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Customer Service Insurance

Location:
Leesburg, Florida, 34748, United States
Posted:
August 31, 2017

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TERESA WOLCOTT, CPC

Leesburg, Florida ***** Tel. 315.***.**** ac13jv@r.postjobfree.com

PROFESSIONAL SUMMARY

Well-regarded Certified Professional Coder with the skill, knowledge and competence that comes from over 3 years of medical billing and coding experience. Follows guidelines to assure consistent quality. Functions independently with limited direction or guidance. Ensures medical records are maintained with respect to patient confidentiality, completeness and timeliness and in compliance with HIPAA regulations.

Electronic Medical Records (EMR / EHR) and proprietary softwares.

Experienced with insurance verifications, denials, Medicare, Medicaid and Commercial Insurance.

Background includes Family Practice, Cardiology, and Hospitals.

Attention to detail needed to review and correct errors and maintain high levels of accuracy.

Ability to review Medical Records and knowledge of HIPPA

CORE QUALIFICATIONS

Medical Billing • Medical Coding • Payment Posting • Patient Services

ICD-9-CM • HCPCS • CPT • Proficiency in ICD-10-CM • Scheduling • Insurance Verification

CMS 1500 • CMS 1450 (UB-04) • EOB / COB • Collections

Government Payers • Medicare • Medicaid • Tricare • Third- Party Payers • Claims Documentation

Co-Payments and Deductibles • Medical Terminology • Anatomy & Physiology • HIPAA Compliance

Managed Care (HMO, PPO, and POS) • Worker’s Compensation • Office Management

Insurance Claim Processing • Insurance Billing Procedures • Disease Processes

MS Word / Office / Excel • Medical Office Procedures • Computer Skills • Data Entry • 10-Key Skills

CERTIFICATIONS / ASSOCIATIONS

Member of the American Academy of Professional Coders (AAPC), #01191825

National CPC Certification - Current with ICD 10

PROFESSIONAL WORK EXPERIENCE

Holiday Travel Resort – Leesburg, FL 12/2017 – Present

Customer Service of Retirement Community 55+ Park

Activity Director

Plans winter activities for residents of park not limited to dances, shows and special presentations

Print and sell all park club tickets to shows

Coordinate all communication for park’s monthly newsletter

Keep activity notice board current and organized

Maintain records of building use so there is no conflicts with clubs and shows

Ollies Bargain Outlet – Leesburg, FL 8/2017 – Present

Cash Sales Associate: Direct sales and service to public

New store set up

Freight processing

Customer service at registers

Replenish front end at close of day

Train new employees

Follow company policies and procedures

Michael’s Craft Store - Lady Lake, FL 11/2015 - Present

Customer Service of retail merchandise: Direct sales and service to public

Replenishment Team

Unload merchandise from freight truck

Work merchandise to floor

Read POG’s for new merchandise and set to POG

Work new merchandise to aisle’s and free standing power point sale units

Run register to service customers for fast friendly service

Assist customers in finding items in store when working on the floor.

Visiting Nurse Services of Central Florida – The Villages, FL 04/2015 – 12/2015

Provider of residential home health care services.

Medical Biller

Perform insurance billing duties for commercial insurances, including review and verification of patient account information against insurance program specifications.

Review claims for compliance and completeness for claim submissions.

Submit and follow up on payer claims.

Resolve routine patient billing inquiries and problems.

Obtain addition authorizations via use of Patient Medial Records as needed for Nursing, Therapy, or HHA.

Verify ICD-9 & ICD-10 CPT, and HCPCS coding and handle payroll duties for 30 employees.

St. Elizabeth Medical Center – Utica, NY 11/2013 – 03/2015

General medical and surgical hospital with 181-beds and part of the Mohawk Valley Health System.

Medical Coder / Medical Biller

Worked remotely and on-site.

Processed medical billing utilizing EHR software for 8 physicians

Read physician notes, and coded notes for billing to patient insurance (commercial, Medicare and Medicaid).

Entered office visit procedures and diagnosis using ICD-9-CM and CPT codes into patient records.

CNY Cardiology – Utica, NY 12/2011 – 04/2014

Practice comprises a group of board certified cardiologists, nurse practitioners, and cardiovascular technicians providing state-of-the art cardiac care.

Medical Coder / Medical Biller

Verified insurance coverage (commercial, Medicare and Medicaid), updated patient demographic information utilizing EMR software, and obtained authorizations.

Processed insurance denials and duplicate claims and applied ICD-9 codes for Holter monitors.

Formatted a program to ensure all Echocardiograms were read by physicians, and billed and coded accurately and in a timely manner.

Brought past due accounts to a status of being current.

Fielded customer phone calls on accounts, balances, and insurance questions.

EDUCATION

Ultimate Medical Academy – Associate in Science Degree / Medical Billing & Coding, 01/2012

Ultimate Medical Academy – Diploma / Medical Billing and Coding, 05/2011

Mohawk Valley Community College – Associate of Science Degree



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