Medical Billing/Coding Manager
Resume:
Dawn Pratte, CPC
AAPC Member ID#********
Florissant, MO.63034
Objective:
I am a motivated medical billing and coding specialist with over 14 years’ experience in health care management. Highly skilled in analyzing and validating patient information diagnosis and billing data. Demonstrated leadership skill that enables the processing of high volumes of patient information to achieve revenue generation goals.
Experience:
DR. MICHAEL SPEZIA D.O., INC. 02/2011-PRESENT
MEDICAL BILLING/CODING MANAGER
Supervisor over front desk and my assistant.
High level of knowledge in CPT and ICD-10 coding.
Audit claims before sending them over to the clearinghouse
Chart reviews to provide and verify accurate Medicare HCC diagnostic coding based on services rendered.
Coding for hospital visits(EPIC),home health along with in house coding
Work on aged receivable and identified improper payments, inappropriate claim denials, billing errors and discrepancies on all return claims through final resolution.
Paying claims, making deposits, mailing out invoices.
Account receivable and payable. Prepare files for transfer to collection agency when necessary.
Experience with Medicare, Medicaid and Private commercial payers.
Prepare medical records to be sent out once copied.
Communicate with all attorneys involved in Legal Accident case in the office.
Maintain constant communication between the doctor and my assistant on Appropriate coding rules, teaching physician regulations, billing guidelines, and department policies.
Part-time remote work
Notary Public
KURSAR EYECARE 07/2009-2/2011
MEDICAL CODER/BILLING MANAGER
Medical administrative & management skills
High level of knowledge in CPT and ICD-9 coding.
Responsible of insurance billing and calling when there are problems with a patient’s claim not getting paid. Investigate all denials received and contact patients or insurance company as needed to resolve claims
Paying claim, making deposits, mailing out invoices, working on collections, sending out secondary claims.
Setting up accounts and scanning super bills, referral, EOB’s.
Experience with Medicare, Medicaid, Private and commercial payers.
Maintain constant communication between the doctor and me
DR. MICHAEL SPEZIA D.O., INC. 03/2006-07/2009
MEDICAL BILLING/CREDIT MANAGER
Responsible of insurance billing and calling when there are problems with a patient’s claim not getting paid. Investigate all denials received and contact patients or insurance company as needed to resolve claim.
Coding for hospital wound care, nursing home and general office coding.
Do part time auditing. Making sure that we are getting the right pay in our office for E/M coding.
Account receivable and payable. Prepare files for transfer to collection agency when necessary.
Medical administrative & management skills.
Experience with Medicare, Medicaid, private and commercial payers.
Prepare prior authorization for patients that are referred to a specialist.
Prepare medical records to be sent out once copied.
Communicate with all attorneys involved in Legal Accident case in the office.
Maintain constant communication between the doctor and me. To insure the best turnover of patient and reimbursement.
MAGELLAN BEHAVIORAL HEALTH 02/2005-03/2006
CLAIMS PROCESSOR
Data entry information in the computer system for processing and /or denial of the claim.
Reinstated previous claims that have been denied or paid incorrectly.
Returned claim to provider when information is incomplete. Provided backup support to other team members with their assigned duties.
Education:
Technological Advantage Inc. Career Education ATA Certified Professional Coder, AAPC-July 2005
CUE’s up to date- keep up on the latest medical coding updates, compliance rules, and government regulations.
Reference upon request
Contact this candidate