Data Entry Medical

RICK T. BREEDEN

Home 804-***-****

Cell 804-***-****

Email: *********@*******.***

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** ***** ** ******* *******, 6 years of Management experience, Administrative & Clerical Billing and Collections, Bookkeeping, Office Management, various Medical Billing Software,

EMPLOYMENT HISTORY

Centura College / Richmond, VA –Part-time 09/15-Present

Instructor-MBC/ Instructor-High School Diploma Program

.Computer Applications

.Advanced Coding

. Medical Insurance

. CPT / ICD-9-10-HCPCS Coding

. Anatomy Physiology

. Medical Terminology

. Medisoft &Virtual Medical Office Software

. Billing & Coding Essentials

. Billing & Coding Capstone

. Success in College & Work place

American International Biotechnology / Richmond, VA 12/13-6/15

Billing Administrator Associate

Created/ Administrated Appeals dept.

Healthcare Provider contact daily.

Correlated via fax, mail Medical Records for Appeals.

Researched data entry doctor’s NPI for verification.

Contacted doctor’s office for verification of member’s insurance.

Follow up on all levels of Appeals, IRO, and Administrative Appeals.

Created Reports for Appeals team for timely filing, for quick response.

HIPAA test and policy procedures,chemical training, Emergency training

Correlated with members concerning status of Appeals, and follow up.

Write off accounts for Experiment, investigational, Medicare reimbursement

Researched, Verification for demographics.

Processed corrected claim, revised claim for correct payer

Administrator for online insurance verification, Emdeon, Availity, Navinet, Etc.

Client services, data entry of specimen.

Pediatrix Medical Group/ Glen Allen, VA

Billing & Collection Administrator 03/12-/05/13

Collections Administrator:

Processed commercial & Government claims

Appealed claims & coding correction medical records

Corresponded with other departments for posting of payments

Verification of all insurance & government payers’

Collections of Patient responsibility balances using soft calls

Refund processing for personal & commercial over payment

Claim adjustments & Write-offs

HIPAA Compliance Training

Next Gen software

Aerotek C/O (Health Diagnostic Labs) Richmond VA 04/11-03/12

Medical Billing Rep-Contractor

Processed Blue cross Blue shield claims

Follow up on denials claims

Processed appeal, patient statements

Processing aging Reports .

Accessioning of samples and data entry.

Robert Half Company Accounts Temps/ Virginia Premier, MCV, VC Corrective Coding Unit/Contractor 09/10-04/11

Analyze claim codes for procedures & modifiers.

Multiple / CPT coding procedures

Review unit amount for coding

Authorization and referral inquiries

HIPAA compliance training

Denied claims for Conflicting codes, duplicates, and global coding procedures.

Bostwick Laboratories Glen Allen, VA

Insurance Validation, Verification, Registration, Accessioning, Appeals, 4/07- 8/10

Supervisor Payment Posting

Resolution of errors for claims.

Medicare & Medicaid & commercial validation.

Customer service inbound and outbound calls.

Lab assistant.

Plate builder, plate verification of culture samples.

Registered insurance data.

Electronic billing, manual receipts posting, remittances, checks, and credit cards.

Daily reports, distribution of batches for posting of payments, correction and editing of payments.

Archived receipts, Eobs, ERA’s remittances and workers reports of financial transactions.

Interactive with other departments for processing of claims and resolutions

Trained employees of software and procedures of daily transactions.

Processed waivers, medical records for processing of claim appeal for reimbursement of denied claims.

Contacted insurances companies for appeal processing in and out of network benefits claim address, time limit for filing of denials.

Unicare LLC. Bridgeport, CT 3/07-/6/06

BILLING/MANAGER

Tracking authorization orders, patient information

Scheduling and confirming encounters

Episode management

Billing patient charges UB92, HCF1500-invoice, Rap, E.O.E claim

Generate billing batches, Edi billing Medicare, Medicaid, Anthem, and Bluecross.

Tracking accounts receivable

Inventory management

Managing OASIS Data

Success Systems, Stamford, CT 3/03-03/04

HELP DESK TECHNICIAN /Driver

CSR, data entry, technical support

Assisted clients with software, editing, installation, and usage of features.

Instructed client’s in billing online procedures

Management of software, registration, updates, restore data

Installation of hardware & software of clients locations

EDUCATION

St. Vincent’s College, Bridgeport, CT 05-2003/12-2005

Healthcare Reimbursement Specialist Certification

Medical terminology, insurance reimbursement, office procedures, coding procedures, computerized billing, EDI and practice management, ICD 9 and CPT codes.

Cross Country Education, Hartford CT 06/2006

Insurance billing, claims and collections certification

Co-Data Computers Service and school, Milford, CT 2001-2002

A+ Certification program

Pc Success School, Milford, CT 2000-2001

Pc client user Specialist Certification

Technical Career Institute, West Haven, CT 1990-1991

Electronic fundamental Certification

Central High School, Bridgeport, CT 1986

Public relations, personal hygiene, diploma

Certification –CPR & First Aid Training YMCA 06-2008

Class B Commercial Driver license: Experience with Delivery, Transportation, Defensive driving, Page 2of 2

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