Customer Service Office
Resume:
ANNETTE HODGE
**** *. ************** **** **** L*05
Turlock, California 95382
acqgl1@r.postjobfree.com 904-***-****
OBJECTIVE
To work as an administrative assistance or clerical support for a company that may use my excellent customer service experience while allowing me to grow and gain new knowledge.
WORK EXPERIENCE
Golden Valley Health Center, Merced, California 2014 - present
Certified Medical Coder/Trainer
Reads and interprets medical record documentation to assign diagnosis codes, assigns ASA codes and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement.
Essential Duties and Responsibility
Adheres to the ICD-9-CM (International Classification of Diseases, 9th revision, Clinical Modification) coding conventions, official coding guidelines approved by the Cooperating Parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association and any other official coding rules and guidelines established for use with mandated standard code sets. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets for ambulatory surgery centers. Utilizes up-to-date versions of CPT and ICD-9 resources and remains current on changes in coding and billing standards.
Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines
Consults physicians for clarifications and additional documentation prior to code assignment when there is confliction or ambiguous data in the health record.
Diagnosis coding must be accurate to level of specificity.
Assigns and reports codes that are clearly and consistently supported by documentation in the health record.
Follow up status of charges held for clearance.
Work interface error report and pull missing demographic information.
Display knowledge of clinic profiles.
Responsible for properly performing month end tasks within the established time-frame including month end reports for each center assigned and tracking of cases that are not yet billed for the month.
University of Florida Internal Medicine Business Office, Jacksonville, Florida 10/2013-05/2014
Charge/Follow Up Coordinator
Data Entry, inputting in customer information and updating their demographic
Liaison between customer and insurance companies to resolve issues or unpaid claims
Receive incoming and make outgoing calls.
Completed work queue of average 100+ claims per day. Maintained team goal of reviewing individual denials within seven days of notice and reviewing no response of claims within 30 days of record.
Verified and assigned key data elements for proper charge entries. Categories included: location codes, provider numbers, authorization numbers, referring physician information.
Completed correspondence requests via multiple online insurance portals as well as contacting internal staff and direct calls to patients to complete claims request for payment processing.
Audited completeness of patient registration information:
oVerified insurance benefit plans for VA patients; TRICARE members; Workers Compensation; Medicare; Private insurance enrollees.
oUpdated patient's demographic and financial class (primary and secondary insurance) information using hospital's automated billing system.
Mayo Clinic, Jacksonville, Florida 2013
Physician Office Specialist
Successfully completed all front desk tasks for busy office while maintaining excellent customer service skills with both patients and team members.
Expedited appointment setting and patient registration for all clinic practices and specialties (300+ doctors) to ensure timely patient care.
Initiated and completed patient registration ensuring accurate patient records. Tasks included:
oConfirming and entering demographic and insurance information.
oObtained consent form signatures, prepared files and forms for billing staff.
oResearched patient history at other Mayo sites through internal computer systems.
oVerifying insurance benefits and researched plans that may have out-of-network benefits.
oCollected various forms of payments and documented/reconciled cash received. Posted all payments.
Built rapport with patients. Answered all billing and insurance questions completely and efficiently.
Assisted patients in providing and explaining financial questionnaires for potential charity care. Initiated financial arrangements with patients making sure communication was made in a clear and professional manner according to policies and procedures.
Followed up patient inquiries with appropriate personnel to either resolve issues or to appropriately transfer responsibility for further actions.
Maintained knowledge of insurance requirements and made certain that requirements were met. Assisted patients with explanations of charges or insurance denials.
University of Florida Family Medicine Center, Jacksonville, Florida 2002 - 2013
Team Leader/Customer Service Representative
.
Led all new employee and staff training. Ensured all front office staff were properly trained and followed procedures in schedule maintenance, patient registration, medical records review and maintenance, referral procedures, managed care programs, fee collections, appointment/discharge process, and proper customer care at all times.
Prepared staff payroll using Kronos Software System.
Created strong team management applications with Office Manager. Responsible for daily supervision of all front desk activities and personnel issues. Liaison with other internal teams to assure smooth function of office.
Assisted Office Manager with personnel and payroll functions as well as participating in staff hiring process, training, coaching, and performance evaluations.
Trained on all office procedures and filled in for Office Manager as needed.
Provided patient billing using CPT 4 and ICD-9.
COMPUTER and OFFICE SKILLS
Epic Medical Records
Allscript
Type: 35 WPM
IDX Web
Med Data
Powerchart
Health Quest
Office Equipment and Multi-line telephone systems
Scanning Electronic Kronos Payroll System
Medical Records
Microsoft Word, Excel,
PowerPoint
EDUCATION
Certified Professional Coder (CPC) Physician Practice, 2011
AAPC Certification for ICD-9 and CPT Professional, Jacksonville, Florida
Medical Terminology (for Health Professionals), 2012
Office Management Certificate, 2009
Office Specialist Certificate, 2008
Office Support Certificate, 2007
Florida State College, Jacksonville, Florida
Ic10 Proficiency Complete
References Available Upon Request
Contact this candidate