Medical Customer
Resume:
Crystal Simpson~ Medical Insurance Biller & Coder
**** ****** ***** ****, **********, GA 30039
**************@*****.***
Experienced Medical Professional seeking a position in a medical facility, professional third-party
administrator or other industry sector where I can apply the skills and knowledge I have acquired through
professional experience and targeted training.
Skill Highlights
EMR Scheduling, Patient Registration, Insurance Verification, Billing, Payment Posting, Claims Resolution, Month
End Reporting, Microsoft Excel, CPT and ICD-9 coding, Microsoft word, Windows XP/vista, electronic claims
submissions, CPR certified, 45 WPM, CMS/1500, HIPAA /OSHA training
Professional Work Experience
September 2013 - October 2013
North Georgia Digestive Disease Consultants LLC - Lawrenceville, GA
Medical Insurance Biller & Coder
Responsibilities included; scheduling appointments for the provider, coordinated patient flow, verified insurance
benefits, collected co-pays and deductibles, entered charges, and provided referrals. Assisted medical staff on in-office
procedure days. Coded patients' encounters, posting Explanations of Benefits, followed-up on claims aging, appealing
denials, and followed up on outstanding balances. Managed actions relating to delinquent accounts, collection agencies,
special adjustments, and/or write-offs. Completed and dropped off bank deposits.
Medavant Health Inc– Norcross, GA May 1999-January 2008
Quality Assurance Engineer
● Ensured quality which includes the following: developing, Applying, and maintaining Quality Standards for
Medavant Health's EDI Transactions, Real-Time/Web Services, Products, Reporting, etc.; Be competent in
performing complex QA functions, develop and execute software test plans, be proficient in QA methodologies,
analyzed and wrote test standards and procedures, maintained documentation of test results to assist debugging
and modification and analyzed test results to ensure functionality.
● Working experience on X12 EDI Transactions: 270/271, 276/277, 835, UB92 and 837
● Knowledge and experience using UNIX, Windows, and DOS.
● Worked directly with Vender's from all over the United States to get Providers up and running on the many
platforms and products we offer our customers.
● Assisted vendors with understanding of specifications and resolving field updates as related to software.
● Walked customer and venders through software installation.
● Acted as 2nd level or escalation support to general support department.
● Guided vendors in the correction of medical claim errors to eliminate rejection rate.
● Trained new employees and explained protocols clearly and efficiently
● Served as escalation point for all VIP special care clients.
● Received inbound customer calls regarding clearinghouse edits, analyzing customer issues to offer step by step
problem solving tactics.
● Mentor for National Account Team employees.
● Provided customer training for web based products, informed customers about issue resolution progress.
● Supported multiple Practice Management Systems, Software programs, and Platforms (i.e. Medisoft, Lytec)
Education
Everest Institute -Norcross, GA Medical Insurance Billing & Coding Diploma
Brighton High School- Rochester, NY High School Diploma
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