Medical Billing and Coding Specialist

Kawisha Janell Willis

**** ******** ***, *********

GA 30294

Email: ********@*****.***

Phone: 404-***-****

1

Objective:

To secure a challenging position whereby my 12 years of Medical Office and

Billing skills and learning experiences can be used to promote positive and

professional objectives within your company.

Professional Experience:

DeKalb Medical Center, Decatur, GA

Revenue Cycle Division Electronic Billing Specialist (4/2005-2/2015)

. Responsible for handling all Corrective Coding Initiative edits and

Medical Necessity edits to process clean claims for the Centralized

Business Office by addimg appropiate modifiers to CPT codes and making proper adjustments

. Use coded data to produce and submit claims to insurance companies. NCD, LCD, Coding manuals

. Working directly with the insurance company, healthcare provider, and

patient to get a claim processed and paid

. Responsible for bringing in revenue by billing all primary, secondary

and tertiary insurance carriers for reimbursement

. Work monthly report billing Medicaid, Medicare, Commercial, Auto

carriers

. Obtain and attach EOB to claim and mail to insurance carrier

. Prepare claims for electronic submission and follow up utilizing all

payor systems

. Worked N.E.I.C Claims Reject Report daily

. Correct errors on the rejected claims to resend to payers for

processing and timely reimbursement

. Utilize Insurance carriers websites for eligibility verification

. Receive hard copy returned claims to resend to correct payers' address

. Update insurance and address information in system

. Proficient and effective phone communication with all insurance

carriers to obtain proper information for clean claims and timely

reimbursement

Revenue Cycle Division Patient Accounts Specialist (1/04-4/2005)

. Printed Itemized charges from patient accounts using Sovera and Report

Manager

. Fax and/or mail bills to Attorneys for payment

. Processed accounts falling under Chapter 7, 11, 13 bankruptcies

. Reviewed and Document Accounts, follow-up on patient and attorney

inquires

. Reviewed and processed all correspondence mail

Center Neurology, Riverdale, GA

Front Office/ Scheduler, 3/02-4/03

. Provided a full range of front desk operations in a busy neurology

practice as well as provided customer service to patients, families

and staff as needed

. Greeted, check-in patients to prepare charts in a friendly manner and

collected co pays

. Scheduled and confirmed all patient appointments into the scheduling

system

. Answered multiline telephones using proper phone etiquette

. Check-out patients and scheduled patients for diagnostic procedures as

needed

. Insurance verification, follow ups, approvals, workers comp, auto and

health

. Called insurance carriers for proper authorization and faxed referrals

to appropriate destinations

Education:

Medicare University, Decatur, GA

Certificate of Completion (2012)

Clayton State University, Morrow, GA

CPT-4 Coding-Certificate (2002)

Medical Billing Reimbursement and Collections-Certificate (2002)

Children's Advanced Therapeutic Services, Morrow, GA

Medical Insurance Claims Examiner (Extern 2001)

< Insurance verification

< Pulling records and updating patient information periodically to

ensure accuracy

< Data collection, Follow-ups,EOB's

< CPT and ICD-9 coding

< Medicaid billing, commercial billing using MediSoft and DOS

< Electronic claims submission

Georgia Medical Institute, Jonesboro, GA

Medical Insurance Claims Examining and Billing-Certificate (2001)

Completed seven month course learning proper management and execution of

various medical insurance plans and programs

Proper methods of obtaining patient information necessary for successful

claim management and billing

Knowledge of medical, diagnostic and procedural terminology

Various coding procedures including ICD-9, CPT, DRG, APC

Knowledge of Medicare A and B

Knowledge of HCFA 1500 and Billing

Courses included:

Medical Terminology/Anatomy and Physiology

Medical Billing Theory and Practical

Health Claims Examining Theory and Practical

Medical Office Basics

ICD-9 and CPT

Chesterfield Marlboro Technical College, Cheraw SC

Computer Programming Certificate (1997)

COMPUTER SKILLS

Windows, Internet, Microsoft Office, Word, Excel, Power Point, Access,

Typing (80+wpm),

Data Entry (10,000+kph)

SYSTEMS

Siemens, Invision OAS Gold, Allscripts, ePremis, Internet, Sovera, DDE,

HIM, PFS, FSS, NaviNet, Availity, MedAssets, Lotus Notes, Webmail

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