Manager Insurance
Resume:
Melinda Moreland
Email: *********@********.***
Address: **** ***** ****
City: Centerburg
State: OH
Zip: 43011
Country: USA
Phone: 614-***-****
Skill Level: Management
Salary Range: $60,000
Primary Skills/Experience:
See Resume
Educational Background:
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Job History / Details:
Melinda J. Moreland, CPC, CMRS
3090 Croton Road
Centerburg, OH 43011
*******.********@*****.***
Summary of Qualifications
* Excellent organizational skills with attention to detail; Exceptional problem solving skills
* Superior written and oral communication skills; Ability to properly handle confidential data; professional and courteous
* Strong leadership abilities; a team player;
* Efficient and effective at meeting deadlines; highly motivated
* Managed 10 direct reports
* Excellent coding skills and compliance knowledge
Relevant Skills and Experience
* Over 13 years` experience in coding, compliance and reimbursement regulations
* Experience in using CPT, ICD-9-CM and HCPCS codes, E/M auditing
* Knowledge of authorization procedures, billing requirements, reimbursement requirements
* Knowledge of HIPAA and Compliance regulations
* Ability to establish effective relations with physicians, patients and insurance companies
* Administrative skills and experience; ability to multitask in fast paced work environment
* Experience with training peers and physicians, instructing over 11 coworkers
* Ability to exercise initiative, creativity, motivation
* Experience in the daily administration and financial activities of running a small business
Employment History
2012 - Present Billing Manager Central Ohio Urology Group, Inc., Columbus, OH
My responsibilities include management of a team of 10. Ensuring accurate and timely filing of claims for largest urology practice in Central Ohio with 26 physicians. Overseeing AR, tracking productivity of team members, PQRS, ASC billing, working rejected claims. Implementation of projects as assigned, setting fees, answering billing, coding and compliance questions, auditing physician charges, reporting findings. Ensuring correct coding initiatives and billing compliance are followed. Knowledge of insurance company regulations. Work with other managers to resolve billing issues. Interact with physicians and staff.
2011-2012 Billing/AR Manager Modern Medical, Inc., Lewis Center, OH Manager of the Quarter, 4th Quarter 2011
Modern Medical is a DME, pharmacy services and service coordinator for worker's compensation nationwide. My responsibilities include creating a billing team and implementing proper billing services. Coding and assuring compliance with national correct coding initiatives. Implementing a process for efficiently working rejected claims. Assisting team members with claim corrections and AR management. Supervise a team of 10 members. Prioritize daily workloads. Management of team members as is required.
2008- 2011 Senior Certified Coder OSU Internal Medicine, LLC Columbus, OH
My responsibilities include insurance billing, Medicare/Medicaid, Worker's comp, primary and secondary billing. Coded and billed for several internal medicine specialties. Audit and supervised five team members. Created several internal processes for improving handling rejections and quality controls. Did both inpatient and outpatient billing for physicians. Responsible for managing the back end of claims billing, assisting team with claim corrections, tracking productivity and accuracy. Audit physician charges and ensure correct coding initiatives followed. Assisting manager with duties and projects as assigned.
2000-2008 Self-Employed McQuesten Billing Agency Pataskala, Ohio
My responsibilities include insurance billing, Medicare/Medicaid, Worker's comp, primary and secondary insurance billing and patient statements. Responsible for obtaining and tracking authorizations, insurance follow-up, patient accounts and account management. Extensive experience interacting with the providers, patients and insurance companies. Skilled in coding, compliance and reimbursement regulations; HIPAA compliancy. Experience in using CPT, ICD-9-CM and HCPCS codes. Knowledge of authorization procedures; accomplished in Medicare/ Medicaid billing requirements. Ability to establish effective relations with physicians, patients and insurance companies. Proficient in Secondary Payer requirements. Experience with Windows XP, Microsoft Office 2000 and Quicken programs. Experience in the daily administration and financial activities of running a small business.
Volunteer Work
2002-2008 Soccer Coach Various Youth Teams Pataskala, Ohio
1995-2000 Troop Leader/Organizer Girl Scouts of U.S.A. Pataskala, Ohio
* Outstanding Leader Award - 1999
1992-1993 Den Mother Boy Scouts of America Pickerington, Ohio
Education
Certified Professional Coder
Certified Medical Reimbursement Specialist
Organizations
American Association of Professional Coders
American Medical Billing Association
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