Medical Billing Insurance
Resume:
Pamela Joy Berryhill
Email: abpdp3@r.postjobfree.com
Address:
City: Walker
State: LA
Zip: 70785
Country: USA
Phone: 225-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Medical billing and coding specialist with 11 years providing administrative and patient support in medical office settings. Advanced knowledge of private insurance processes and codes.
Educational Background:
High School Dipolma from Fortis College, Baton Rouge LA 1/2001 to 11/2012 (Medical Billing and Coding)
High School Dipolma from Nicholls State University, Baton Rouge LA 1/2001 to 11/2012
Job History / Details:
Professional Summary
Medical billing and coding specialist with 11 years providing administrative and patient support in medical office settings. Advanced knowledge of private insurance processes and codes.
Skill Highlights
Medical terminology expert
Maintains strict confidentiality
Knowledge of HMOs, Medicare and Medicaid
Billing and collection procedures expert
Medical Manager Software
Inpatient records coding proficiency
Electronic Medical Record (EMR) software
Outpatient surgery coding specialist
Vast anatomy/physiology knowledge
ICD-9 coding
HCPCS Coding Guidelines
Familiar with commercial and private insurance carriers
CPT and HCPCS coding
Internal and cardiac medicine billing
Behavioral health billing and collections
Insurance and collections procedures
Insurance report analysis
Interpreting instruction
Understands insurance benefits
HIPAA compliance
Composed and professional demeanor
Strong planning skills
Research and data analysis
Technical expertise
Office management professional
Excellent problem solver
Strong work ethic
Resourceful and reliable worker
Team player with positive attitude
Close attention to detail
Deadline-driven
Adept multi-tasker
Good written communication
Office support (phones, faxing, filing)
Exercises good judgment
Excellent verbal communication
Professional Experience
March 2001 to September 2012
Southern Medical Corp. Baton Rouge, LA
Insurance Billing Specialist
Accurately entered procedure codes, diagnosis codes and patient information into billing software.
Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.
Consistently ensured proper coding, sequencing of diagnoses and procedures.
Quickly responded to staff and client inquiries regarding CPT codes.
Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.
Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.
Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Received, organized and maintained all coding and reimbursement periodicals and updates.
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
Analyzed and interpreted patient medical and surgical records to determine billable services.
Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
Thoroughly reviewed remittance codes from EOBS/AR's.
Confirmed patient information, collected copays and verified insurance.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Completed appeals and filed and submitted claims.
Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.
Submitted refund requests for claims paid in error.
Carefully prepared, reviewed and submitted patient statements.
Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.
Meticulously tracked and resolved underpayments.Consistently informed patients of their financial responsibilities prior to services being rendered.
Performed quality control of the data entry system to verify that claims and payments were posted correctly.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Performed full-cycle medical billing in a fast-paced medical billing company.
Education and Training
2012 Fortis College Baton Rouge, LA
Associate of Applied Science Medical Billing and Coding
Coursework in Insurance Billing I&II
Coursework in Anatomy/Physiology
Coursework in Medical Terminology
Coursework in Psychology
Coursework in HIPAA Compliance
Coursework in Business Communications
3.94 GPA
On schedule to graduate in September of 2013
1986 Nicholls State University Thibodeaux, LA
Accounting Business
Attended for 2 years had to leave due to lack of funding to complete studies
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