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Medical Billing

Location:
Long Beach, MS, 39560
Posted:
December 08, 2016

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Resume:

Julius Ariel C. Garcia

**** ******** **** *** ***, Long Beach, MS 39560

Iphone 228-***-****

acxtmk@r.postjobfree.com l acxtmk@r.postjobfree.com

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, NueMD, Medisoft, (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

228-***-****

acxtmk@r.postjobfree.com

References:

Caretta Brown

Laboratory Director/Instructor

Former Colleague

228-***-****

Mari Bactad, R.N.

Memorial Hosptial at Gulfport

Gulfport, MS 39501

228-***-****

Bharat Sangani, M.D.

New Coast Cardiology Center

Chairman

Encore Entreprises, Inc.

228-***-****

217-***-****

Darlene Purve, N.P.

Gulfport, MS 39503

228-***-****

Mike Arledge

CEO

205-***-****

228-***-****

Chris Boudreaux

New Coast Cardiology Center

Gulfport, MS 39503

228-***-****

Carol Pearson

Camero Medical Clinic

Gulfport, MS 39503

228-***-****



Contact this candidate