Customer Service Manager

LISA ASHTON

**** ******* ***** #**, *******, Texas 77036 C: 832-***-**** **********@*********.***

Professional Summary

Offers over twenty years of combined experience in medical billing and coding. Possesses excellent communication skills and customer service; readily able mobilize and motivates interdepartmental staff members to achieve business goals. Proven successes in implementing effective process improvements that streamline operational efficiency, enhance morale and increase the bottom line. Education and Training

Diploma, Medical Billing and Coding 2004 Sanford Brown College - Houston, Texas, United States

High School Diploma, Basic Studies 1986 Kashmere Senior High - Houston, Texas, United States

Select One, Nursing Houston Community College - Houston, Texas, United States Skill Highlights

Microsoft Office, Medisoft, Bright Tree, Ten Key, Typing speed 70 WPM, Care Cloud, Urochart and Athena Professional Experience

Medical billing and coding, credentialing, organizing

OFFICE MANAGER Apr 2013 to Aug 2014 Durrani M.D. & Associates

Review of the health records, superbills, and computer generated report, and other reporting tools to identify conditions treated and the services provided to each patient. Timely and accurately coding of diagnoses, services and procedures performed by the physicians, and any other provider performing billable services, and supplies used utilizing the appropriate coding system including ICD- 9 and HCPCS codes. Preparation of paper and, or electronic claims and submission of paper claims to the appropriate payer. Follow up on unpaid claims and maintain collection efforts from patients and facilities. Specialized urology practice billing, commercial and non- commercial carriers. Payroll, new hire orientation, credentialing, conduct bi weekly staff meetings, inventory control, EMR set up and prepare expense reports. Processing appeal and refunds, obtain referrals and authorizations for surgeries and procedures.

DME Biller Aug 2011 to Apr 2013 Altus Medical Equipment - Pearland, Texas

Prepared and submitted DME billing. I ensured that claims were entered and submitted with 48 hours of receipt. Accurately applying payments to patient accounts including insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts. Set up new patient accounts. Assign ICD-9 code to physician's diagnosis and insurance correct level of service and various other CPT codes.

Skills

Work with clearinghouse to resolve to resolve file compatibility issues. Send secondary claims upon processing of the primary insurance. Re-submit insurance claims as necessary. Knowledgeable in timely filing restrictions.

Aug 2009 to Aug 2011 ACCOUNT MANAGER Medical Office Solutions of Texas - Houston, Texas

Responsible for full cycle billing for a rheumatology practice. Accurately posting payments and resolving any incorrect payments, Appeals and refund processing, preparing monthly reports. Enter charges and submitted claims electronically. Set up EMR and electronic claims submission, credentialing.

Jun 2007 to Jul 2009 ACCOUNT MANAGER Physicians Medical Billing - Houston, Texas

Prepared paper and electronic claim submission for an oncology group. I was responsible for charge entry and payment posting. Processed appeals and refunds, Verified insurance. and obtained authorization and referrals. Data entry and payment posting.

Feb 2004 to Jun 2007 INSURANCE SPECIALIST Athletic Orthopedic and Knee Center - Houston, Texas

Submitted appeals for all denials for various insurance company. I worked extensively with workers' comp claims and obtained prior authorization for procedures and surgeries, Data entry, charge entry and payment posting, patient collections, submitted claim electronically and on paper.

May 1995 to Jul 2004 ACCOUNT MANAGER Travis Centre Outpatient Surgery - Houston, Texas

Responsible for billing and collections of daily surgery charges. Submitted appeals and obtained prior authorization for surgeries. Prepared monthly billing statements for mailing, Financial counseling. Data entry, payment posting, charge entry. Submit claim electronically, Surgery scheduling.

Feb 1988 to May 1995 OFFICE MANAGER/MEDICAL ASSISTANT Jim L. Walkup, M.D. - Houston, Texas

Responsibilities were to checking patients, collect copays, schedule surgeries and procedures. Order supplies, billing and coding, payment posting, working the back office. Preparing the monthly reports for the accountant, electronic claim submission and appeals. Credentialing.

Ten Key, accountant, billing, counseling, CPT, Data entry, filing, ICD- 9, Insurance regulations, inventory control, Medisoft, meetings, Microsoft Office, office, Payroll, coding, reporting, Research, scheduling, Typing speed, 70 WPM, credentialing.

Contact this candidate