SUMMARY OF SKILLS
Professional with experience in customer service, accounting, payroll and quality control in various industries
Medical coding and billing certification (ICD9) and knowledge of HIPAA privacy laws
Solid problem-solving and analytical skills
Knowledge of word processing, spreadsheet and database programs
Excellent interpersonal, communication and leadership skills
Highly motivated individual and team player
GENTIVA HEALTH SERVICES 2007 – Present
Perform initial assessment to determine patient’s need for home care services and provide information to clinical team.
Identify payer sources, verify benefits, negotiate rates and obtain authorization for services.
Ensure accounts are paid in accordance with terms of contact and notify management team of any potential problems with payer source.
Document and maintain patient files to comply with company policy, legal requirements and regulatory mandates.
Payroll and Data Entry Clerk
Maintain admission and billing data for 375- 400 patients and payroll information for 18 clinical professionals in the local office using CaseMatch software.
Verify completeness and accuracy of information maintained in database for consistency with company policies, legal requirements, and Federal healthcare regulations, including HIPAA.
Compile and distribute compliance documentation as requested by management and operations staff.
Collect data from internal and external sources to respond to requests for information, obtaining appropriate approval and maintaining log of requests.
Set up and maintained patient files consisting of medical charts, nursing assessments, physical and occupational therapy session reports and physician orders.
Ordered supplies for 10 assisted living facilities and maintain records for Medicaid billing.
Sent out new hire packets for new employees, perform reference checks, criminal background checks, and entered results into company database; maintained employee files.
Performed monthly compliance reports for Director Clinical Operational Specialists, Director Clinical Management and Manager of Clinical Practice.
Answered multiline phone system and perform other clerical duties, as needed.
NORTH CAROLINA DIGITAL IMAGING &MOBILE ULTRASOUND 2006-2007
Medical Billing Clerk
Coded medical invoices in accordance with ICD9 and submit insurance claims to private insurance companies, Medicare and Medicaid for medical services provided.
Reviewed all invoices and records to ensure accuracy. Maintained records for accounts receivables.
Researched and reconciled overdue claims, insurances denials and appeals.
OTHER PROFESSIONAL EXPERIENCE:
CITY OF WINSTON SALEM DEPARTMENT OF REVENUE (2005-2006)
Customer Service Agent (Temporary Assignment)
REPUBLIC MORTGAGE INSURANCE COMPANY (2002-2005)
Quality Control Analyst
JOHNSON CONTROLS, BATTERY DIVISION (2000 - 2001)
Payroll Clerk, Data Entry Clerk
ADAMS MARK HOTEL (1994 – 2000)
Accounts Receivable Clerk, Reservation Agent, PBX Operator
North Forsyth High School
Guilford Technical Community College (2016-Present)
Canyon College of Idaho, Medical Billing and Coding Certificate (2006)
Forsyth Technical Community College- Medical Coding Course Certificate (2006, 2015)
Forsyth Technical Community College- Medical Billing Course Certificate (2006, 2015)
Forsyth Technical Community College-Medical Terminology Certificate (2005, 2015)