Medical Customer Service

Celines Rodriguez

** ****** ***** ? Burlington Twp., NJ 08016

Home: 609-***-**** ? *******.***********@*****.***

Summary OF Qualifications

. Bilingual and versatile professional with 5+ years' customer service

experience, working in diversified work environments.

. Recent graduate of a Medical Billing, Insurance, CPC Coding & EHR w/ICD-

10 course.

. Proficient in the use of Microsoft Word, PracticePartner & Medisoft.

. Spanish & English bilingual, with the ability to read, write and speak

Spanish fluently; able to interpret effectively for others.

. Very fast learner, able to pick up new procedures and software quickly,

adjusting rapidly to departmental changes.

. Highly reliable and capable of handling a wide variety of customers in

various diversified work environments and industries.

Core Medical Billing & Coding Competencies

. Payment Posting

. HIPAA Knowledge

. Medical Records Management

. ICD-10 Coding

. Medical Terminology

. Medicaid

. Write-Off's

. Basic Anatomy

. Insurance

. EMR/EHR

. CPT, HCPCS & ICD-9 Coding

. EOB's & COB's

. CMS-1500 Forms

. Medicare

. Scheduling

Education

Medical Billing/Coding, Insurance & ICD-10 Merit Training Institute,

Burlington Twp., NJ 2014

. Able to code diagnoses & procedures to the highest level of specificity,

using correct ICD-9, ICD-10, CPT codes & modifiers.

. Well educated on ICD-10, able to code from ICD-9 to the new ICD-10 code

set.

. Skilled at HCPCS coding; with a strong understanding of medical

terminology, physiology, anatomy and HIPAA regulations.

. Knowledge of Managed Care standards, with the ability to identify

specific criteria set forth by the individual insurance carriers; skilled

at minimizing declined or rejected insurance claims.

. Understanding of the EOB or RA; skilled in applying charges, payments and

adjustments.

. Exposure to computerized HCFA / CMS-1500 and UB-92 / CMS-1450 forms.

. Trained in the use of PracticePartner, an Electronic Medical Records

(EMR) software.

. Working knowledge of Medisoft, including appointment scheduling,

disbursements and third party billing.

. Scheduled to sit for the American Academy of Professional Coder's (AAPC)

Certified Professional Coders (CPC) examination, a nationally recognized

certification.

Medical Experience

. Translated conversations and written material from English to Spanish or

vice versa for the doctor, the patient and the patient's family.

. Called upwards of 30 patient's medications into the pharmacy on a daily

basis.

. Utilized Medisoft to input patient's demographic and insurance

information via the phone, handling upwards of 40 daily.

. Obtained pre-authorizations from the insurance company and verified

patient's insurance, handling 100+ cases per week.

. Added in patient's charge amounts per insurance coverage amounts, while

making sure the patient paid their required co-pay.

. Scheduled patient visits, appropriately triaging to ensure that the time

scheduled with the physician was appropriate.

Employment History

Dental Office Assistant Egg Harbor Family Dental, Egg Harbor, NJ

11/07 - 08/08

Certified Medical Assistant SJ Family Medical Center, Hammonton, NJ

11/06 - 02/07

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