Barbara Corinne Thrower

**** ******** ******

Lakeland, FL 33801

863-***-**** Cell

863-***-**** Home

acqrc1@r.postjobfree.com

Summary of Qualifications:

Twenty years experience in office administration. Three years experience in coding claims. Two years experience Account Receivable reconciliation. Over five years in Customer relations. Highly organized and motivated and detail oriented. Dedicated and focused, able to prioritize and complete multiple tasks, able to follow through to achieve project goals, independent and self-motivated professional with excellent research and writing skills. Knowledge of Medical terminology, Anatomy and physiology, ICD-9-CM, HCPCS and CPT coding guidelines, able to grow positive relationships with clients and colleagues at all organizational levels.

Computer Qualifications

MS Word, Excel, PowerPoint, Access, Windows 98 and Internet. Operating Systems DOS, Mac OS X, Windows 2000, Windows NT, Windows Vista, Windows XP, Medical Manager, DART, Collect. IDX and Next Gen system.

Software Applications

Access, Illustrator, Med iSOFT, MS Excel, MS Outlook, MS PowerPoint, MS Word, Photoshop, Photoshop II, Publisher

Employment Experience

The Hubbell Eye Clinic- April 2015 to June 2015

Lakeland, FL

Front Office

Answered phones

Scheduled appointments

Verify Insurance

Billing

Correspondence

Reconsideration and appeals.

Check in and cashier.

Watson Clinic – March 2014 to March 2015

Lakeland, FL

Coder II and Billing

Reviewed physician claims that denied due to edits derived from LCD and NCD coding guidelines.

Corrected the diagnosis codes, as well as Evaluation and management services.

Reviewed medical record for both inpatient and outpatient claim for the physicians to determine correct coding.

Entered claim charges as needed for Hospital Radiology and clinical EKG billing.

Used the HCPCS, ICD-9-CM and the CPT coding books.

Had to know medical terminology, anatomy and physiology.

Had to have some clinical knowledge to read and interpret lab reports.

I received two ACE rewards for service to Watson clinic.

Recondo Technology, Inc. - May 2012 - January 2014

Lakeland, FL

Claims Representative II and Coding Analyst-

Handled the collections for outstanding balances for this company's client.

Research reasons why patient's account had an outstanding balance.

Contacted the member's insurance company to obtain status on the patient's claim(s) and attempt all efforts to bring the account for that patient current.

Determined if a claim needed to be re-billed or filed for an appeal with the payer.

Reviewed insurance contracts for various groups including Medicaid AHCCCS.

Promoted to Coding Analyst in 2012.

Reviewed claims of over 25 major hospitals and handled over 300 accounts for coding resolution.

Advised the operator for that account what codes needed to be added or deleted. Extensive research was needed at times.

Reviewed carrier's policies to make sure that the claim denial met the medical necessity level of care according to the carrier policy.

Reviewed medical records and operative reports to determine denial of claim and to see if the claim was coded according to the Coding Guidelines

Used the HCPCS, ICD-9-CM and the CPT AMA coding books.

Had to know medical terminology, anatomy and physiology

Read and interpret lab reports

Advised nursing staff for coding issues as well.

Amerilife - June 2011 to March 2012

Clearwater, FL

Claims Analyst 1

Processed Medicare Supplemental claims for payment from the I-series system. Types of claims were Veteran’s, Outpatient and Inpatient, Skilled Nursing Home. Adjusted claims,

Contacted providers for resolution of payment.

Research needed at times to resolve provider and insurance contract issues.

The CSI Company - November 2010 to June 2011

Tampa, FL

Provider Accounts Representative

Handled the collections for outstanding balances for this company’s client.

Contacted the member’s insurance company to obtain status on the patient’s claim(s)

Attempt all efforts to bring the account for that patient current.

Reviewed patient information in Medical Manager to determine why claim was unpaid or short paid, and determines if insurance company was adhering to the contract.

Determined if an adjustment was needed or if claim was not payable by the insurance company.

Documented all collection activities in Medical Manager for patient collections

Kept records of funds that were collected.

Printed UB Billing forms as needed to re-bill claims and maintained all records.

Wakely and Associates (IAS) - November 2006 to October 2010

Largo, FL

Claims Adjuster

Processed Medicare Supplemental claims for payment. Types of claims were Veteran’s, Outpatient and Inpatient, Skilled Nursing Home.

Adjusted claims, Contacted providers for resolution of payment.

Research needed at times to resolve provider and insurance contract issues.

Education and Training

Florida Career College Clearwater, FL February 2009 - October 2009

Health Insurance Billing and Coding

Diploma Program

Tampa College Lakeland, FL 1993 - 1995

Associate of Science in Medical Secretary

Associate Degree

MEDICAL CERTIFICATIONS/LICENSES

Certified Billing and Coding Specialist (CBCS)

NHA Credentials

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