JULIA RILEY

**** ******* ******, **. *******, MO 63301 636-***-**** ac4or8@r.postjobfree.com

PROFESSIONAL SUMMARY

Ambitious and pro-active allied health professional seeking a position where my customer / patient care service, medical administration and billing/coding experience can be best utilized.

Highly structured and have high attention to detail skills

Adept at resolving medical billing issues, including insurance verification.

Thrives individually or within the constructs of a team dynamic.

Proficient in MS Office, data entry and 10-key while typing 60 words per minute. Pharmacy Technician License till May 2018

KEY PROFICIENCIES

Medical Billing & Coding Extensive Training in ICD-9-CM, HCPCS, CPT Co-Payments & Deductibles HIPAA Compliance Greenway PrimeSUITE EHR/PMS Insurance Billing Procedures Introduction to ICD-10-CM Insurance Verification Anatomy & Physiology Medicare, Medicaid, TRICARE CMS 1500, CM 1450 (UB-04), EOBs Managed Care (HMO, PPO, and POS) Insurance Claim Processing Electronic Payment Posting Appointment Scheduling Medical Terminology Government & Third-Party Payers Office Management MEDICAL EDUCATION

Ultimate Medical Academy – Tampa, FL

● Medical Billing and Coding Associate in Science Degree 07/2012 Diploma, Medical Billing and Coding 10/2011

Sanford Brown College 2005

Medical Billing and Coding Diploma

Pharmacy Technician Certificate/License valid until May 2018 Work Experience

Integrated Resources- Magellan Healthcare May 2017 --June 2017 Claims Processor

● Printed remittance advice reports,census reports,billing summary reports.

● Generated new claims after they were researched and verified of all insurance information, balances due and Demographics updated as needed .

● Clear of all errors to be downloaded into the bucket batches and mailed out as assigned.

.

.

The Joint Chiropractic Dec.2016-Jan.2017

Wellness Coordinator

● Checked in New patients,collected payment at time of service.

● Processed data entry from intake form and hipaa compliance sheet signed by patients.

● Handled cash box monies and billed patients that had past due accounts. K- Force- staffing Oct 2016- Nov 2016

Data Entry

● Extracted health plan main folders housing the disclosure forms titled, dated and year.

● Processed disclosure forms using PDM Syntax numbers, ssn numbers.

● Putting all information into excel spreadsheet format into folders .

● Downloading all folders into system and scanning them to my boss. Healthcare Scouts-Conifer Health Solutions May 31,2016 - June 2016 St.Ann Mo 63047

Full Time -Billing

working Hospital contracts (4 weeks)

● Working Accounts given by manager

● Electronic Claims,Paper Claims,corrected all UB04’s,

● Updated system for the next working day, software used Optum Claim Administrator. Contract Jobs by Robert Half

.

St. Louis ENT

Kirkwood Mo (2 days) June 2015

● Data Entry,billing medical claims for dos,using software Epic Traffic Law Counselors(2 days) Aug-2015

● Filling Charts for lawyers,Delivering files to clients in the area. Logan College Of Chiropractic(2days) Sept. 2015

-Chesterfield Mo

● Receptionist, Scheduled patients for the doctors. Direct Hire Positions:

United Scripts Oct.2016-Nov. 2016

Maryland Heights Mo.

Full time-Data Entry Pharmacy tech

● Data entry for Pharmacy company receiving faxes into the Queque in the orders from Doctors offices, Hospitals

● Added all the SIG codes and all information on the refill forms and new orders.

● Software used QS/1 Docutrak.

Midwest Administrative Services

Nov.2015-April-2016

Midwest Administrative Services Nov.2015-April.2016 Billing A/R Medicare

● Printing census reports,Billing Summary Reports,

● Generating new Claims,Updating claims.scrubbing claims, making corrections to all claims .

● Scrubbing claims,Making corrections to all claims that were rejected .

● Downloading EDI claims into E Solutions then downloading claim batches into system for billing

● Sending the bills out in a timely manner,Using the software Vision,E Solution.

.

Great Strides Behavioral Consultants Aug 2015 - Sept. 2015 Full Time -Billing

Submits Claims to clearing house, insurance company, individuals

● Responsible for tracking and receiving EOB’s

● Sending out billing statements to all past due patient accounts,performs accounting and all accounts Receivable tasks.

Volunteer in Medicine July-2014-Aug-2015

St.Charles Mo

Part time -Administrative Assistant (1 year)

● Greeting Patients when they are walk ins,registered all new patients being treated.

● Updated Medical records as needed, purged records, organized files.

● Made cold calls to patients with reminder of appointment times and doctors being seen. Valarity Oct.-2013-March-2014

St.Louis Mo 63141

Full -Time EBO

● Reviewing insurance payments in relation to the Patient Responsibility

● Completed skip tracing calls to patients that returned mail was not answered

● Scheduling patients for repayments on any past due accounts agreement for credit cards and

● checking accounts

● Using Nexgen software.

Advent medical Group March 2013-Oct 2013

St.Peters Mo 63376

Full Time- Front Desk/Medical records

● Checking in new patients having them fill out hipaa forms,insurance information .

● Demographics and Emergency contact form

● .Scheduled follow up appointments,collected copayment and balance due at time of services.Collected Co -pay, entered payments into system and gave the patients a receipt.

● Pulled all the Patients charts for the Doctors that were being seen that business day.

● Data entry for all doctors notes into the patients charts and updated all prescriptions,Test ordered.

Sent records requests, workman comp paperwork to assign attorneys, Processed FMLA Paper work.Software

● Used Benchmark, Epic.

Express Medical Billing Feb.2005-July 2005

Billing Medicare/Medicaid

Corresponded with insurance companies,verified record status with attorneys.

● Provided customer service,maintained accurate and up to date patient records

● .Handled Medicare/ medicaid billing issues and processed payments Externship for Sanford Brown College

Missouri Dept. of Corrections Dec. 2005-Nov. 2011

Full Time -C O 1

● Maintained the security of all inmates that I was assigned to during any 8 hour shift

● Worked in the medical dept for a total of 3 years combined.

● Made sure that all inmates followed by all the rules.

● Kept a signed logbook that kept track of all offenders that were scheduled for a dr. appointment, called housing units that inmates lived in if patients were not on time to see doctors.

● I made sure that inmates went to work or school .When inmates violated rules that they were suppose to follow I reported them and followed policy. True Manufacturing (1 year) Jan-2003/Jan-2004

Pacific Mo

Machine Operator

● Operated a sheet metal machine

● Metal press machine

Contact this candidate