Medical Management
Resume:
Julius Ariel C. Garcia
**** ******** **** *** ***, Long Beach, MS 39560
Iphone 228-***-****
********@*****.***
Personal Objective
A position utilizing my expertise in business office, management, medical coding and billing, creative market researcher and skills as a computer programmer/artist.
Summary of Qualifications
Offering more than 25 years of successful experience encompassing expertise in business office - medical billing and coding, marketing research (consumer, dealer & media), and in management.
Areas of expertise include:
Medical billing and coding. Preparation of research study for account clients (qualitative and quantitative studies); design conceptualization of various merchandising, audio-visual, and similar materials such as final/ready artwork, websites, brochures, flyers, and concept materials; promotion and enhancement of corporate image externally and internally.
Personal strengths:
Professional appearance and demeanor. Creative and adaptable to a variety of people and situations. Ability to work independently and/or cooperate with others as a team. Strong communicative skills, self-motivated, quick learner, willing to do what it takes to get the job done, work well in a fast-paced environment, excellent troubleshooting skills, ability to handle multiple tasks, excellent written and verbal communication skills, work well with others and with minimal supervision.
Work Experience
CAMERO MEDICAL CLINIC 1202 Broad Ave., Gulfport, MS 39501
Medical Billing – July 2015 to present
Manages billing and AR duties, charge-entry, claims status, appeals, and working delinquent patient accounts. Works commercial, Medicare, and Medicaid insurance carriers and familiar with standard coding principles including ICD-10. Attention to detail, analytical and problem-solving skills, customer service
Manage/responsible in posting payments/account receivables, coding and billing charges
Expertise in developing and delivering daily, monthly and annual financial reports for management within tight deadlines
Download all EFTs & remittance advice for postings and work on all denials
Daily EMS transmission and ERS retrieval as needed/trouble-shoots/correct audit reports
Checks and reviews overpayment, refund and small payments
Responsible for setting up medical/practice management software/Medisoft – ICD10 and billing compliant
Writes correspondence in response to inquiries from both patients and insurance companies
Research necessary appeals/reviews to insurance companies on denied charges
Audits patient charts for the preparation for payer reviews
Verifies and research on correct and medically necessary diagnoses
Administrator for all payers web sites/portals
Make/answer calls to all payers and address inquiries/requisitions
Manages and updates provider enrollment-credentialing applications/in-network contracts
Assures smooth operations and communication between Intake, Billing, Referrals, Access, and back clinic operations
Additional duties include cross-training for front desk duties and other special assignments as requested by management
Prepares monthly reviews and plans for the billing/clinical office
Updates and obtains billing/payer policy guidelines through webinar trainings
Skill Proficiencies
Daily/Monthly/Yearly Reports
Account Receivables
Productivity Reports
Payment Analysis Reports
Process Improvement
Progress Reports
Non Patient Revenues
NEW COAST CARDIOLOGY CENTER 14055 Seaway Road, Gulfport, MS 39503
Billing Manager - June 2002 to February 2016
Summary of Qualifications
Heavily involved in the business office and management. Highly organized, self-motivated, detail-focused/oriented-person with experience of accurately handling financial reporting, and medical billing and coding issues in deadline-oriented environments. Directly reporting to all physicians.
Supervise and manage business office
Responsible in posting, coding and billing charges (diagnostic, clinic and hospital charges)
Expertise in developing and delivering daily, monthly and annual financial reports for management within tight deadlines
Daily EMS transmission and ERS retrieval as needed/trouble-shoots/correct audit reports
Check and review overpayment, refund and small payments
Write correspondence in response to inquiries from both patients and insurance companies
Research necessary appeals/reviews to insurance companies on denied charges
Verify and research on correct and medically necessary diagnoses
Update payers policies and guidelines changes and its incentives
Audit patient charts for the preparation for payer reviews
Administrator for all payers web sites/portals
Responsible for setting up medical/practice management software/Cerner – EMR & ICD10 complaint
Manage and update provider enrollment-credentialing applications/in-network contracts
Proven ability to identify and implement improvements to streamline process and increase efficiency and productivity
Train new hired billing staff
Facilitates communication between providers and enabling services staff on different work issues/concerns
Provides operational supervision to clinical support staff including front desk, medical assistants, lab tech and doctor
Additional duties include cross-training for front desk duties and other special assignments as requested by management
Clinical and billing/payer policy guidelines obtained through webinar training
Conduct monthly reviews and strategic planning in the business office
Skill Proficiencies
Daily/Monthly/Yearly Reports
Yearly Tracking
Account Receivables
Productivity Reports
Accurate Data Entry
Process Improvement
Payment Analysis Reports
Patient Statements
Non Patient Revenues
Hospital List
Work Experience (continuation)
AUDITS & SURVEYS WORLDWIDE, AP Metro Manila, Philippines
Creative Research Executive, June 1997 - January 2001
Prepared research materials for account clients (Colgate-Palmolive, Coca-Cola Bottlers Phils., Smithkline Beecham, McDonald’s Phils, Jollibee, Kimberly-Clark Phils.,Wyeth Phils., Procter & Gamble Phils., Shakey's Phils., Burger King, Int’l Distillers Phils., SMB, Sterling Tobacco, Mitsubishi, Nestle)
Analyzed/interpreted data tables and prepared research materials (e.g., summary tables and presentation charts)
Supervised research projects in the preparation of other research-related matters (quantitative and qualitative studies, and client servicing)
Conceptualized designs of various merchandising, audio-visual, and similar materials such as final/camera-ready artworks, web site, brochures, flyers, concept materials, and other printed materials for clients and public distribution
Recruited/screened qualified respondents for qualitative (FGD sessions) and quantitative studies
Coordinated with concerned departments regarding cost estimates of projects and other project requirements
Supervised staff and trainees in in-service training/seminars; prepared qualitative and quantitative requirements
ACNIELSEN PHILIPPINES Metro Manila, Philippines
Creative Assistant, Research, January 1994 - June 1997
Promoted and enhanced corporate image externally and internally and performed various assignments essential to the department’s delivery of its services
Supported and assisted research departments in qualitative and quantitative studies
Provided materials to the corporate newsletter and supported company’s service divisions on merchandising materials such as brochures, flyers, audio-visual presentations and enhancing graphic layouts/designs of presentation materials.
ACNIELSEN PHILIPPINES Metro Manila, Philippines
Editorial Assistant, January 1990 - December 1993
Edited newsletters/publications for grammar and style, wrote news releases and internal publications, and assisted in the preparation of various research-related and editorial materials
Conducted numeric and logical checking of data tables/prepared summary tables. Provided assistance/support to research groups.
Operated desktop publishing systems, scanners and printers. Prepared plates for printing and set type. Job and cost tracking, ordering and re-ordering of office supplies and office equipment.
ORIENTAL & PETROLEUM AND MINERAL CORP. Metro Manila, Philippines
Research Assistant, January - November 1998
VENTURES, Inc. Metro Manila, Philippines
Field Organizer, January - June 1987
CONSUMER ADS, ABS-CBN Channel 2 Metro Manila, Philippines
Research Assistant, May 1986
Education
MEDICAL CODING SKILLS Oschners, New Orleans, LA
Advanced Level, August 2003 – Angela B Adler RHIT, CPC
DATAMEX Metro Manila, Philippines
Dbase IV (Computer Programming), 1986
EMPLOYMENT & APPRENTICESHIP RESEARCH NETWORK Metro Manila, Philippines
Office Management and Procedures (Scholar), 1985
FAR EASTERN UNIVERSITY Metro Manila, Philippines
BS Accounting, 1984
PATEROS CATHOLIC SCHOOL Metro Manila, Philippines
High School, 1980
SEMINAR/TRAINING
2015 Novitas Solutions Medicare Symposium (A/B), International Classification of Diseases – Tenth Revision, Evaluation & Management Services: Physician Coding – Hospital Setting (B), Office & Outpatient Evaluation & Management Principles (B), Coliseum, Biloxi, May 13, 2015
Vascular, Peripheral and Carotid Reimbursement Seminar, VP Jeff Majchrzk, Radiology Services Medical Learning Inc., Isle of Capri, June 2009
Family Health Care Plus Provider Workshop, Dr Aggie McDonald, Garden Park, Gulfport Mississippi, July 22, 2003
The Future of Marketing (By Dr. Mike Ewing, ASW AP) conducted at the Audits & Surveys Worldwide AP, Makati City, Philippines on May 3, 2000
Global Brand (By Mr. Robert Dubow, ASW Europe) conducted at the American Chamber, Makati City, Philippines on June 2, 1998
Stress and Time Management Workshop conducted at the ACNielsen, Ortigas Avenue, Philippines on April 14-15, 1997
ACNielsen 5th Management Conference conducted at the Valle Verde, Pasig City, Philippines on March 11, 1997
COM-DAP Expo '96 conducted at the Manila Shangri-La Hotel, Philippines on October 5, 1996
ACNielsen 4th Management Conference (Follow-Through) conducted at the Club Filipino, San Juan, Philippines on September 18, 1996
ACNielsen 4th Management Conference conducted at the EDSA Shangri-La's Plaza Hotel, Philippines on August 5, 1996
Re-Orientation for Associates Program (REAP) conducted at the ACNielsen Philippines on July 31, 1996
Teambuilding Workshop conducted at the Philippine Village Hotel on July 22-23, 1996
Values Identification Session conducted at the ACNielsen Philippines on February 14, 1996
SOFTWARE APPLICATIONS (Knowledgeable and expertise in the following software programs)
Practice Management Software/Data Processing: (Medical) CERNER, Visionary & Medical Manager, (Research) Quantum, SPSS, Merlin
Word Processor/Spreadsheet: MS Word, WordPerfect, Excel, Libre
Desktop Publishing/Graphic (Mac/PC): Adobe PageMaker, Powerpoint, PhotoShop
DOS: MicroStat, Coran
Julius Ariel C. Garcia
4401 Beatline Road Apt 14A
Long Beach, MS 39560
********@*****.***
References:
Caretta Brown
Laboratory Director/Instructor
Former Colleague
Mari Bactad, R.N.
Memorial Hosptial at Gulfport
Gulfport, MS 39501
Bharat Sangani, M.D.
New Coast Cardiology Center
Chairman
Encore Entreprises, Inc.
Darlene Purve, N.P.
The VIP Clinic
Gulfport, MS 39503
Mike Arledge
CEO
Chris Boudreaux
New Coast Cardiology Center
Gulfport, MS 39503
Carol Pearson
Camero Medical Clinic
Gulfport, MS 39503
Contact this candidate