Connie Wirth

Email: abpbyi@r.postjobfree.com

Address:

City: Spokane Valley

State: WA

Zip: 99206

Country: USA

Phone: 509-***-****

Skill Level: Any

Salary Range:

Primary Skills/Experience:

Medical Billing Specialist with experience supporting in house Group Health physicians. Process Medicaid and Medicare Provider Enrollment on behalf of physicians. Expertise includes verifying insurance coverage, adding coverage and determining primary, secondary or tertiary filing order. Submit claims and following up with Medicaid and Medicare on unpaid, denied or rejected claims.

Educational Background:

High School Dipolma from Spokane Community College and Spokane Falls Commun, Spokane WA 1/2001 to 6/1997 (Liberal Arts)

Job History / Details:

Professional Summary

Medical Billing Specialist with experience supporting in house Group Health physicians. Process Medicaid and Medicare Provider Enrollment on behalf of physicians. Expertise includes verifying insurance coverage, adding coverage and determining primary, secondary or tertiary filing order. Submit claims and following up with Medicaid and Medicare on unpaid, denied or rejected claims.

Licenses

Certified Medical Billing Specialist

Skill Highlights

ICD-9, ICD-10

CPT and HCPCS coding

Medical billing software

Office support (phones, faxing, filing)

Knowledge of Group Health, Commercial, Private Insurance, HMOs, Medicaid and Medicare

Answer external and internal billing questions and guidelines

Submit electronic claims to Medicaid and Medicare in ProviderOne and/or Epic

Resolve and resubmit denied, unpaid or rejected claims

Process patient billing statements for charges not covered by Medicaid or Medicare with ABN or HCA 13-879 form

Familiar with CMS and WAC rules

Adhere HIPAA compliance, guidelines and regulations in handling patient information

Understands Medicaid and Medicare billing instructions and guidelines or coverage limitations

Excellent in creating a standard job breakdown

Knowledgeable on Medicaid and Medicare billing and reimbursement process

Proficient in use of computers and office equipments and applications such as Word, Excel, PowerPoint, IBM, Epic, ProviderOne, etc.

Excellent data entry skills

Detail oriented and ability to prioritize work and multi-task

Excellent verbal and written communication

Composed and professional demeanor

Resourceful and reliable worker in analyzing and researching Medicaid and Medicare billing guidelines

Ability to work in a team environment or independently.

Bilingual- English and Tagalog

Professional Experience

October 2003 to Current

Group Health Cooperative Spokane, WA

Medical Billing Specialist and Provider Enrollment

Generate revenue by submitting electronic claims to Medicaid and Medicare in ProviderOne and/or Epic billing system

Maintain work operations by following policies and procedures according to Medicaid and Medicare compliance

Create and update processes for job breakdown

Process Medicaid and Medicare Provider Enrollment Applications on behalf of in house Group Health physicians

Resolve and resubmit denied or rejected claims

Apply or move patient payment, guarantor payment or insurance payment to the correct account

Move charges from account to account or from guarantor to guarantor

Follow HIPAA guidelines

October 1998 to September 2003

Special Mobility Services Spokane, WA

Program Assistant

Arrange medical transportation and interpretive services for Eastern Washington clients with Medicaid coverage to their medical appointments. Trained over 25 employees. Built a good relationship with medical providers, clinics, nursing home facilities, lodging and community resources.

August 1995 to October 1998

Lamonts Apparel Spokane, WA

Sales Associates

Provide good customer service to clients and sell store products. Organize and merchandise clothing by size, color, style and classification based on floor plan. Set up promotions and sale items per overlay schedule. Manage inventory and cash register.

June 1992 to August 1995

Riverview Retirement Community Spokane, WA

Dining Room Attendant and PBX Receptionist

Prepare and set up dining area. Service meals and drinks to the residents and their guests/families. I also worked as a PBX Receptionist at the same facility. Answer and transferred incoming phone calls. Schedule transportation on behalf of the residents. Create time cards for employees. Provide secretarial duties and file invoices for CEO, HR and other Administrative Staff.

Education and Training

1997 Spokane Community College and Spokane Falls Community College Spokane, WA

Associate of Arts Liberal Arts

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