Medical Customer Service

Bridgette Gardner

*** * **** ***** . ******* Heights, IL 60411

HOME PHONE 708-***-****

***********@*******.***

PROFESSIONAL SUMMARY

Results-driven, deadline-oriented professional poised to transition solid

background and life experience to excel within the medical industry. Able

to make difficult, mature decisions leveraging a dedicated work history and

experience in providing outstanding customer service. Regarded as loyal and

competent with unquestionable honesty and integrity. Capably manages

sensitive and confidential information. Experienced in fast-paced,

stressful environments.

APPLICABLE SKILLS

. Ability to work independently and meet deadlines in a multi-task

environment.

. Displays dedication and determination in all endeavors with diligent

attention to detail for optimal end results.

. Efficiently prioritizes tasks with excellent time management and

organization skills.

. Attentive and able to effectively manage data and information.

. Knowledge of administrative and clerical procedures and systems.

. Gives full attention to what others are saying and asking questions as

appropriate.

KEY QUALIFICATIONS

Medical Billing . Medical Coding . Payment Posting

ICD-9-CM . HCPCS . CPT . Introduction to ICD-10-CM . Scheduling . Insurance

Verification

Co-Payments and Deductibles . Medical Terminology . Anatomy & Physiology .

HIPAA Compliance

Government Payers . Medicare . Medicaid . Tricare . Third- Party Payers

CMS 1500 . CMS 1450 (UB-04) . EOB's

Electronic Medical Records (EMR/EHR) . Worker's Compensation

Managed Care (HMO, PPO, and POS) . MEDISOFT . Office Management

Insurance Claim Processing . Insurance Billing Procedures . MS Word/Office,

Brightree, Insync, Rehab Tool Kit (RTK)

Medical Office Procedures . Computer Skills . Data Entry . Type 45wpm . 10-

Key Skills

EDUCATION

Ultimate Medical Academy, Tampa, FL

Medical Billing and Coding, 2011 (GPA 3.72)

Hands-on experience includes: medical terminology, anatomy and physiology,

disease processes, surgical procedures, life cycle of an insurance claim,

health care settings, health care payers, procedure and diagnosis coding

from medical records, reimbursement systems, facility billing, keyboarding,

word processing, medical practice management systems, and life skills for

success.

CERTIFICATION

Pursuing CPC-A Certification, Expected 02/2012

ASSOCIATIONS

Member of the American Academy of Professional Coders (AAPC)

WORK HISTORY

ATI Physical Therapy) Bolingbrook, IL 2012-Present

Medicare Insurance Verification Specialist

. Responsible for accurately verifying commercial insurances,

Medicare, and Medicaid via phone or online for all incoming patients

entering the East Coast and Midwest clinics.

. Paying close attention to Medicare physical and occupational therapy

caps.

. Entering all information needed in system to assure appropriate,

timely filing for services rendered.

. Communicating with all employees concerning account problems, via

email or phone to assure all information needed is available so all

request can be processed timely.

Grande Prairie Services) Tinley Park, IL 2001- Present

Mental Health Professional

. Responsible for providing the highest quality of care for clients who

suffer from substance abuse/dependency with or without co-occurring

psychiatric illness.

. Monitoring medication doses and times for clients and noting any

changes in behavior for doctor

. Charting behavioral changes and moods of clients daily.

. Identifying opportunities to involve the clients in cultural, family

and social work skill developing activities

. Providing programming tools to assist each client in establishing

attainable goals designed to re-instill and re-enforce self-worth and

self-respect.

Walgreens Respiratory Services Tinley Park, IL 2008-2011

Documentation/follow up Representative

. Processes orders for home care supplies and durable medical equipment

utilizing Medicare and Medicaid fee schedules and guidelines.

. Answer a high volume of phone calls while maintaining and completing

daily tasks in a timely manner

. Verify insurance paying close attention to HMO replacement policies

along with any auto or liability insurance associated with Medicare.

. Process all monthly reorders as well as maintaining and updating

required CMN's and detailed written orders.

. Assists Supervisor with QA'ing orders for completion. Entails

verifying doctors for PECOS, ensuring HCPC coding and the ICD-9 codes

assigned to the order are correct, allowable and retail charges are

correct, insurance is properly assigned to the items being dispensed,

and that the items are not over the allowed amount. Electronically

filing DME claims to payers Medicare and Medicaid for payment.

Requesting prior approvals from Medicaid, requesting referrals from

private payer while paying close attention to timely filing guidelines

ADDITIONAL WORK HISTORY

Illinois Collections Services Tinley Park, IL 2007- 2008

Account Representative

Responsible for medical collections

Illinois Title Loans Chicago Heights, Il 1997-2005

Store Manager

Responsible for processing car title loans, collections and managing 2

other employees

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