Shirley Carter

Oak Park, IL ***** Cellular: 773-***-**** Email: abqyqj@r.postjobfree.com

Education- Graduate-H/S king-( College,) Knox, Galesburg, IL. Health Care Seminars, Continuing Educations Seminars and other forums,.

AREA OF EXPERTISE

Strong verbal and written communications, including effective telephone exchanges: Experienced: Medical Billing, Professional. Responsible for personal and professional growth and development. With Other duties and responsibilities as assigned Office products; Word, Power Point / Microsoft office: Intermediate --Excel – (Basic) 1500/-HCPC-Billing/Wisconsin Medicaid Primary and Manage care contracts/for rate reimbursement. Established/Maintained Interpersonal Relationships as part of a successful team, serving both patients and clients-Proven Successful Customer Interactions.(i.e (pharma Point ) MRO(electronic system) medical records.,Meditech 5.5 and 5.6--IDX,(Centricity Web)/Ecare–Avality-Advanced-.MD. /PCS/LLS/CMS-ASF/EZ claim/ Nebo, SSI, Knet., Power Chart-,Prime,- Epic-Hyperspace- Med Assets-Any accessible PC. Systems. CPR+ (pharma point -experience, with change hlth/ and ZirMed as electronic connection for billing portals, Aka I emphysys,-a site accounts receivables to connect

KEY CAREER ACCOMPLISHMENTS

Medical/Billing, Reimbursement/Specialist, Collection/Medical/Registration-Front-Desk Receptionist, Billing Specialist for DME, Equipment and Infusion, Home Health Therapy -Charge Entry, Coder, Cash poster - Customer Service Rep/, (Improved customer service) support of Medical Collections/ Met deadlines, exceed expectations, and objectives consistently. Ability to complete assignments on a timely manner Researched billing discrepancies. Committed to continuous performance improvement:

Familiar withFDCPA/HIPAA satisfying resolutions. Managed and updated personnel files while protecting proprietary information. Applied coding and charges from manuals provided. Able to read eob’s for updates to issues. Relating to a denial or short/pay. Billed - Manage Care and Medicaid Carriers/ and age reports .Help analyze Trends on denials in billing history will reach out to other department for clarification on any issues that stop Growth. Kept closed contact with/department for updates, on codes/ Diagnosis/changing of carriers Authorizations Familiar with NDC/Rx/Compound/Delivery ticket info. Modifiers. Fastrack, Module. Some specialty-collection. Familiar with EFT/ERA/ Blue Cross Blue Shield /Government- 1500/UB04/UB92-Billing.-Medicaid Billing In-Patient and Out –Patient - and-- (Medicare Billing, Out –Patient only-)--Commercial Billing In/ Out. Physical Therapy, Internal Medicine, Radiology, Pathology, OB-GYN, Psych, SNF, LTAC, Ophthalmology, DME/ Home-Infusion Billing Familiar with NDC/Rx/Compound/Delivery ticket info. Modifiers, info on therapies such as INF/TPN/IGG etc.

Verification /updated on carrier changes or fee schedules/Contracts, being used Making sure Doctors orders are in compliance and up to date.. Appeal of unprocessed/ un paid claims./Correction and resubmission of claims. Processing of rebills if needed, etc. Ensuring all claims go through the electronic payer site. Troubleshooting Delinquent claims and problem-solving skills in order to secure payment flow. Reviewed actions in queues or A/R for any issues of claims pending. Submitted Claims in Queues for billing, Utilize corporate billing system to process weekly billing including electronic transmission (or paper submission if required.

Always proactive on any issues that may come up to hinder the process of a claim not paying according to the contract and or fee schedule - Monitor claims payments High attention to detail. Review daily reports distributed..Being able to adjust to situations, inside and outside of the organization. Work backlog underpayments .Called insurance’s for non- pays / denials/and billing issues. Manage assigned queues, keeping up-to-date and current on all Under payments Met deadlines, exceeded expectations

CAREER HISTORY— Present -Loyola University Medical Center-Hospital- In/Pt-Reimbursement-Specialist-

06/2013-09/27/18-Option-Care, DME, Infusion Therapy-Medicaid-Biller/Collector

08/2012 - 05/2013 -Kindred Hospital-(LTAC In pt, Biller /(Commercial / UB04’s

12/2011 --02/2012--Dr. Lyndon B Taylor-(OBGYN – (Temp) -Front Desk- Receptionist/Registrar/Biller1500

06/2011--12/2011—IDES-Illinois/Dept/of/Employment/Security (Volunteer)-Client/Representative)-Maywood, IL

11/2008 -06/2011--Joy of Health LLC--Physician Billing-Internal Medicine (Registrar/Receptionist/Biller-1500’s

01/2008 -07/2008-- Addison Search /Salem Group-(Agency) - Charge Entry Customer Service Rep. Medical Biller

09/2005-01/2007-- University of Il @ Chg.-Collection Specialist II) - Pathology lab-UB92’s

06/1999—03/2005--Mount Sinai Hospital –Chicago, IL Medicaid Biller- Rep (Patient Accounts)