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Medical Billing Insurance

Location:
Monticello, New York, 12701, United States
Posted:
January 04, 2018

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Resume:

Darlene Smith

PO Box ***

Monticello, NY *****

Email: iimagez2@yahoo

845-***-**** -Home – 845-***-****-Cell

Summary: Energetic, enthusiastic team oriented leader with broad and diverse experience and skills. Experienced in optimizing revenue and performance, with on hand experience in Medical Billing and Counseling. Self-motivated and an effective communicator, demonstrating a keen understanding of the Therapeutic concept and Medical Billing procedures with full competency of OASAS and HIPPA compliance.

SUMMARY of QUALIFICATIONS

Inquisitive, resourceful and creative experience counselor, with problem solving, conflict resolution, relationships and relapse prevention skills.

Strong team building and excellent communication and collaboration skills, and experienced withmandated clients and MICA clients.

Skilled in medical billing and coding. Good working knowledge of DMS-4 codes and medical terminology.

Knowledge of implementation of therapeutic community services and full competency of OASASregulations, and STARS reporting.

PROFESSIONAL EXPERIENCE

Sullivan County Department of Community Servcices 2015 - 2017

Conduct screening interviews to determine the need for a drug and alcohol assessment and for services in the specific areas of detoxification,

Make referrals to appropriate health and human services agencies as needed based on the outcome of the screening interview.

Use a strengths-based and trauma-informed approach to work collaboratively with clients.

Meeting with clients to evaluate their health and substance problem.

Collect and review referral information upon assignment of clients from the referral source.

Consult with others as needed to support coordination of services and scheduling of client.

Based on assessments, make referrals to the most appropriate programs and agencies in an effort to help clients access the right level of care to best meet their treatment needs.

Assist clients with scheduling an admission or first appointment date at the program or facility where they are referred.

Monitor client access to and involvement with treatment and other providers to help address barriers to treatment and the recovery process; follow up with clients.

Assess process and client’s satisfaction with adjusting to the program

Complete paperwork requirements and maintain quality, up-to-date clinical records, including Outcomes Survey information and Discharge Plan.

Remain in compliance with internal and external policies, procedures, regulations, and

standards, According to OASAS requirements

Identifying issues and create goals and treatment plans

Teaching clients coping mechanisms

Leading group therapy sessions

Providing updates and progress reports to courts

Referring clients to support groups

Setting up aftercare plans.

Daytop Village Inc. Parksville and Swan Lake, NY 2006 - 2012

Provided case management services for individuals with substance abuse through ethical, respectfuland realistic counseling methods, which includes prepared rehabilitation plans and engaging clients intheir own recovery.

Coordinated with the site supervisor to assess and facilitate appropriate level of services. Provide Intakes, referrals, and psychosocial assessments as well as behavioral modification, counseling,and crisis intervention services.

Documented progress notes and treatment plans with clients to develop high quality rehabilitation plansaccording to OASAS requirements.

Facilitated daily group meetings, individual-counseling sessions completed shift reports, and chartedbehaviors.

Implemented court procedures and training to build a positive rapport with law enforcement officers,court officials and community service agencies in order to help clients comply with legal mandates.

Refer clients and family members to outside support options and other resources in the community forfurther services.

Catskill Regional Professional Billing. Monticello, NY 2007-2008

Physician Professional Billing Service. Monticello, NY 1994-2007

Performed full-cycle medical billing in a fast-paced medical facility investigating past due invoices andminimized number of unpaid accounts.

Prepared financial statements and billing procedures, and attach all required claims documentation including referrals, completed insurance and claim forms and other required correspondence.

Recorded and review medical records for accuracy by ensuring compliance of procedure codes, diagnosis codes and patient information. And accurately recorded data electronically for collection, storage, analysis, recovery and reporting.

Demonstrate knowledge of HIPPA Privacy and Security Regulations by appropriately handing outpatient information and accurately explaining patient bill of rights.

Post medical charges and collected payments from health insurance providers, adjustments and denials into medical manager systems while confirming patient information and verifying insurance information.

Handled all kinds of insurance claims, including private insurance, Medicare and Medicaid and insurance fraud.

Utilized classification software to assign clinical codes for reimbursement and data analysis.

Education:

Bachelors of Applied Science, Sociology - New Paltz College, New Paltz, NY.

Associates of Applied Science, Human Service / Alcohol and Drug AddictionSullivan County Community College, Loch Sheldrake, NY.

Certifications / Educational Training

New York State Office of Alcoholism and Substance Abuse Services

Credential Alcoholism and Substance Abuse Counselor Trainee



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