To Whom It May Concern:

I read your ad for a Medical Billing Specialist and am submitting my resume for your review and consideration. I have an Associate Degree from HCC, Houston Community College and I have been billing and coding for over 23 years. While I've contracted for many different physicians and practices, they've all in one way or another added perspective to my experience.

In my most recent contract position, I worked as a Medical Billing Specialist for two urgent care facilities within a hospital system and I handled the Medicare account for all Physician Based Billing using ECW and Trizetto software. My previous work experience is comprised of contracted positions within many different specialties including Orthopedics, Neurology, Urgent Care, Hospital Systems, Ophthalmology, General Surgery, ENT, Cardiology, Long Term Care, SNF, Nursing Home, Pediatrics and Labs.

In working with Account Receivables, there are some important factors that I adhere to in regards to billing:

-Identifying and resolving underpayments

-Correct use of modifiers (e.g. making sure that any add-ons are being billed subsequent to the primary procedure and with correct modifiers)

-Quantifying and Analyzing first claim submission denials

-Verifying that the primary diagnosis code is not listed as the external cause diagnosis code

-Double checking clinicals for any E/M service billed within a global period to ensure correct billing

-Submission of operative reports within 24 hours of written/verbal notification by the insurance company

I maintain a high ethical work standard and understand patient confidentiality procedures. Some of my philosophies include supporting leadership to become part of the solution, setting personal goals to exceed management expectation,

being disciplined and timely with assigned workloads, and communicating with team members and management personnel.

In lieu of our growing technological world, and my newly found hobby of coding and creating websites, I have attached the link for my resume website below:

www.melodykimera.com

I look forward to your call to discuss this mutually beneficial opportunity and I will make myself available according to your schedule. Thank you for your time and consideration.

Sincerely,

Melody Miller

140 Orchid Woods Ct Email: acxrgx@r.postjobfree.com

321-***-**** Website: www.melodykimera.com

OBJECTIVE

To pursue my career path with diligence and perseverance always keeping the needs of patients and/or customers first.

SKILLS AND ACCOMPLISHMENTS

• Extensive knowledge in ICD-10 updates, ICD-9 Coding and CPT Coding.

Actively involved in all phases of the private healthcare facility.

Managed day-to-day office activities: establishing priorities and troubleshooting.

Conducted sessions to develop solutions for improving patient services.

Conducted successful analysis for maximizing income potentials.

• Proficient in coding, billing, collections, and insurance reimbursement.

Proficient in various software programs and knowledgeable of HIPPA regulations.

WORK EXPERIENCE

04/2016 – 11/2016 Medicare Billing Specialist Confidential Client/Urgent Care

• Managed the Medicare account for Physician Based Billing

• Performed appeals and submitted all request for medical records

• Handled Medicare RTP’s and Trizetto rejections

• Generated 70% of total monthly revenue for PBB

11/2015 – 04/2016 Billing Specialist / Poster Confidential Client/Dermatology

• Posted all electronic payments and balanced ledgers

• Scrubbed and submitted claims through Emdeon

• Handled patient calls and submitted patient statements

10/2014 – 10/2015 Revenue Analyst / Collections CSI/Access Mediquip LLC

• Worked via matrix systems for accounting and calls

• Negotiated settlements on surgical implants for work comp cases

• Appealed 10-12 cases daily for resolution of payment

09/2013 – 07/2014 Managed Care Manager Confidential Client/Long Term Care

• Responsible for monthly billing and collections of claims for 97 facilities

• Managed the managed care team in billing, collections and posting of revenue

• Collecting revenue on past due claims due to various denial reasons

• Submitted appeals and requested medical records from facilities

• Identified denial trends such as contract and clearing house issues and resolved

• Required to meet monthly revenue goals and deadlines

02/2013 – 09/2013 Appeals Specialist / Collections Confidential Client/Clearinghouse

• Worked State of CA claims including Medicare, Medicaid and commercial

• Electronic billing and first end clearinghouse rejections

• Handled denials and submission of appeals

• Assisted with project of 3rd party claim denials and rebills

09/2011 – 02/2013 Billing Specialist / Coder Florida Sports Ortho & Spine

• Resolving denials and appealing insurance claims for payment

• Electronic billing and scrubbing of claims

• Credentialing of physicians and physician assistant

• Analyzing claims for CPT and ICD-9,10 compatibility / surgery coding

03/2011 – 08/2011 Medical Billing Specialist Confidential / Labs

• Electronic billing and scrubbing of claims through clearinghouse

• Reported denial trends to management for front end reviews

09/2010 – 01/2011 Volunteer Entebbe, Uganda

• Worked with midwives in L&D at Entebbe Hospital B

• Taught English in the village primary school

09/2007 – 09/2010 Government Billing & Accounting HCA Shared Services

• Billing and collections for Medicare and Medicaid traditional and HMO’s

• Managed account payables for contracted hospitals

• Meeting daily productivity of a minimum of 95 accounts

03/2004 – 06/2007 Medical Billing Specialist Dr. Levenson/ Ophthalmology

• Insurance verifications, data entry and payment posting

• Submitted claims electronically through the clearinghouse

• Resolved claim denials and submitted appeals

• Supported the front office with scheduling, patient check-in and medical records

• Billed patient statements and handled patient A/R

EDUCATION

06/2008 - 05/2010 Houston Community College Associate Degree

Houston, TX

AFFILIATIONS

09/2010 – 01/2011 Enetebbe Hospital B Volunteer / Hospital Admin

Uganda, Africa Labor and Delivery / Teaching

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