Medical Insurance
Resume:
PROFESSIONAL SUMMARY
WORK HISTORY
EDUCATION
ALFREDA SIMMONS
SOUTHEAST HOUSTON • C: 832-***-**** • ********@*****.*** Organized Medical Records Technician with over 5 years of foundation in medical records management, with the ability to readily adapt to
changing enviroments in a busy, diversed population medical office setting. 02/2015 - 10/2016
RELEASE OF INFORMATION SPECIALIST/MEDICAL RECORDS TECHNICIAN CIOX HEALTH (FORMERLY HEALTHPORT) - HOUSTON, TX
Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).
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. Maintained strict patient and physician confidentiality. Expertly transcribed medical reports for a variety of physicians in a hospital setting. Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner. 09/2010 - 10/2014
MEDICAL RECORDS TECHNICIAN, INSURANCE REIMBURSEMENT SPECIALIST, SUPERVISOR ASSISTANT AVANTE USA, LTD - HOUSTON, TX
Precisely completed appropriate claims paperwork, documentation and system entry. Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).
Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation. Verified patients' eligibility and claims status with insurance agencies. Diligently filed and followed up on third party claims. 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. 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. Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Expertly transcribed medical reports for a variety of physicians in a hospital setting. Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Submitted electronic/paper claims documentation for timely filing. Accurately posted and sent out all medical claims. Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services. Precisely evaluated and verified benefits and eligibility. Responded to correspondence from insurance companies. Confidently and adeptly handled claim denials and/or appeals. Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner. MED INSURANCE BILLING & CODING CERT, GED: MEDICAL INSURANCE REIMBURSEMENT, SKILLS
2010
EVEREST COLLEGE INSTITUTE (MEDICAL INSURANCE BILLING & CODING), EVAN E. WORTHING SR HIGH SCHOOL - HOUSTON, TX
Top 10% of class
Health Information Technician (RHIT) coursework
Certificate in Health Information Administration
Coursework in Healthcare Administration
Coursework in Medical Front Office Assisting
Hospital inpatient and outpatient records
Familiar with commercial and private insurance
carriers
Composed and professional demeanor
Resourceful and reliable worker
Office support (phones, faxing, filing)
Adept multi-tasker
Records maintenance professional
Insurance and collections procedures
Research and data analysis
Close attention to detail
Excellent verbal communication
Excellent problem solver
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