Deborah Archer

Resume

Melbourne, FL *****

ad043b@r.postjobfree.com

+1-321-***-****

Authorized to work in the US for any employer

Work Experience

Billing Specialist, Follow Up Specialist

CHAMPION HOME HEALTH CARE - Melbourne, FL

February 2023 to July 2023

Bill claims to insurance, fix errors in the RCM and submit to insurance, contact insurance for claim status, review denials, initiate appeals and reconsiderations, submit what insurance needs to get claim paid including proof of timely filing. Review correspondence and work claim accordingly, track all re-works and outcomes on spreadsheets. Verify insurance and eligibility the first of the month. I worked and re-submitted claims from 2021 in addition to working current claims which all were paid with no write offs.

Medical Records Manager

Atlantic Shores Nursing & Rehab Center - Melbourne, FL January 2022 to January 2023

Review and audit resident charts upon admission, also perfom12, 24, 72 hr chart audits as well as ongoing monthly audits. Note deficiencies on audit tool, report to department head for correction and audit chart to ensure corrections have been made. Review chart for resident personal information accuracy; Advance Directives, diagnosis, physician orders are present/current. Perform audits on physician orders & visit frequency are within MCR guidelines. Close out charts within 30 days of discharge from facility, audit while closing chart to ensure discharge documentation is charted. Onboarding Coordinator-Contract

HHS/Acuity International - Cape Canaveral, FL

September 2021 to December 2021

Review and upload candidate information electronically into system, request missing documentation via phone or email, check drug screen and background checks for status, research and analyze documents and client information, update and maintain client records, navigate between multiple databases and spreadsheets.

Biller/Coder-Temp

Walk In Clinic - Merritt Island, FL

March 2021 to July 2021

Bill and review claims ensuring computer assigned diagnosis is appropriate with procedure code, query physician regarding conflicting information, scrub claims and make corrections prior to submitting to clearing house. Perform follow up on claim status, review denials, submit appeals, resolve issues with claims. Verify insurance eligibility and benefits, request authorizations, post patient and insurance payments, submit requested documents to insurance for review & payment, provide customer service to patients regarding their account, work aged report. Responsible for logging insurance checks and making deposit.

Billing/ Follow Up Specialist

Fl Eye Consultants - Melbourne, FL

January 2020 to March 2021

Capture CPT and ICD codes for claims, review claims ensuring computer assigned diagnosis is appropriate with procedure code, perform audits ensuring all compliance measures are present, notify provider of any noncompliances found. Query physician regarding conflicting information, scrub claims and make corrections prior to submitting to clearing house, follow up on claim status, review denials, submit appeals, resolve issues with claims, verify eligibility and benefits, request authorizations, post patient payments, submit requested documents to insurance for review & payment, review correspondence, provide customer service to patients regarding their account, work aged report. Billing/Follow Up Specialist

Spherion Staffing Svc-Temp Agency - Cocoa, FL

June 2019 to January 2020

Bill mental health/ Behaviour health claims while company transitions to new billing system. Enter and review CPT and ICD10 codes per documentation and computer assignment, scrub claims prior to submitting to clearing house, perform chart audits to include HEDIS compliance. Follow up on claim status, review denials, submit appeals, resolve issues with claims, verify eligibility and benefits, request authorizations, post patient payments. Resolve coding or billing issues, document deficiencies, incomplete charts or errors to providers for correction, track insurance carrier and claims filed to insurance to determine number of outstanding charts left to bill. Insurance Billing/Follow Up Specialist

The B.A.C.K. Center - Melbourne, FL

2018 to 2019

Follow up on claim status, resolve billing issues with insurance companies, submit Work Comp, Auto, VA, Tricare claims with office notes or other documentation as required, obtain authorizations/referrals, review denials, initiate appeals, submit claims to secondary insurance, assist patients with billing questions.

Medical Coder I

Jess Parrish - Titusville, FL

2015 to 2018

Code Inpatient and outpatient charts. Assign appropriate diagnosis based on documentation and computer assignment, scrub claims prior to submitting to clearing house. Querry physicians' when information is lacking or conflicting. Track missing charges on physicians spreadsheet, perform chart audits for HEDIS measures and compliance, notify providers of noncompliance issues. Maintain and update individual physician spreadsheet against daily signature report. Medical Records Specialist

Health First Private Duty - Melbourne, FL

2010 to 2014

Melbourne, FL 2010-2014

Assigned to various offices to assist with daily operation (HR, Benefits, Medical Records, Coding, Marketing/Public Relations, Work Comp). Review Medical Records for accuracy and completeness to physician documentation, signatures and orders; review ER paperwork for accuracy and completeness of notation, signature, discharge instructions /orders and follow up instructions are documented. Additionally merge duplicate charts and scanned all facilities' hard charts into Electronic charts. Patient Account Rep/Follow Up Specialist

Osler Medical - Melbourne, FL

2007 to 2009

Follow up on claim status, submit Work Comp, Auto, VA, Voc Rehab and Tricare claims, submit notes and/or documentation with claims, resolve billing issues with insurance companies, obtain authorization and referrals, review denials, initiate appeals, submit claims to secondary insurance, assist patients with billing questions, set up patient payment plans.

Medical Records

Melbourne Terrace Rehabilitation Center - Melbourne, FL 2003 to 2006

Review admission paperwork for accuracy/completeness, audit patient charts for required documentation, notify appropriate persons/departments of chart deficiencies, review med card, review medicare certifications and re-certification, review department assessments and enter IDC-9 codes, review Physician's Orders, process medical record requests. Medical Records

Rockledge Health and Rehabilitation Center - Rockledge, FL 2000 to 2003

Review admission paperwork for accuracy/completeness, audit all patient charts for required documentation, notify appropriate persons/departments of chart deficiencies, review med card, review medicare certifications and re-certification, review Physician's Orders, back-up for receptionist, review all department spend-down sheets' accuracy, process medical records requests. Education

CPC in Medical Billing and Coding

Keiser College - Melbourne, FL

January 2000 to June 2000

A.S. in Business Administration

Herzing College - Melbourne, FL

1997 to 2000

Skills

• Medical Terminology, Medical Billing/Coding,Insurance Verification, Authorizations, Referrals, Data Entry, Medical Records Relases, MicroSoft Excel, Power Point, Word (10+ years)

• Medical Billing (8 years)

• Medical Coding (8 years)

• ICD9/ICD10 (10+ years)

• Medical Insurance (8 years)

• Insurance Verification (8 years)

• Billing (8 years)

• claims (8 years)

• Collections (6 years)

• Filing (10+ years)

• Receptionist (6 years)

• Data Entry (10+ years)

• Microsoft Office (10+ years)

• coding (10+ years)

• CPT (8 years)

• Medical Terminology (10+ years)

• Microsoft Excel (4 years)

• training (3 years)

• Outlook (6 years)

• Excel (4 years)

• EMR Systems (10+ years)

• Medical Scheduling (6 years)

• Kronos (3 years)

• Medical Office Experience (10+ years)

• Transcription (5 years)

• Anatomy Knowledge (10+ years)

• Hospital Experience (7 years)

• HIPAA (10+ years)

• Medical Receptionist (6 years)

• Auditing (6 years)

• Accounts Receivable (10+ years)

• ICD Coding (10+ years)

• Quality Assurance (3 years)

• Phone Etiquette (10+ years)

• Triage (4 years)

• Clerical Experience (10+ years)

• Supervising experience (4 years)

• English (10+ years)

• Customer service (10+ years)

• Typing (10+ years)

• ICD-9

• CPT coding

• ICD-10

• Medical collection (4 years)

• eClinicalWorks

• Ophthalmology

• Vital signs

• Computer skills

• Leadership

• Management

• Medical records (10+ years)

• Office experience

• Administrative experience

• Microsoft Word

• Microsoft Outlook

• Documentation review

• Organizational Skills

• Experience Administering Injections

• Computer literacy

• Employee Orientation

• Communication skills

• EHR systems

• Physiology Knowledge

• Recruiting

Assessments

Written communication — Proficient

December 2021

Best practices for writing, including grammar, style, clarity, and brevity Full results: Proficient

Medical terminology — Proficient

September 2021

Understanding and using medical terminology

Full results: Proficient

Medical billing — Proficient

July 2022

Understanding the procedures and forms used for medical billing Full results: Proficient

Protecting patient privacy — Proficient

December 2021

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Attention to detail — Proficient

June 2022

Identifying differences in materials, following instructions, and detecting details among distracting information

Full results: Proficient

Customer service — Completed

August 2021

Identifying and resolving common customer issues

Full results: Completed

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

Additional Information

QUALIFICATIONS

Individual with extensive medical experience working in Human Resources, Workman's Compensation, Medical Billing/Coding, Medical Records, Reception, Verify insurance/eligibility, initiate/review authorizations, multi physicians offices, specialty physician offices, nursing home and rehab facilities. Skills and knowledge utilized:

Insurance Verification Insurance Follow-Up Insurance Billing ICD-9/ICD10 CPT Coding Medical Terminology Authorizations/Referrals Medical Records Auditing Electronic Medical Records Admissions Process Front Desk Medical Manager Meditech/Medisoft Microsoft Applications Word Perfect/Excel Ellen Mysis Tiger NextGen Oasis

Styx KRONOS

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