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Medical Customer Service

Location:
Columbia, Maryland, United States
Posted:
September 07, 2018

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Resume:

Samuella Tucker Dartey

Columbia, MD *****

ac6yrk@r.postjobfree.com 240-***-**** ac6yrk@r.postjobfree.com

Billing & coding Specialist

Scrub Claims Reduce Rejections Speed Reimbursement Increase Cash Flow

Multi-task effectively among 3 – 6 eligibility databases, obtaining current insurance billing information. Communicate effectively with customers and all levels of staff. Good understanding of medical terminology, anatomy, and path physiology.

ICD-9-CM, CPT-4 and HCPCS Coding Medicaid, Medicare, and Workers Compensation

Commercial Insurance Claims Processing HIPAA Rules and Regulations

Professional Experience

AMERITOX, Columbia, MD 2017 – 2018

Ameritox provides pain medication monitoring, offering urine drug testing services helping physicians assess medication adherence of patients on chronic opioid therapy.

Error Processing Team Lead

Manage error processing and clearing house department.

Analyzed, improved, and directed work flow and assignments of 6-member team, increasing efficiencies, eliminating back log, and reducing error rate to less 0.5 %.

Developed long-range plan for billing operations and training areas, identifying and implementing cost containment and increasing efficiencies by 98%.

Identified and developed improvements, enhancing billing system quality (including charge entry, registration, and collections).

Shared and implemented billing best practices, increasing departmental efficiency.

AMERITOX, Columbia, MD 2010 – 2017

Error Processing Representative

Processing clean and clear claim.

Identify missing medical information from correspondence and other related documents.

Work simultaneously between multiple eligibility databases to obtain current insurance billing information, eligibility, demographic and other pertinent information.

Enter missing medical information into the Billing System, and Partner with team members to identify problem carriers & accounts.

Identify and provide timely Primary Payor Id changes (i.e. name, address, changes etc.).

Samuella Tucker Dartey Page Two

Assign Primary Insurance Payor Ids to claims that are missing information.

Provide feedback regarding new or additional insurance billing findings to the team to ensure timely processing of claims.

Partner with team members to improve the capture of missing information so as to ensure increased efficiencies in the Error Processing Process.

Provide high level of quality customer service to all internal and external clients in need of unbillable billing guidance.

Maintain required levels of performance and quality as determined by management.

Maintain complete understanding of the Unbillable Operational processes.

Adhere to company policies, including attendance and punctuality.

Adhere to confidentiality (HIPAA) rules and regulations.

Center for Accounting & Business Services, Hyattsville, MD 2010

Data Entry

Assists taxpayers and small businesses with taxes in Hyattsville MD and the surrounding communities

Performed general office duties including data entry.

Maintained proper book-keeping and accounting records.

Coordinated all client requests displaying accuracy to details.

Liaised with other managers and clients through e-mail and phone contact.

Handled incoming phone-calls with professional phone etiquettes.

ImagiMed, Shady Grove, MD 2009

Billing Specialist / Medical Coder (Extern ship)

Doing business as OPEN MRI, provides magnetic resonance imaging services for patients

Processing Explanation of Benefits

Assigns appropriate CPT for procedure code(s) to accurately report the physician services provided to patients

Assigns appropriate ICD-9 diagnosis code(s) to accurately support the need for each physician service.

Assists with the submission of billing data

Other duties as requested by supervisor.

SODEXHO, Gaithersburg, MD 2007 – 2008

IT/Customer Relationship

Develop Quality of Life services that reinforce the well-being of individuals, improving their effectiveness and helping companies and organizations to improve performance every day.

Samuella Tucker Dartey Page Three

Updated Spread sheet and downloading Reports

Processing Orders and attending to emails

Mailing orders to customer

Education

Master in Business Administration, Strayer University, MD, Dec 2015

Concentration in Health Service Management

Medical Coding and Billing Master Certificate Program, Computer Training, Johns Hopkins University, Columbia, MD, 2009

Courses: Medical Terminology, Medical Billing, Insurance Claims and Processing, Medical Administrative Procedures, Medical Ethics and Law, Pharmacology, Pathophysiology, and ICD-9-CM Coding CPT-4 coding (surgical and non-surgical)

Bachelor of Science in Database Management, Strayer University, MD, April 2009 – Aug 2013

Courses: SQL Programming, PL/SQL Programming, Database Fundamentals I&II, Data Warehousing and Senior Seminar: Information System

Technical Skills

Microsoft Office Suite (Word, Excel, Access, Outlook, and Power Point)

Billing Soft (Medisoft billing software, XIFIN billing system, EMDEON, and LANCELOT)

Professional Affiliation

Member, America Academy of Professional Coders – AAPC



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