Medical Insurance

Karin King

Medical Biller/Coder/Collections

Texas City, TX 77590

**********@*****.*** - 517-***-****

I have twelve years experience as a medical biller/coder working for multi-speciality facilities. Within those years I've gained exceptional knowledge and confidence of medical billing for family practice, internal medicine, ob/gyn, pediatrics. My daily duties included insurance benefits verification, charge entry, and all the billing task required for full reimbursement from insurance companies such as state Medicaids,Medicare, including Medicare advantages, and commercial insurances. Also deligence in working A/R reports with goal at 23%. Experience navigating local hospital billng systems. Working with patients related to their account balances and with collection agencies for patient balances. Authorized to work in the US for any employer

WORK EXPERIENCE

Claims Specialist

Grace Health - Battle Creek, MI - 2014 to 2015

My responsibilities included electronic charge entry of CPT medical office charges at the same time reviewing the CPT and ICD-9 for accuracy and discrepancies and compliance for fullest reimbursement. After which I submitted and posted claims electronically within timely filing limits When needed I interactive with providers and clinical staff regarding accurate coding, documentation, policies and procedures.

Verification of insurance plans/policies eligibility, threw insurance verification websites, automated systems, or by person.

In my position I worked diligently worked off accounts receivable reports, corresponded with major insurance companies such as BCBS, BCN, Tricare, Medicare, UHC, and many others to resolve claim issues. I have knowledge and know how to read remittances, and eob's from major insurance companies/payers and confidently handled claim denials and appeals

I have always maintained strict patient and physician confidentiality threw HIPPA Kept updated of job knowledge by participating in educational opportunities such as seminars, webinars and conference calls.

Collect on delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur. Utilize collection agencies to collect on past due accounts. Continuing my education with ICD-10 (effect 10/2015) ACCOMPLISHMENTS

Involved in with the client/patient enrollment into the Affordable Care Act and the new Medicaid Expansion.

*Gained knowledge of Medicare FQHC billing guidelines and UB claims. Revenue codes. Including IPPE/AWV G codes.New established PPS G codes. CPT/charges as related to Medicare Cost Reports. Billing guidelines for Medicare MSP claims. Knowledge of FISS-DDE. Patient Accounts Representative

Center for Family Health - Jackson, MI - October 2003 to April 2014 As a Patient Accounts Representative:

Ran and worked Daily Charge Review Report for accuracy of CPT codes their diagnosis, modifers, payors that are attached to the charge. Once reviewed charges then posted and submitted for electronic claim submission to payors thru clearing house.

Also worked front end edits with the clearinghouse for release of clean claims. Other daily task inlcude working A/R reports of unpaid charges from 60 days up to 120 days Worked insurance companies paper rejections, remittances and eob's. Collect on delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occured Utilized and worked with collection agencies to collect on past due accounts Maintained strict patient and physician confidentiality threw HIPPA Maintain work operations by following policies and procedures; reporting compliance issues Enhance billing department and medical center reputation by accepting ownership for accomplishing new and different request: exploring opportunities to add value to job accomplishments. Accomplishments:

Involved in with the client/patient enrollment into the Affordable Care Act and the new Medicaid Expansion. Skills Used

COMPUTER SKILLS

• NEXTGEN

• Netwerks

• Viatrac

• WordPerfect, Microsoft word

• Microsoft Excel

• Webdenis, Mytricare, Champs, FISS-DDE, CSNAP

EDUCATION

Two year college in Medical Biller/Coder

Jackson Community College - Jackson, MI

2001 to 2003

SKILLS

COMPUTER SKILLS• NEXTGENNetwerksViatracWordPerfect, Microsoft wordMicrosoft ExceWebdenis, Mytricare, Champs, FISS-DDE, CSNAPl (10+ years)

GROUPS

Linked In

August 2002 to Present

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