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Medical Billing Insurance

Bellbrook, OH
March 26, 2019

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Monta N. Finch

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

Bellbrook, Ohio *5305




Miami-Jacobs Career College Dayton, Ohio

AAS Graduated Nov 2009


Dayton Physicians Network LLC 07/2018 – present

Precertification Specialist

Verifies insurance eligibility and benefits via phone and /or internet access. Update insurance policy information in NextGen system and Onco as required.

Microsoft Office and Windows based computer applications, insurances portals

Check insurance payment policy for scheduled procedures and obtain authorization when required. Verify documentation of all necessary pre-authorization information prior to completing.

Assign appropriate ICD10 and CPT codes pre-operatively based on orders from physicians.

Strong verbal communication skills, highly organized and self-motivated

Knowledge of medical billing and managed care

Proven experience handling irate patients and dealing with conflict.

Premier Health Corporate 05/2017 – 04/2018

Central Scheduling

Proficient with a multi-line phone system, and professionally answer a high volume of incoming and outgoing calls. Transferring calls

High volume of highly sensitive medical, financial and personal information is handled daily, strong knowledge of medical terminology and a thorough understanding of HIPAA law.

Experienced using Epic, Solcom, RightFax, creating inpatient and outpatient orders, electronic medical records, medical billing, patient access, medical imaging, ICD-10/coding.

Able to prioritize and perform multiple tasks in a fast-paced environment is essential. 4 years' experience in an ambulatory health care facility will be a strong advantage.

Care Source 10/2016 - 04/2017

Prior Authorization Specialist DME

Answer calls from physician offices, hospitals, and patients using exemplary customer service

Accurately enter required information (non-clinical and structured clinical data) into computer database.

Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes

Follow established procedures for authorizing request or referring request for further review.

Call hospitals for discharge dates as needed. Refer callers to benefit departments of correct claims

Print and send form letters from iCare system as directed.

Premier Health 05/2016 - 07/2016

Centralized Billing Office

Collects delinquent accounts by establishing payment arrangements with patients; monitoring

Monitor payments, follow with patients when payment lapses occur. Utilizes collection agencies and small claims court to collect money.

Evaluate selecting collection agencies; determining appropriateness of pursuing legal remedies; testifying.

Maintain Medicare bad-debt cost report by tracking billings.

Compiling information that Initiates claims against estates by monitoring deaths and unpaid accounts; informing legal department to act on.

Maintains work operations by following policies and procedures; reporting compliance issues.

Maintain quality standards, hospital policies and procedures, federal, state, and local requirements, and jcaho standards enhancing billing.

Kettering Health Network 09/2014 - 03/2016

Administrative Representative

ICD coding done for insurance billing

Identify source of payment, up-front cash collections

Used Epic to set up insurance, scheduling surgeries, set up testing and orders

Verify and call insurance companies to make sure patients are covered for services

Data entry/typing, insurance medical office knowledge, medical terminology

Set up billing and in person payment plans for patients

File workers comp claims

Set up drug urinalysis testing

Greet patient and provide customer care in regards to patient needs

Responsible for all registration activities including gathering and processing of patient demographics, insurance and financial information

References Upon Request

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