medical healthcare providers regarding application status and verify reports and send post credentialing approval letters to providers.

Data Entry: Excel, MS Word. PIMS, NPDB

4 years of credentialing where I was accountable for ensuring that all personnel and services adhere to facility and staff policies, department guidelines, regulations and government laws. I follow a strict credentialing checklist per NCQA standards for potential provider's Insurance network participation.

I had to maintain regular cooperation and compliance with all regulatory, accrediting and membership-based organizations. I had to create and carry out various credentialing processes in relation to physicians, and various other healthcare professionals. I had to ensure that all personnel and services adhere to facility and staff policies, and follow the department guidelines, regulations and government laws.

I process applications and reappointment paperwork, checking for full completeness and accuracy. The work is repetitive where I am constantly collecting and processing significant amounts of verification and accreditation information, and constantly I had to maintain and update accurate databases for both practitioners and facilities. These databases include pertinent education, training, experience and licensure contents, insurance, and boards. I had to prepare mu own records for regular auditing, as well as maintain close communication with all appropriate practitioners to ensure that records are up-to-date and consistent with the companies policy for network participation.

I use the Excel and the company system database.

PIMS (Company System Data Bank)

NPDB (National Practioner Data Bank)

Education

2002 Lincoln Technical Institute Edison, NJ

Diploma Medical Administrative Assistant

Contact this candidate