**+ years successfully inputting and validating medical claims data and overseeing the use of proper documentation and coding on patients’ accounts. Skilled at preparing and submitting clean claims to various insurance companies and performing regular follow-up. Oversee staff of five. Balance daily receivables and run daily/monthly A/R reports. Coordinate referrals and pre-authorizations. Very positive and proactive approach to getting things done.
Claims denial follow-up
Bad debt reporting
Patient data coding
Patient statement review
ICD-10, CPT Coding
Electronic Remittance Advice
Electronic Medical Billing
HCFA 1500 forms
Implementation of EMR
Monitoring and reporting for Meaningful Use
Initiate PQRS reporting
Maintaining Insurance aging at 90-95% current
Elgin Internal Medical Associates SC, Billing Supervisor, March, 2007-Present: Supervise staff of five for Special Procedures, Billing and Referrals department. Review daily encounter documentation for claim submission. Submit appeals. Balance daily receivables, and run daily/monthly A/R reports.
Children and Teens Medical Center, Site Manager October, 2001-April, 2002 and Billing Manager April 2002-March, 2007: Managed staff of three. Balanced daily/monthly receivables for three clinics and review daily charge tickets for electronic claims submission. Refunds and appeals
Highland Managed Care Group, Utilization Review April, 2000-October, 2000, and Claims Adjudication April 2000-October, 2001: Review and enter incoming referrals for authorization. Review and pay monthly EOB’s for three physician groups.
Additional experience includes working as an LPN staff nurse at Friendship Village, Schaumburg, IL, November 1992-November 1994. Health Aid at School District #20 in Hanover Park, IL, May 1993-November 1995, and office nurse at Bloomingdale General Pediatrics, Bloomingdale, IL, November 1995-September 1999.
Chicago Public School’s LPN Program
Pharmacology for LPN’s, Mayfair College, Chicago
Nursing Refresher, Elgin Community College, 1991
Certificate in Physician Office Coding and Billing, College of DuPage, December, 2000
Certified Coding Associate, Certified and Credentialed with AHIMA since 2009
Beth Wendt 847-***-****
Debbie Smith 847-***-****