DEBRA A. ZAPPULLA

**** ********* **

Dunedin, FL 34698

727-***-****

ac7zdz@r.postjobfree.com

QUALIFICATIONS

** ***** *********** ******* *******, Coding & Collections, Accounts Receivable, Accounts Payable, Bookkeeping, General Financial and experience requiring extensive use of organizational, technical administrative and interpersonal skills. problems solving skilled, Detail oriented.

SKILLS

Accounts Payable/ General Led

Accounts Receivable/Collections

Microsoft Excel / Words

Relay Health

Etran

Concuity

Artiva

ICD & CPT Coding

Computerized Billing & EDI

Med-Data

NavaNet

EMPLOYMENT

Revenue Cycle Specialist- CCS Medical

Great Plains AP Systems

DDE/CWF- Medicare Billing

EDS- Medicaid Billing

Medical Terminology

HST Pathways

Lawson Systems

Availity

Citrix Applications

Rev.Link

Next-Gen

8/2018 – 11/2018

Review and submit appeal for Medicare claim.

Ensure all appeals packets are correct, including insurance verification, CMN, doctors’ orders and qualifying labs for diabetic supplies and equipment rentals.

Identifies issues and provides problem resolution

Assists Revenue Cycle Management operations to meet corporate goals for cash collections, net revenue comparisons.

Ensures compliance with all federal, state, and local regulations governing rendered patient services and reimbursement

Bill both paper and electronic DME claims, resubmission of denied claims, billing of secondary payers, collection calls, and printing and delivery of follow-up information.

Posting payments and / or adjustments to individual accounts

Resolving credit balance accounts as needed

Receives inbound and places outbound calls to/from insurance companies and patients to collect outstanding funds

Analyzes and correct accounts receivable problems

Faciliy ACS Collector- Surgery Partners, Tampa,FL 4/2018 – 6/2018

Full Revenue Billing., Coding, Appeals and collection in ASC environment

Knowledge of Managed Care, PPO, Auto and Workers comp. UB04 & 1500 billing. Medical terminology, CPT4 codes, ICD9 codes, and Third-Party payer knowledge & reimbursement rules

Identify coding edits, and discrepancies using Select Coder program.

knowledge of medical terminology, abbreviations, techniques and surgical procedures

Identifies delinquent accounts, thru aging report, EOB’s and lock box correspondence.

Reviews and works electronic rejections – corrects errors and resubmits claims.

Analyzes outstanding balances to determine appropriate course of action, reviews non-paid or underpaid EOBs.

Correct computerized edits, alerts and revenue cycle standards and processes.

Resubmit claims to the appropriate payor

Evaluate patient financial status and establish payment plans as appropriate.

Informs management and facility of changes and keeps documentation current and accessible. Abstracts clinical information from a variety of medical records sources

Verify appropriate ICD, CPT and HCPCS codes to facility operative/procedure notes according to established coding guidelines.

Posts credit card transactions via med-data,

Provides ongoing feedback to facility personnel regarding authorizations / referrals.

Appeal denied claims with appropriate documentation per payer requirements.

Works assigned accounts per collection policies, procedures and strategies.

Provides suggestions to improve daily operations, collections and create efficiencies. Tracks all accounts receivable and pursues all outstanding balances. Runs monthly receivable reports and works through outstanding claims.

Maintain productivity standards

Underpayment Analyst- Parallon Business Performance Group- HCA 1/2017- 2/2018

Perform and validate discrepancy reason coding of underpayment inventory

•Pursue additional payment from payers on underpayment discrepancies through various means of communication, such as telephonically, online or via payment package processes.

•Overcome objections that prevent payment of the claim

•Gain commitment for payment through concise and factual collection techniques.

•Communicate trends to management as identified

•Facilitate correction of non-payment related underpayment discrepancies through I-plan changes or coordination with other departments as needed

•Identify and communicate trends to management, including those that might be appropriate for the dispute resolution process

•Escalate accounts to appropriate individuals at the payer and via SSC management as needed, including accounts with lack of timely payer response

•Utilize effective documentation standards that support a strong historical record of actions taken on the account.

•Complete and comprehend all educational requirements

Billing/ Collection Specialist- Parallon Business Performance Group- HCA 9/2014- 1/2017

•Resolves claim edits based on documented processes in the electronic billing system

•Communicates edit trends to Manager/Director

•Reviews unreleased claims daily to resolve and submit to the payer

•Resolves requests in all designated billing queues in eRequest and CRT daily

•Submit write offs, thru Etran

•Completes secondary claim releases daily

•Reviews the reports daily of post final bill coding changes and rebills as required

•Documents Artiva collection system, eRequest communication system and Relay Health

•Billing system related to activities completed for claim release

•Work Medicare insurance pools resolve claims that are not paid in a timely manner

•Review EOB’s, remits and payer correspondence in the course of performing account follow up

•and escalate any identified issues

•Maintain required productivity and QA standards

•Work with patients and guarantors resolve payer requests and discrepancies to promptly

•resolve pending claims.

Accounts Team Specialist II – Suncoast Hospice, Palm Harbor. FL 12/2005-6/2014

Accounts Receivable

Verify all insurance, consents & documents are obtained upon admission

Key notice of election for Medicare patients thru DDE Medicare system.

Set up Medicaid, Medicare and other in payor source for billing purpose.

Identify coding or billing problems from EOB's and work to correct errors to bill.

Collaborate with Team and HIT insuring all LOC and documentations are correct and updated.

Code & enter Continuous Care and Doctor’s visits. Key HHA time-sheets for bill purposes

Set up and bill Room & Board claims for Nursing Homes, VA Patients, and Patient Pay Patients

Bill, code and adjust Medicare & Medicaid claims from aging reports. Reduced AR by 30%.

Identify coding and//or billing problems from EOB’s and correct insurance claims errors.

Obtain insurance authorizations. Billing and coding of private insurance claims.

Contact patients and insurance companies to resolve and collect outstanding AR balances.

Accounts Payable

Interpret & review medical documents such as Doctors notes and Hospital records.

Verify AP claims to determine if related to hospice dx, Send denial letter to vendors

CPT coding, key and batch claims into Great Plains

Resolve disputed and outstanding invoicing problem with Vendors

Assist Patients with Bills, Assist in Quarterly closing.

EDUCATION

St. Petersburg College, Clearwater, FL

Health Science A.S Degree 2011-present

Medical Coder Certification

College of Staten Island, Staten Island, NY

Attended: Business/Finance Coursework

Contact this candidate