Medical Insurance

LATASHA TAYLOR

**** ********* **. ****, ** *****

CELL: 832-***-**** *******.********@*******.***

Objective: Highly capable, resourceful, and detail-oriented professionally trained in surgical technology and

medical administrative support with academic qualifications, a Certificate in Surgical Technology and a

Certification in Medical Billing and Coding. Seeking a career opportunity with a fast paced medical office that

will utilize both my skills and abilities.

Special Skills: ICD-9, CPT, ICD-10, and HCPCS Patient/Customer Relations

Medical Insurance MS Word, Excel, PowerPoint

Medical Terminology Problem Solving/ Scheduling

Specialty Coding Type 58 WPM

Bookkeeping/ Invoicing 10-Key by touch

Insurance Verification Claims Processing

Epic Hyperspace Cigna Web Portal

Collections Reimbursements

System: Epic, NextGen, Optuminsight, ADP advancedmd, SpringCharts, Navicare

Experience:

Visualutions

AR Billing Specialist/Team Lead 02/2015- Present

• Enter charges for Behavioral Health Physicians

• Enter insurance and patient deposit daily that come into the office for Behavioral Health

• Answer calls from patients inquiring on a billing statement they received

• Verify Insurance and correct claim in system, resubmit claim to correct secondary insurance

• Billing for Medicare and Medicaid

• Collections on past due accounts from patients and insurance

• Respond to correspondence

• Scan paid claim batches and check into the system

• Enter payments in for patients

• Work denials

• Explain EOB’s to patients

• Worked charges in Manatee, Elizabethtown, and North Country

• Filled claims, entered charges and deposits using Centricity system

• Auditing files and claims, and charges for Manatee before they are submitted daily

• Run reports on claims and deposits that were entered into the system

• Handled special claim projects

• Recruiting for the Risk Management team

• First step interviewer

United Healthcare 09/2013-2/2015

Provider Resolution Specialist

• Quoting claims, approvals or denials for Provider’s and Provider Reps

• Quoting member’s Medicare/Medicaid plan benefits to ensure coverage for Providers

• Researching appeals and quoting the determination results

• Re-submitting corrected claims for reconsideration on provider claims

• Reviewing Provider contracts ensuring contracts are loaded correctly

• Ensuring claims are being processed correctly

• Answering a High call volume and reviewing over 80 to 100 claims per shift

• Deescalating provider issues on claims and getting the correct adjustment on claims resolved for

Providers.

• Assessing multiply systems at once to correctly research claims, negative balances, recoupments, and

denials.

• Going on procedure codes with providers and helping them correctly assign the correct procedure codes

• Review of 1500 claims and UB-04 claims

• Handle special claim projects over 20 clams for review and reprocessing

Texas Children’s Pediatrics Houston, TX 07/2014- 09/2014

Medical Biller and Coder

• Insurance Verification

• Claims follow up

• Appeals follow up

• Epic Hyperspace

• Cigna denial code claims

• Correspondences

Gramercy Houston, TX 09/2010-09/2013

Coder/In-patient

• ICD-9 and CPT outpatient Eye and Plastics surgery coding

• Claims Follow-up

• Maintenance on patient’s accounts

• denial code claims

• Insurance Verification

• Spring charts

• Correspondence

• Account maintenance

• Clinical Coder

• Collections on outstanding accounts

• Invoicing

• Anesthesia coding

West Houston Medical Center Houston, TX 09/2008-09/2010

Lead Biller& Coder- In-Patient

• ICD-9 and CPT coding inpatient and outpatient surgery

• Claims Follow-up

• Maintenance on patient’s accounts

• denial code claims

• Insurance Verification

• Spring charts

• Correspondences

• Billing

• Collections on outstanding accounts

• Reimbursement

• Specialty coding Plastics, General, GYN, and Anesthesia coding

Medical Staffing Network Houston, TX 09/2007-09/2008

Surgical Tech/ Coder In-patient

• ICD-9 Coding inpatient and out patient

• Claims Follow-up

• Maintenance on patient’s accounts

• denial code claims

• Insurance Verification

• Spring charts

• Correspondences

• Scheduling

• Maintain a proper sterile field during surgical procedures

• Count sponges, needles, and instruments, during and after operation

• Assist the surgical team in putting on proper PPE

• Provide technical assistant to surgeons, surgical nurses, or anesthesiologists

• Prepare patients for surgery including positioning patients for surgery

• Assist Surgeon and Surgical Assistants during surgery including holding retractors and cutting sutures

• Prepare, care for and dispose of tissue specimens taken for laboratory analysis

• Monitor and continually assess operating room conditions

Christus St. Catherines Houston, TX 04/2007-04/2008

Surgical Tech

• Maintain a proper sterile field during surgical procedures

• Count sponges, needles, and instruments, during and after operation

• Assist the surgical team in putting on proper PPE

• Provide technical assistant to surgeons, surgical nurses, or anesthesiologists

• Prepare patients for surgery including positioning patients for surgery

• Assist Surgeon and Surgical Assistants during surgery including holding retractors and cutting sutures

• Prepare, care for and dispose of tissue specimens taken for laboratory analysis

• Monitor and continually assess operating room conditions

EDUCATION:

Fortis College Houston, TX 09/2013-09/2014

Medical Billing and Coding Certification (CBCS)

Sandford Brown Institute Houston, TX 01/2006- 02/2007

Surgical Technology Certificate

Contact this candidate