High School Customer Service
Resume:
Harriet Wadley
Email: abpe73@r.postjobfree.com
Address:
City: Baltimore
State: MD
Zip: 21230
Country: USA
Phone: 410-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Medical billing and coding specialist with [twenty-three] years experience providing administrative and patient support in a multi-health insurance company, outpatient hospital and medical office settings. Advanced knowledge of private insurance processes, codes, policies and procedures.
Educational Background:
High School Dipolma from Harrisburg Area Community College, Harrisburg PA 1/2001 to 6/1981 (Business Administration / EC Education)
High School Dipolma from Cheyney State University, Harrisburg PA 1/2001 to 10/2012
High School Dipolma from Harrisburg High School (JH Campus), Harrisburg PA 1/2001 to 10/2012
Job History / Details:
Professional Summary
Medical billing and coding specialist with [twenty-three] years experience providing administrative and patient support in a multi-health insurance company, outpatient hospital and medical office settings. Advanced knowledge of private insurance processes, codes, policies and procedures.
Licenses
Certified Professional Coder (CPC)
Certified Coding Specialist - (Outpatient and Inpatient Hospital Based)
Skill Highlights
Inpatient records coding
Outpatient surgery coding
HCPCS Coding Guidelines
Anesthesia coding
Familiar with commercial and private insurance carriers
Dermatology billing
Behavioral health billing and collections
Insurance and collections procedures
Understands insurance benefits
Ambulance coding
Office management
Excellent problem solver
Resourceful and reliable
Team player with positive attitude
Deadline-driven
Good written communication
Medical Terminology
ICD-10 (International Classification of Disease Systems)
Billing and collection procedures
Medical terminology expert
Office management professional
Close attention to detail
Patient chart auditing
Dermatology billing
Records management
Hospital inpatient and outpatient records
Inpatient records coding proficiency
Outpatient surgery coding specialist
Patient referrals expert
Patient chart auditing ability
Professional Experience
February 1999 to November 2012
Crossroads Centers Baltimore, Maryland
Outpatient Medical Insurance Claims Billing Specialist
Meticulously tracked and resolved underpayments.
Consistently informed patients of their financial responsibilities prior to services being rendered.
Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
Performed quality control of the data entry system to verify that claims and payments were posted correctly.
Billed all lab claims with attached lab slips.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Thoroughly investigated past due invoices and minimized number of unpaid accounts.
Recorded and filed patient data and medical records.
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Strictly followed all federal and state guidelines for release of information.
Scheduled patient appointments.
Accurately entered procedure codes, diagnosis codes and patient information into billing software.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Initiated, performed and documented quarterly coding audits for physicians.
Managed collections claims for unpaid bills against the estates of debtors.
Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Accurately posted and sent out all medical claims.
Submitted electronic/paper claims documentation for timely filing.
Precisely evaluated and verified benefits and eligibility.
Responded to correspondence from insurance companies.
Posted and adjusted payments from insurance companies.
Identified and resolved patient billing and payment issues.
Maintained and updated collections tracking spreadsheet to help organize payment information.
Confidently and adeptly handled claim denials and/or appeals.
Evaluated patients' financial status and established appropriate payment plans.
Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.
Prepared billing correspondence and maintained database to organize billing information.
Wrote clear and detailed clinical phone messages for physicians.
Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
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.
June 1988 to July 1998
Blue Cross Blue Shield of Maryland Owings Mills, Maryland
FEP / BGE - Claims & Telephone Customer Service Representative
Consistently informed patients of their financial responsibilities prior to services being rendered.
Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
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.
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Strictly followed all federal and state guidelines for release of information.
Monitored shared email in-boxes and ensured inquiries were addressed.
Resolved and clarified issues with patient medications and collaborated with local pharmacies.
Coded outpatient encounters at a rate of 160 per day and 120 complex specialty coding.
Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient setting.
Accurately entered procedure codes, diagnosis codes and patient information into billing software.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Accurately posted and sent out all medical claims.
Submitted electronic/paper claims documentation for timely filing.
Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
Precisely evaluated and verified benefits and eligibility.
Responded to correspondence from insurance companies.
Posted and adjusted payments from insurance companies.
Identified and resolved patient billing and payment issues.
Confidently and adeptly handled claim denials and/or appeals.
Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.
Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Arranged and assisted with hospital admissions.
Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.
Consistently ensured proper coding, sequencing of diagnoses and procedures.
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.
June 1987 to April 1988
Blue Cross Blue Shield of Pennsylvania Harrisburg, Pennsylvania
Medical Claims Specialist
Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
Performed quality control of the data entry system to verify that claims and payments were posted correctly.
Billed all lab claims with attached lab slips.
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Strictly followed all federal and state guidelines for release of information.
Coded outpatient encounters at a rate of 160 per day and 120 complex specialty coding.
Carefully coded disease and injury diagnoses, acuity of care and procedures in an inpatient setting.
Accurately entered procedure codes, diagnosis codes and patient information into billing software.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Accurately posted and sent out all medical claims.
Submitted electronic/paper claims documentation for timely filing.
Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
Responded to correspondence from insurance companies.
Posted and adjusted payments from insurance companies.
Confidently and adeptly handled claim denials and/or appeals.
Prepared billing correspondence and maintained database to organize billing information.
Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
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.
Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.
June 1987 to June 1989
US Army Reserves Harrisburg, Pennsylvania
Medical Supply Specialist
Strictly followed all federal and state guidelines for release of information.
Monitored shared email in-boxes and ensured inquiries were addressed.
Wrote clear and detailed clinical phone messages for physicians.
May 1984 to May 1987
US Military - Army Division Various US Locations, Various / Germany
Subsistence Supply Specialist
Honorable DischargeManaged food and produce receiving process with 100 percentage accuracy.Ensured minimal product shrink and coordinated secondary usage of productLocated items requested by customersPerformed dishwasher dutiesPerformed serving, cleaning, and stocking duties in establishmentsPrepared a variety of foods according to customers' orders or supervisors' instructionsStocked and rotated products, stocked supplies, and paper goods in a timely basisSupervised and coordinated activities of cooks and workers engaged in food preparationTook orders from patrons for food or beveragesTransferred supplies and equipment between storage and work areasUsed all food handling standardsWashed, peeled, cut, and seeded fruits and vegetablesWrote patrons' food orders on order slips, memorized orders, and entered orders into computers for transmittal to kitchen staffCommunicated with customers regarding orders, comments, and complaintsCompiled and maintained records of food use and expendituresEnsured first-in-first-out system with all ingredients labeled and stored properlyMaintained contact with kitchen staff, management, serving staff, and customersTrained staff of eight employees for correct facility procedures, safety codes, proper recipes and plating techniques.Answered telephone calls and responded to inquiries.
Checked temperatures of freezers, refrigerators, and heating equipment to ensure proper functioningMopped floors and cleaned walk-in refrigerators and storage areasOversaw the operation and maintenance of equipmentPresented menus to patrons and answered questions about menu items, making recommendations upon requestProvided excellent customer serviceRelayed food orders to cooksRequested and recorded customer orders, and computed billsShopped for and ordered food and kitchen supplies and equipmentConsistently offered professional, friendly and engaging service.
Followed all safety and sanitation policies when handling food and beverage to uphold proper health standards.
Immediately reported accidents, injuries or unsafe work conditions to manager and completely and promptly filled out required safety forms.
Developed and maintained positive working relationships with others to reach business goals.
Conducted inventory and restocked items throughout the day.
Verified amount of cash in the cash drawer against the day's receipts.
Education and Training
Harrisburg Area Community College Harrisburg, Pennsylvania
Business Administration / EC Education
Received 30 Credit Hours from Institution in Business Administration and the Early Childhood Education studies.
Cheyney State University Cheyney, Pennsylvania
Psychology-Child Development
Attended from September 1979 to December 1979. Receive 15 Credit Hours while studying in field.
1979 Harrisburg High School (JH Campus) Harrisburg, Pennsylvania
High School Diploma Academic / Work-Study
Academic Studies / Honor Roll / Work-Study worked at IBM in the morning as a Order Parts Puller Processor - Inventory Control, Audit, Customer Service. Went to High School in the afternoon to complete academic studies required for graduation.
Candidate Resume - John Hodd
Contact Information -
Email: abpe73@r.postjobfree.com
Address:
City: Newport Richey
State: FL
Zip: 34652
Country: USA
Phone: 727-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Trained and certified building engineer for Marriott Courtyard Hotel in Salisbury, MD. Responsibilities included: maintenance and upkeep of all hotel equipment; work closely with General Manager and all other departments; apply and implement hotel standards;develop time-saving and efficiency centric strategies; manage and train new staff.
Educational Background:
High School Dipolma from SUNY Farmingdale, Farmingdale NY 1/2001 to 6/1991 (Business)
High School Dipolma from SUNY- Farmingdale, Farmingdale NY 1/2001 to 10/2012
Job History / Details:
Summary
Trained and certified building engineer for Marriott Courtyard Hotel in Salisbury, MD. Responsibilities included: maintenance and upkeep of all hotel equipment; work closely with General Manager and all other departments; apply and implement hotel standards;develop time-saving and efficiency centric strategies; manage and train new staff.
Highlights
operate and maintain all plumbing,electrical,boiler and refrigeration systems.
team player
self motivated
reliable
honest
develop daily schedule for department
work with vendors and other subcontractors
evaluate and solve guest issues as they arise
research and investigate new methods or equipment
meet budget requirements
cross train where applicable
trained in CPR
certified as a pool operator
Accomplishments
Promoted to manager within first year
Remained under budget for three years
Utilized warranties to fix or update equipment
Scheduled employees time to best suit needs of hotel
Assisted in design plans for lobby upgrade
Upgraded hotels' internet and cable systems
Received certifications for pool and refrigeration maintenance
Experience
April 2008 to October 2012
Courtyard by Marriott Salisbury, MD
Maintenance Supervisor
April 2003 to April 2008
Tim Merritt Construction Company Salisbury, MD
Assistant Foreman
- worked on job sites that included roofing;flooring;framing,dry wall;insulation;plumbing;electical and HVAC.
March 1997 to April 2003
Eastern Correctional Institute Westover, MD
Corrections Officer
Care, custody and control of inmates
February 1991 to March 1997
Rikers Island Department of Correction East Elmhurst, NY
Corrections Officer
Care, custody and control of inmates
Education
1986 Lindenhurst High School Lindenhurst, NY
High School Diploma
SUNY- Farmingdale Farmingdale, NY
Associate of Science Business
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