Traci Barnes, CMRS

**** ******** ***** **** **** Chester, OH 45069 513-***-**** ac7xui@r.postjobfree.com

PROFESSIONAL SUMMARY

High volume medical biller with strong knowledge of medical terminology ICD10 and ICD9. Ability to adapt to change multi task and prioritize and experience with various electronic health record systems.

SKILLS & SOFTWARE EXPERIENCE

ScriptMed

SharePoint

RX Nova

ZHI

ICD 9 AND ICD 10 coding

Clearwave

AccelaCAPTURE

NextGen

AdvantX

Vision

Navicure

Availity

RealMed

McKesson

SharePoint

Encoder

Pro-LP

PIMS

Manus

PECSO

FISS

HIMR

Case 471FACETS

WMDS

IMASIS

NACO

AIM

Fasttrack

Xactimed

Encore

ClaimTrac2000

MBI

GIS

TALEO

PEOPLESOFT

MYSIS/Medic Medical Billing System, SurgeON, ASC400, Microsoft Office. Clearwave Provider Portal, Virtual Terminal, Rev Link Navinet.

EDUCATION

CERTIFIED MEDICAL REIMBURSEMENT SPECIALIST 12/17/2010 AMERICAN MEDICAL BILLING ASSOCIATION

Medical Billing and Coding

CERTIFICATION IN HUMAN RESOURCE MANAGEMENT 06/2002 UNIVERSITY OF CINCINNATI

Major: Human Resource Management

Organizational Management and Behavioral Management

VOLUNTEER WORK

Organized Bowling Fundraiser in Fall 2016 for friend awaiting a Kidney Transplant at Brentwood Bowl, Cinti OH

Volunteer work through Crossroads Church; Packing food baskets for Christian Missions Abroad

Volunteering at my son’s schools in Lakota School District

MEDICAL BILLING SPECIALIST EXPERIENCE

HUMANA 10/15-current Currently working in Specialty Pharmacy as a contract employee. Researching financial assistance for patients and submitting claims as required. Currently accepting interoffice calls from CCP and PPC. I possess extraordinary communication skills a must as well as general medical office knowledge.

CEI 03/2016-08/2018

Patient Services Rep- Scheduling patient appointments, verifying insurance, verifying demographic data, collecting copays and payment on balances account balances, balancing end of day batches, directing patients to specific clinical areas. Medical Billing Specialist. submitting, and following up on, claims with health insurance companies to receive payment for services rendered for doctors’ visits and procedures. Medical coding doctor’s office visits the diagnosis and treatment.

SOURCE MED 05/2014-03/2016

BILLING/COMPLIANCE SPECIALIST

Follow up of Government Insurance claims for ambulatory surgical centers. Processing refunds for overpayments and submitting quarterly credit balance reports to Medicare.

TracI Barnes

AEROTEK STAFFING SOLUTIONS/WELLPOINT-ANTHEM 09/2012-01/2013

UTILZIATION MANAGEMENT REP I

Managed coordination of cases for precertification and prior authorization by working with patients and medical staff to ensure that proper health care is provided, and protocols are followed preliminary triage and requesting additional patient medical records.

AEROTEK STAFFING SOLUTIONS/ (Medicare Part A) 10/2011-06/2012

PROVIDER ENROLLMENT SPECIALIST

Assisted in the analysis of data among multiple claims systems and the application of CMS (Centers for Medicare/Medicaid Services) rules and guidelines as they apply. Completed validation of data to be entered into the Medicare provider database (PECOS) while ensuring adherence to business and system requirements of customers as if pertains to Medicare contracting and credentialing. Received, classified, consolidated and summarized documents and information; processes and codes documents. Sets and maintained records, logs and files. Complied regular and special reports utilizing established formats and procedures.

BROADPATH/NATIONAL GOVERNMENT SERVICES 04/2011-08/2011

PROVIDER SERVICES REPRESENTATIVE

Received calls from Providers of Medicare Part A services. Including: Hospitals, Nursing Homes and Home Health Agencies Answered inquiries about claim status, gave instruction as request to various billing guidelines and regulations to aid in initial submission and correction of Medicare Part A claims. Utilization of FISS< HIMR< CW< PIMS and ASC360 and various other internal systems and CMS and NGS website materials.

K-FORCE STAFFING/Contract Omnicare Collections Department 06/2010-09/2010

ACCOUNT REPRESENATIVE

Collected on outstanding pharmaceutical accounts with both Government and Commercial payers. Updated registration as necessary with patient demographic and insurance information.

CCHMC 04/2007-12/2008

FINANCIAL SERVICES REPRESENTATIVE

Collections for Home Health Care accounts for government insurance medical policies such as Medicaid, Medicare and BCMH payment tracking for inconsistencies and refiling of claims.

HYDE PARK INTERNISTS 06/2005-09/2006

Medical Billing Collector

Follow up on all outstanding accounts receivable over 90 days, resubmitted claims, filed appeals, audited patient demographics, scheduled appointments. Was closing staff member of medial office.

ANTHEM-WELLPOINT/ADMINISTAR FEDERAL 04/2001-04/2005

MEDICARE PART A CALL CENTER REP/RECOVERY SPECIALIST

Provided education on coverage and benefits, Coresponded with attorneys, insurance company and beneficiaries to recoup monies paid out by Medicare that should be paid by another primary insurance MSP (Medicare Secondary Payer). Utilization of FISS< HIMR< and CWF.

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