Medical Billing

RHONDA DENISE BARNETT

**** **** **** ***** *** Angeles, California 90002 323-***-**** Cell ********@*****.***

PROFESSIONAL PROFILE

To secure a position in the accounting field or as a medical biller with an established company where my education and work

experience can be utilized and there is opportunity for growth.

MAJOR ACCOMPLISHMENTS

Highly motivated individual with a strong background in Accounting and Collections, with 20+ years of experience,

which includes the successful collection of over $100,000.00 in charge backs within a 2-month period with

Warner Music Group.

SKILLS

Systems: eClinicalWorks Next Gen, Care Connect (EPIC), EMR, Image, Medi-Soft, Rescue-Net, SAP, Oracle, Great Plains,

ADP, AS400

Software: MS Outlook, MS Word XP, MS Excel XP, QuickBooks, Kronos, PeopleSoft, Lawson

PROFESSIONAL EXPERIENCE

Aids Project Los Angeles – (APLA) (Medical Professionals Employment Agency) Los Angeles, CA 08/18 – 04/19

Medical Billing Specialist

•Audit patient’s accounts for charge entry submission of claims to health plans, either electronically or by hard copy.

•Working with out-of-network claims, submit and follow-up with insurance carriers & patients on unpaid claims until paid by correcting billing errors and resubmitting claims.

•Determine if a claim is a hardship case and what classification code or description should be assigned and apply Sliding Fee from Discount Program as appropriate.

•Work aggressive appeals filing process till claim is paid in full by insurance, work ERAs, denials, correspondences, and issue adjustments.

•Answer inquiries from insurance companies and patients, and explains all actions pertaining to the billing/accounting/collections processes.

RADNET (Helpmates Employment Agency) Los Angeles, CA 09/17 - 03/18

Medical Biller/Collections Reimbursement Representative (Radiology)

•Performed all follow-up duties associated with re-billing, adjustments, and collections of all overdue accounts/claims.

•Utilized aging reports, researched backlog of issues related to billing & coding errors, and delays on unpaid claims over 120+ days. Correct and resubmit rejected & denied claims by accessing provider portals and calling insurance companies.

•Review patient bills for accuracy, completeness by obtaining any missing CPT/ICD 9/10 codes and ensure all claims are submitted with a goal of zero errors. Using in house computer system (IMAGE).

•Worked appeals, denials, timely filings, and follow-up with various insurances such as PPOs & HMOs, to obtain maximum reimbursement and ensuring timely filling guidelines are met. Make necessary arrangements for medical records, and completion of additional information as requested by insurance companies.

N THRIVE (K-Force Employment Agency) El Segundo, CA 01/17 - 03/17

Commercial PAR (Patient Account Receivable Representative)

•Responsible for assisting patients with financial aspects of their hospital services and collecting on outstanding balances managed care claims for Stanford Hospital.

•Working through (EPIC) & Collections Management (In house system), researched & resolved billing/payment errors, perform contact insurance companies via phone, email and/or websites for claim status, resubmitted corrected claims manually or electronically to insurance carriers.

•Reviewed EOBs for proper reimbursement, denials, applied adjustments and initiated appeals as necessary.

PLANNED PARENTHOOD (All’s Well Employment Agency), Los Angeles, CA 07/15 - 07/16

Medical Biller/Collections

•Full revenue cycle of patient’s accounts included: billing, collections, A/R follow-up, claim processing electronic & hard copy filing, verified patient eligibility, researched EOBs & process self-pay payment postings using NextGen system.

•Researched denied/rejected claims through Office Ally or (DSG) Data Systems Group, re-submitted corrected claims for accurate reimbursement and processed insurance appeals as needed.

•Followed-up on accounts aged over 60 days, worked correspondences, handled inbound/outbound calls to resolve patients

& insurance companies concerns/complaints, and other clerical duties as assigned. Worked with HMO, PPO, and IPA plans, also knowledge of ICD-9/10, CPT/HCPCS codes, & compliance with HIPAA regulations.

UCLA MEDICAL GROUP (Randstad Employment), Los Angeles, CA 03/13 - 02/15

Administrative Assistant II (Medical Biller)

•Processed over 100+ HCFA -1500 claims daily into (EPIC) Care Connect for multiple specialty providers to ensure payments

are adjudicated in a timely manner, working from aging reports, follow-up on unpaid claims within standard billing cycle time frame,

denied/unpaid claims and re-submitted claims for payment.

•Verified patient eligibility, from patients & insurance companies and other administrative duties

•Working knowledge of ICD-9, CPT & HCPCS codes, HMO, PPO plans and medical terminology.

INNOVATIVE DIALYSIS SYSTEMS (Ajilon Finance), Long Beach, CA 07/12 – 01/13

Medical Biller

•Worked from aging reports to clear a backlog of claims for outpatient charges that have been denied through Medi-Care

resubmit denied/appealed claims to insurance payor, A/R follow-up on past due accounts, and posted EOB’s payments.

SYBE MEDICAL MANAGEMENT (Third-Party/Physician Billing), Los Angeles, CA 06/11 – 02/12

Medical Biller

•Submittal of electronic and manual billings claims, entered patient billing charges from patient demographics/super bills, post EOB’s, payments, A/R follow-up, patient eligibility, authorizations, resubmitted appealed/denied claims, worked clearinghouse rejection log (Office Ally), assist patients with collections; perform account reconciliation on assigned accounts.

•Working knowledge HMO’s, PPO’s, Medi-Cal, Medicaid, Private Insurance, IPA’s, ICD-9, CPT/HCPCS codes and medical

terminology.

EDUCATION

Medical Billing Certification Career College of America, South Gate, CA 05/10 – 01/11

High School Diploma Lynwood High School, Lynwood, CA 06/91 - 06/84

REFERENCES UPON REQUEST

Contact this candidate