Insurance Medical Billing

Deborah Wagley

**** ********** **.

Douglasville, GA 30134

Cell: 404-***-****

** ***** ** ***** ** experience in medical billing and office management.

Currently an Insurance Specialist in a multi-specialty practice in Atlanta,

Ga. Confident in learning new financial and practice management software.

Self starter in managing multi million dollar A/R.

. In-depth claims knowledge

. Claims analysis and review specialist

. Extensive knowledge of insurance precerts and appeals

. Negotiate contracts with insurance carriers

. Knowledge of Physician/Hospital organizations

. Extensive knowledge of filing complaints with GA insurance

commissioner's office regarding insurance company compliance with

claims payment

. Staff training and development

. Confident in learning new financial and practice management software

Pride Medical Dec 2001 thru present

Multi-Specialty practice which includes Internal Medicine, on site

Pharmacy, Infusion Services, HIV care, Physical Therapy, Psychotherapy.

Carefully selected, developed and retained qualified staff, as well as

trained all new staff annually.

Minimized staff turnover through appropriate selection, training, staff

education and development.

Directed the installation of improved work methods and procedures to

achieve Pride Medical financial objectives.

Provide thorough supervision for day-to-day operations of our insurance

department in accordance with set policies and guidelines.

Serve as liaison between management, clinical staff and our patient

community on insurance matters.

Actively maintain up-to-date knowledge of applicable state and Federal laws

and regulations regarding insurance claims filing.

Closely monitor all claims coding and submission.

Closely monitor all claim rejections and denials.

Closely monitor all insurance payments to ensure claims were paid according

to negotiated fee schedules.

Extensive knowledge in HMO, POS, PPO and indemnity insurance plans.

Extensive knowledge in insurance verification and pre-certification.

Closed the deal for our new EHR software and in doing so was able to

capture the government incentives that over a 3 year period will more than

cover the cost of our new software.

Russell Harris MD, PC Sept 1997 thru Dec 2001

Billing specialist and front office coordinator for busy one physician

Dermatology practice.

Approx 30 patients per day. Check in/check out. Filing all insurance claims

by the close of business each day. Balancing financials at the close of

business each day. Follow up on all A/R. Working all claim rejections and

posting all payments. Sent patient statements and worked with patients to

coordinate all payment agreements.

Douglas Neurological Clinic/Atlanta West Women's Center July 1996 thru Sept

1997

Both business's were housed in the same building and I worked for both

practices. The 2 business's shared the financial responsibility for my

salary.

I was responsible for the same duties for both practices. These included

staff supervision, all claims/surgery pre-cert, coding, submission and A/R

follow up. Patient statements, patient financial counseling. General office

duties, ordering of supplies and all other duties to maintain the business

operations.

Neurodiagnostic Center March 1994 thru July 1996

Clinical Research Coordinator for neurology/pain management practice.

Maintain all research records for pharmaceutical drug studies. Intake of

all new patients to the practice. Insurance verification, worker's

compensation case management and claim filing.

Buckhead Neurology Sept 1993 thru January 1994

Secretary for Dr. Eric Awad. Duties included patient scheduling, check

in/check out, insurance verification, worker's comp case management, claims

coordination and follow up.

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