Medical Biller
Resume:
Astride Delva
Lithonia, GA 30058
OBJECTIVE:
Pursuing a position with an organization that will utilize my experience while offering opportunities for professional development.
SUMMARY:
Proficient with 10 key by touch, knowledge of medical terminology, knowledge of ICD-9 and CPT-4 coding, excellent verbal and written communication
skills, knowledge of Medicare, Medicaid and Commercial insurance procedures and possess supervisory skills. Proficient in the following systems: NextGen,
Medical Manager, Sovera Kareo, Citrix, Allscripts, Multi-Health Net, Medicom, Proclaim and Microsoft Office.
PROFESSIONAL EXPERIENCE:
Radiant Women;s Health 2012 –October 2014
BILLING & CODING COORDINATOR
• Review clinical documentation for charge posting and enter.
• Educate staff of all new policies and procedures.
• Identify and resolve patient-billing complaints, including handling correspondence and all patient billing calls.
• Ensure that daily closes are accurate and complete, including maintaining all related paperwork.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Planning daily schedule for the providers; Create various reports for the practice
• Liaison between the practice and different hospitals and vendors
Dekalb Women’s Specialists 2005 -2012
BILLING SPECIALIST
• Prepare and submit claims/electronic claims for reimbursement.
• Posts to accounts all charges, payments and appropriate adjustments.
• Identify and resolve patient-billing complaints, including handling correspondence and all patient billing calls.
• Review all EOBS to ensure accuracy and appropriateness of payments and appeal payment as necessary.
• Ensure that daily closes are accurate and complete, including maintaining all related paperwork.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
Georgia Internal Medicine 2004-2005
CLAIMS EXAMINER II
• Responsible for the timely and accurate processing of managed care claims in a highly productive, quality oriented environment.
• Acknowledge and resolve customer concerns and complaints in a timely manner.
• Analyzation of claims to ascertain payment eligibility in accordance with customer contract specifications.
Atlanta Cancer Care 2003-2004
PROVIDER INQUIRY TEAM LEAD
• Provided courteous and efficient service to providers over the telephone, using email or live online chat to respond to inquiries, accurately obtain/provide
information, or initiate problem resolution.
• First point of contact for call center staff answering and clarifying any question or issues in reference to Medicaid
• Maintained a high level of customer service care by exhibiting a pleasant and professional manner.
• Ensured that concerns were promptly addressed, documented and rectified, accurately and on time, with proper follow-up professional customer service.
• Coordinated and conducted training in the areas of Medicaid, HIPAA compliance, claims re search, and customer service.
• Prepared team statistics and reviewed daily reports with provider inquiry supervisor.
• Helped to create a work environment that fostered teamwork and was conducive to job satisfaction and productivity by motivating, mentoring staff and
providing feedback on professional development.
EDUCATION:
Bachelor in Sciences in Law Haiti 1993
Brenau University Atlanta GA Early childhood Education studies 2005
CERTIFICATION:
Certified Professional bilingual translator with Lionbridge 2008
References available upon request.
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