LAVERNE RAMBES

Professional Summary

Highly efficient Medical Biller with experience in out patient dialysis and acute billing. Excellent multi-tasker and demonstrated team player with a positive attitude. Seeking a position requiring HMS and Medisoft billing systems. Licenses

Family Practice Certified Medical Biller

Skill Highlights

HIPAA compliance

Medical billing software

Strong planning skills

Patient-focused care

Strong work ethic

Team player with positive attitude

Good written communication

Exercises good judgment

Maintains strict confidentiality

Knowledge of HMOs, Medicare and Medi-Cal

Professional Experience

AR SPECIALIST

December 1996 to January 2016

Dialysis Clinic Inc - Albuquerque, NM

Thoroughly investigated past due invoices and minimized number of unpaid accounts. Recorded and filed patient data and medical records. Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information. Carefully reviewed medical records for accuracy and completion as required by insurance companies. Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses. Strictly followed all federal and state guidelines for release of information. Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered. Acquired insurance authorizations for procedures and tests ordered by the attending physician. Accurately entered procedure codes, diagnosis codes and patient information into billing software. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Received, organized and maintained all coding and reimbursement periodicals and updates. Thoroughly reviewed remittance codes from EOBS/AR's. Confirmed patient information, collected copays and verified insurance. Completed appeals and filed and submitted claims. Posted charges, payments and adjustments. Applied payments, adjustments and denials into medical manager system. Submitted refund requests for claims paid in error. Carefully prepared, reviewed and submitted patient statements. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. Education and Training

High School Diploma : General, 1980

Rio Grande High School - Albuquerque, NM, Bernnlillo 3236 Mata Ortiz Dr SW, Albuquerque NM 87121

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