Front Office Medical Billing
Resume:
Ms. Emily Hurst
***********@*****.***
EDUCATION/ CERTIFICATIONS/ MEMBERSHIPS/SKILLS:
Everest Institute 2010 for Medical Insurance Billing and Coding (4.0 GPA)
Gwinnett Tech in 1999 for Web Page Development and P.C. Administration
OSHA, HIPAA, AAPC, AHIMA, GHIMA; HTML I, HTML II, Flash
Noridian/CMS certification for “Urological Supplies” and “Ostomy Supplies”
Medical Health Professional certification for “Remote Coding”
CPT, ICD-9/10, HCPCS, CMS 1500,UB04, EMR, EHR
Medical Terminology, Anatomy & Physiology, Medicare/Medicaid
E-Clinical (ECW), Next Gen, Claim Gear, Medi-Soft, Eclipse, Mysis, Navision, Centricity, Oracle, Athena, Quick Books, Navinet, Medical Manager, Citris, Eyemed, Greenway- Prime Suite, Athena, Trizetto, Gateway, Timberline, Solomon, Availity, Inscribe, Med-force, Microsoft programs
Chiropractics, Orthopedics, Orthotics, Physical Therapy, Pain Management, DME for Urology and Ostomy, Allergist/Asthma, Pediatrics, OB/GYN, Workers Comp Cases, Geriatrics, Assisted Living, Family Practice/Urgent Care, Ophthalmology
Patient Account Representative
(09/18 - 03/19) Buford Family Practice and Urgent Care
A family practice that was integrated with Pediatrics, Geriatrics, Urgent Care and Orthopedic Injections. As a member of the Billing Department, my duties included:
Obtaining referrals and pre-authorizations as required for procedures.
Checking eligibility and benefits verification insurances for treatments and procedures.
Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
Following up on unpaid claims within standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance with contract discount.
Calling insurance companies regarding any discrepancy in payments if necessary
Identifying and billing secondary or tertiary insurances
Post and locking insurance remittance advises.
Reviewing accounts for insurance of patient follow-up.
Researching and appealing denied claims.
Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
Setting up patient payment plans and work collection accounts.
Run collection reports, send statements and call on patient overdue balances
Medical Billing/Coding Specialist
(06/18 – 09/18) Clinica’ Union – (Family Practice) Contract Work
A Clinic that focused on Family Practice, Pediatrics, OB/GYN, Family Medicine. As a Medical Biller, I would Generate, Review & Transmit Claims, for a multi-specialty group, to 3rd party Payers/Insurance companies, Coding patient’s encounters, posting EOB’s, following up on aging claims, appealing denials, submitting medical records, collections on outstanding balances, patients’ questions on their EOB’s and benefits. Weekly Revenue Cycle Reports, Meetings with the President/CEO and Management.
ICD-10 Coder
(03/18 – 06/18) National Vision – (Ophthalmology ) Contract Work
A Corporate setting in which I did the billing for multiple customers of National Vision such as Walmart Vision, America’s Best, and the Military. I helped a particular customer get caught up on their billing that was behind at least 1 year due to new system change. Coding, Claim entry, Auditing, Spreadsheets, Productively
(02/17 – 03/18)**Physically injured by a very serious Car Accident**
Billing/Patient Care Representative /Front Office
(05/16-02/17) Gwinnett Clinic (Family Practice/Urgent Care)
Family Practice/Internal Medicine practice in which I performed Medical Billing/ Coding/Posting and also worked in the Front Office, Explain Benefits to patients, Bill patients as they leave their appointments, Do the Billing to be sent off to Insurance companies, Verify Cpt codes for Physicals, Medical Records, Chart Organization, Collections, mark Super-bills correctly, Apply Payments to ICD10 Dx & Cpt codes for Date of Service, Check-Out patients, Referrals, assist to the Physician's needs, Prepare for the next day, Balance out end of day, Drop money, Close everything out, Open and Close the Office, Make appointments, Check-In/Check-out patients, Verify Insurance, Phones, Filing, Labs, Team player, Assist with the other 19 Locations, Travel to Multiple Locations as needed on a regular basis.
Patient Services Coordinator
(05/14 – 05/16) North Side Hospital (OB/GYN)
Women’s Center for OB/GYN: Coding, Billing, Daily Balancing, EMR, Scheduling, Front Office (check in/out), Insurance verification, Lab Assistance, Month End, Dexa Scans, Mammograms, Scheduling “Lunch Ins” for Reps’ presentations, Educating Ob patients their appointment schedules, Communicating with Providers & Ultrasound Techs about patient care, Caring for patients who had complications with either GYN or Ob, Scanning, Phones, Ordering Supplies, Marketing for the practice to be on websites such as Yelp.
Medical Billing and Documentation Auditor
(04/11 – 04/14) Uromed, Inc. Corporate Office (DME)
DME company that supplies Catheters, Incontinence Products, Ostomy supplies to patients
Billed and Posted payments from various insurance companies and Medicare/Medicaid
Responsible for obtaining compliant documentation per carrier, state, and federal regulations in order to provide requested supply regimen to patients. Obtain/process insurance coverage, benefit and reimbursement information. Updated patient records based on patient changes and carrier regulations.
Communicated with New and existing Client Relations and Inside Sales for processing new patients. Audited all information given, verified all accreditations of insurance policies, medical records, physician information, patient’s diagnosis and regimen for obtaining a Plan of Care for supplies.
Built relationships with the physicians, nurses, hospitals, clinics, case managers to obtain updated prescriptions, medical records, LMN’s to be compliant with Medicare/Medicaid.
Communicated with insurance carriers regarding benefits, reimbursement, PA’s, referrals, denials
Ensured documentation was in accordance with Medicare/Medicaid regulations
Medical Coder/Billing and Front Office Administrator
(01/09 – 04/11) Advanced Integrated Medicine (Chiropractics/Physical Therapy)
Medical Insurance Billing and Coding: Billing, Coding (CPT, ICD-10, HCPCS), Electronically submitted claims, Posted payments, Collections, Denials, Medical Records, Medicare, Communicated with Insurance companies, Audited Charts, Auto & Personal Injury, Itemized statements, mailed out claims
Back Office: Chiropractic Treatments, B-12 Injections, Prescriptions, Dictations, Electrical Muscle Stimulation (EMS), Spineulator, Laser Pads, Cold Laser, Cervical and Lumbar Decompression, TENS Units, Pulled up MRI’s for the doctor, M.R.I. Prescriptions, Orthotics scans for your shoes, Orthotic Consultations, Soap sheets, New patient assessments, Blood Pressure, Pulse, Organized & set up X-Rays, Brought patients back to his rooms, pulled charts and created new patient charts,
Front Office Administrator: New patient information intake, Insurance verification, Scheduled Patients, Gave the proper paperwork to the patients to fill out, greeted patients, phones, Trainer, Team player.
Contact this candidate