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Medical Billing

Location:
Tucker, GA
Posted:
February 18, 2015

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Resume:

T amarasha Smith

**** ******* ****** ***** ******, GA 30096 214-***-**** acodep@r.postjobfree.com

Summary

Inpatient and outpatient medical billing specialist with ICD -9, ICD -10 and ASC coding

experience. Familiar with commercial and private insurance carriers with 6 years of

experience.

Versed in customer support in high call volume environments. Superior com puter skills

and telephone etiquette. Driven to exceed goals and build long term relationships with

customers.

Education

Midwestern State University Wichita Falls, TX Biology

S.H. Rider High School Wichita Falls, TX Diploma 1993

Experience

March 2008-Present

Owner Sweet 1020 Dessert Bar & Events Dallas, TX

Systematically tasted and smelled all prepared dishes, and observed color, texture and

garnishes. Effectively managed and assisted kitchen staff in producing food for banquets, catered

events and member dining areas. Consistently kept a clean and safe environment by adhering to

all federal, state and local sanitation and safety requirements. Followed proper food handling

m ethods and maintained correct temperature of all food products. Consiste ntly produced

exceptional menu items that regularly garnered diners' praise. Conducted daily inspections and

m aintained food sanitation and kitchen equipment safety reports. Regularly developed new

recipes in accordance with consumer tastes, nutritional needs, and budgetary considerations.

Enforced appropriate work-flow and quality controls for food quality and temperature. Developed

s trategies to enhance catering and retail food service revenue and productivity goals. Provided

nutritious, safe, visually appealing, innovative and properly prepared and flavored food. Set up

and performed initial prep work for food items such as soups, sauces and salads. Prepared for

each shift by placing a clean cutting board and utensil bath at workstation. Consistently tas ted,

s melled and observed all dishes to ensure they were visually appealing and prepared correctly.

Displayed a positive and friendly attitude towards customers and fellow team members. Mixed,

weighed and proofed ingredients in accordance with bakery recip es. Properly frosted and

decorated cakes, cupcakes, doughnuts, sweet rolls, pastries and cookies. Correctly operated all

bakery equipment, including ovens, proofers, fryers, sheeters, rounders, scales and mixers.

Prepared bakery and specialty products such as bagels, breads and pastries.Maintained highest

s tandards of bakery product quality. Diligently enforced proper sanitation practices to prevent the

s poiling or contamination of foods. Consistently emphasized food quality and specialized baking

techniques. Creatively decorated cakes, cupcakes, tarts and pastries as well as special order

items.Identified opportunities to increase revenue, decrease kitchen expenses and maximize

departmental productivity without compromising customer satisfaction.

February 2011-May 2011

Medical Biller Lepow Foot & Ankle Specialist Houston, TX

Recorded and filed patient data and medical records.Thoroughly investigated past due invoices

and minimized number of unpaid accounts.Carefully reviewed medical records for accurac y and

c ompletion as required by insurance companies.Strictly followed all federal and state guidelines

for release of information.Examined diagnosis codes for accuracy, completeness, specificity and

appropriateness according to services rendered.Acquired insurance authorizations for procedures

and tests ordered by the attending physician.Consistently ensured proper coding, sequencing of

diagnoses and procedures.Quickly responded to staff and client inquiries regarding CPT

c odes.Acted as a liaison between the business department, billers and third party payers in

resolving billing and reimbursement accuracy.Demonstrated knowledge of HIPAA Privacy and

Security Regulations by appropriately handling patient information.Appropriately and correctly

identified errors and re-filed denied/rejected claims as they were received from the Patient

Account Representative.Interpreted medical reports to apply appropriate ICD -9, CPT-4 and

HCPCS codes.Thoroughly reviewed remittance codes from EOBS/AR's. Confirmed patient

inform ation, collected copays and verified insurance.Evaluated the accuracy of provider charges,

including dates of service, procedures, level of care, locations, diagnoses, patient identification

and provider signature.Completed appeals and filed and submitted c laims.Posted charges,

payments and adjustments.Applied payments, adjustments and denials into medical manager

s ystem.Submitted refund requests for claims paid in error.Carefully prepared, reviewed and

s ubmitted patient statements.Carefully prepared, reviewed and submitted patient

s tatements.Ensured timely and accurate charge submission through electronic charge capture,

including the billing and account receivables (BAR) system and clearing house.Meticulously

tracked and resolved underpayments.Consistently informed patients of their financial

responsibilities prior to services being rendered.Remained up-to-date with all insurance

requirements, including the details of patient financial responsibilities, fee -for-service and

m anaged care plans.Performed quality control of the data entry system to verify that claims and

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payments were posted correctly.Prepared and attached all required claims documentation

including referrals, treatment plans or other required correspondence to reduce incidence of

denials.Efficiently performed insurance verification and pre-certification and pre-authorization

functions.Performed full-cycle medical billing in a fast-paced medical billing company.

January 2007-March 2008

Medical Biller G.E. Healthcare Plano, TX

Thoroughly investigated past due invoices and minimized number of unpaid accounts.

Demonstrated analytical and problem -solving ability by addressing barriers to receiving and

validating accurate HCC information. Carefully reviewed medical records for accur acy and

c ompletion as required by insurance companies. Assigned additional diagnosis codes based on

s pecific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies)

in support of existing diagnoses. Strictly followed all federal and state guidelines for release of

information. Examined diagnosis codes for accuracy, completeness, specificity and

appropriateness according to services rendered. Acquired insurance authorizations for

procedures and tests ordered by the attending physician. Accurately entered procedure codes,

diagnosis codes and patient information into billing software. Consistently ensured proper coding,

s equencing of diagnoses and procedures. Quickly responded to staff and client inquiries

regarding CPT codes. Acted as a liaison between the business department, billers and third party

payers in resolving billing and reimbursement accuracy. Verified and abstracted all medical data

to assign appropriate codes for hospital inpatient records. Received, organized and maintained all

c oding and reimbursement periodicals and updates. Demonstrated knowledge of HIPAA Privacy

and Security Regulations by appropriately handling patient information. Appropriately and

c orrectly identified errors and re-filed denied/rejected c laims as they were received from the

Patient Account Representative. Added modifiers as appropriate, coded narrative diagnoses and

verified diagnoses. Analyzed and interpreted patient medical and surgical records to determine

billable services.Interpreted medical reports to apply appropriate ICD -9, CPT-4 and HCPCS

c odes. Thoroughly reviewed remittance codes from EOBS/AR's. Evaluated the accuracy of

provider charges, including dates of service, procedures, level of care, locations, diagnoses,

patient identification and provider signature. Completed appeals and filed and submitted

c laims.Posted charges, payments and adjustments. Applied payments, adjustments and denials

into medical manager system.Submitted refund requests for claims paid in error. Carefully

prepared, reviewed and submitted patient statements. Ensured timely and accurate charge

s ubmission through electronic charge capture, including the billing and account receivables

(BAR) system and clearing house. Meticulously tracked and resolved underpayments. Remained

up-to-date with all insurance requirements, including the details of patient financial

responsibilities, fee-for-service and managed care plans. Performed quality control of the data

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entry system to verify that claims and payments were posted correctly. Efficiently performed

insurance verification and pre-certification and pre-authorization functions. Performed full-cycle

m edical billing in a fast-paced medical billing company.

September 2002-April 2004

Medical Biller KCI, Inc San Antonio, TX

Demonstrated analytical and problem -solving ability by addressing barriers to receiving and

validating accurate HCC information. Strictly followed all federal and state guidelines for release

of information. Examined diagnosis codes for accuracy, c ompleteness, specificity and

appropriateness according to services rendered. Acquired insurance authorizations for

procedures and tests ordered by the attending physician. Accurately entered procedure codes,

diagnosis codes and patient information into billing software. Acted as a liaison between the

business department, billers and third party payers in resolving billing and reimbursement

accuracy. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately

handling patient information. Received, organized and maintained all coding and reimbursement

periodicals and updates. Appropriately and correctly identified errors and re -filed denied/rejected

c laims as they were received from the Patient Account Representative. Added modifiers as

appropriate, coded narrative diagnoses and verified diagnoses. Thoroughly reviewed remittance

c odes from EOBS/AR's. Confirmed patient information, collected copays and verified insurance.

Completed appeals and filed and submitted claims. Submitted refund r equests for claims paid in

error. Ensured timely and accurate charge submission through electronic charge capture,

including the billing and account receivables (BAR) system and clearing house. Efficiently

performed insurance verification and pre-certification and pre-authorization functions. Performed

full-cycle medical billing in a fast-paced medical billing company.Performed full-cycle medical

billing in a fast-paced medical billing company.

May 2000-August 2002

Claims Processor Blue Cross Blue Shield of Texas Wichita Falls, TX

Thoroughly investigated past due invoices and minimized number of unpaid accounts.Recorded

and filed patient data and medical records.Demonstrated analytical and problem -solving ability by

addressing barriers to receiving and validating accurate HCC information.Carefully reviewed

m edical records for accuracy and completion as required by insurance companies.Strictly

followed all federal and state guidelines for release of information.Applied payments, adjustments

and denials into medical manager system.

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