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Medical Insurance

Location:
Gilroy, California, 95020, United States
Posted:
December 22, 2015

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Resume:

CORINA BARONE

**** ****** ***, ******, ** *****408-***-**** acsv0g@r.postjobfree.com

Professional Summary

Skills

ICD-9(International Classification of Disease Adept multi-tasker

Systems) Office management professional

Billing and collection procedures expert Insurance and collections procedures

Outpatient surgery coding Familiar with commercial and private insurance

HCPCS Coding Guidelines carriers

Patient referrals expert Excellent verbal communication

Work History

Homemaker/School Volunteer, 11/2009 to Current

Homemaker/School Volunteer

Manage household finances and budget, computerized bill paying and banking.

Home and School Club-member,school recycling program director, fundraising.

Room Parent.

Volunteered in school classrooms, assisted teachers with projects and with individual lessons.

Medical Biller/Surgical Scheduler/Office Manager, 07/2004 to 11/2009

Gavilan Footcare, Inc – Gilroy, Ca

Prepared billing correspondence and maintained database to organize billing information.

Printed and reviewed monthly patient aging report and solicited overdue payments.

Accurately posted surgeries, hospital visits and payments for assigned carriers.

Compiled and tracked outstanding balances owed to medical facilities.

Updated patient financial information to guarantee accuracy.

Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining

balances not covered under their policies when applicable.

Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.

Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.

Confidently and adeptly handled claim denials and/or appeals.

Maintained and updated collections tracking spreadsheet to help organize payment information.

Posted and adjusted payments from insurance companies.

Responded to correspondence from insurance companies.

Identified and resolved patient billing and payment issues.

Precisely evaluated and verified benefits and eligibility.

Submitted electronic/paper claims documentation for timely filing.

Accurately posted and sent out all medical claims.

Interacted with providers and other medical professionals regarding billing and documentation policies,

procedures and regulations.

Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation,

protocols and third party requirements regarding billing.

Resourcefully used various coding books, procedure manuals and on-line encoders.

Maintained strict patient and physician confidentiality.

Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

Pre-certified medical and radiology procedures, surgeries and echocardiograms.

Determined prior authorizations for medication and outpatient procedures.

Compiled necessary documents for surgical billing packages.

Prepared patient charts, pre-admissions and consent forms as necessary.

Diligently filed and followed up on third party claims.

Medical Billing/Collections Lead, 07/2003 to 07/2004

Pinnacle HealthCare/Pinnacle Urgent Care – Los Banos, CA

Precisely completed appropriate claims paperwork, documentation and system entry.

Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.

Diligently filed and followed up on third party claims.

Compiled necessary documents for surgical billing packages.

Pre-certified medical and radiology procedures, surgeries and echocardiograms.

Performed qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded

data.

Researched questions and concerns from providers and provided detailed responses.

Accurately selected the proper descriptive code when more than one anatomical location was indicated.

Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient

medical records.

Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

Maintained strict patient and physician confidentiality.

Resourcefully used various coding books, procedure manuals and on-line encoders.

Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation,

protocols and third party requirements regarding billing.

Interacted with providers and other medical professionals regarding billing and documentation policies,

procedures and regulations.

Accurately posted and sent out all medical claims.

Authorization Desk, 01/2002 to 01/2003

Karthikeya Devireddy, MD – Los Banos, Ca

Professionally and courteously verified appointment times with patients.

Verified patients\' eligibility and claims status with insurance agencies.

Prepared patient charts accurately and neatly for the clinic.

Prepared patient charts, pre-admissions and consent forms as necessary.

Compiled necessary documents for surgical billing packages.

Determined prior authorizations for medication and outpatient procedures.

Pre-certified medical and radiology procedures, surgeries and echocardiograms.

Shelter manager/administrator, 01/2001 to 01/2002

Town Cats – Morgan Hill, CA

Responsible for daily maintenance, cleaning, feeding of up to 112 cats.

Supervised all staff and volunteers.

Interviewed potential adopters.

Strong public relations.

Manage medical care, including administering medications, subcutaneous fluids, injections and other medical

treatment as needed for up to 95 cats.

Vet visits, medical record-keeping and maintenance of records and adoption information on PetWhere system.

Heavy public contact.

Adoption interviews and general office work with an emphasis on animal medical care and medical records.

Medical biller/surgical coordinator, 01/1998 to 01/2001

Donald Burt, MD – Gilroy, CA

All authorizations including medications, MRI, CT,DME .All aspects of surgical

scheduling.Recredentialing/contracting.

Supply ordering.

Performed complex billings tasks, daily reconciling, statements, worked as a liaison between patients and

insurance companies.

Investigate accounts and work to resolve issues holding up payment.

Compose letters of medical necessity and appeal letters to insurance companies.

Audit and resolve accounts.

Performed complex billing tasks involving account research and analysis.

High volume medical setting.

Detailed knowledge of insurance billing procedures, CPT and ICD-9 coding, Medicare and Medi-cal guidelines,

HMO, PPO, EPO, POS, and Workers Compensation.

Posted EOBS.

Education

The Professional Medical Transcriptionist Program: 1999

Professional Career Development Institute - Norcross, GA

Diploma: Medical Transcription,

Medical Transcription

Included course studies in anatomy, physiology, diagnostic imaging, pharmaceuticals, medical terminology,

English grammar, language, punctuation, proofreading.:

References

References and Letters of Recommendation available upon request.



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