GWENDOLYN

KENNY

*** *. ******* ******, ******, Ms 39648

601-***-****

ad0c4c@r.postjobfree.com

OBJECTIVE

I began working at Southwest Mississippi Regional Medical Center on April 20, 1995. During that time I have applied myself, learning more in the medical field, learning how to code and bill medical claims. My goal is to join a company where I can utilize my experience in coding, and medical billing. I am currently a follow-up insurance representative at SW Health. I am seeking a full-time remote position with benefits and pay that’s compatible with my credentials that’s listed under education.

EDUCATION —

EXPERIENCE

South Pike High School

Virginia College

Associates Degree in Healthcare Reimbursement

AAPC

CERTIFIED PROFESSIONAL CODER

CERTIFIED PROFESSIONAL BILLER

Insurance Follow-up Representative:

Current duties as a Follow-up Representative are:

Verifying and correcting patient coverage via phone and insurance portals. To identify and correct claims errors using remarks codes from the EOBs, correcting CPT codes, diagnosis, modifiers. Also bill corrected claims, original claims, when not on file with the carrier, and work secondary, tertiary, and sometimes quaternary claims. This position also includes speaking with patients, explaining their coinsurances, copays, and deductible balances. Medical records are uploaded or mailed to the carriers when needed. I have knowledge and know how to use ICD-10CM, CPT, and HCPCs books.

IS/Training Coordinator:

Under general supervision of the Director of Clinic Operations, I used the clerical, business, and training process to perform my duties of Clinic Operations IS Coordinator. I was responsible to provide oversight of clinic training processes to include, but not limit to, in-service training for new employees, ensuring proper training on the Horizon Practice Plus computer system. This was a McKesson product that I helped maintain.

I collaborated with the Director regarding day-to-day activities. I was required to generate reports,

promote effective information systems management, payroll, and maintain public relations/customer satisfaction. I am responsible for solving problems and effectively manage conflict at the secretarial level.

I have experience coding charges for outpatient, rural health clinics DME, and some specialty clinics using the medical records to assign the correct diagnosis and procedure codes. I have knowledge of HCC risk adjustment for patients with Medicare advantage plans, managed Medicaid, and commercial coverage. I review and amended code edits to assure compliance with all applicable regulations adhering to the guidelines. I billed claims on the 1500 claim forms or UB04 claim forms, I entered charges, post payments and adjustments for Rural Health, Family Practice and some Specialty clinics.

I have experience preparing correspondence, answering phones, communicate with carriers/providers, reconciliation, appeals, word, and excel.

I worked 3 years part-time (remote) billing and coding for Hands of Purpose Pain Management clinic. This was a small clinic that used Practice Fusion EHR and Practice Suite software. I entered charges and submitted claims to different carrier. I worked the rejected and denied claims via the claim’s scrubber and the clearing house. I communicated with carrier by phone, worked credit balances, ran statements and month end reports.

Skilled experiences

Trained the clinic’s software to all new hired employees.

Created and ran reports.

Entered charges, worked collections, post payments, billed medical claims, pulled EOBs for secondary claims billing.

Provided issue resolution and technical support for Horizon Practice Plus system use. I have experience working in Paragon. I am now being trained the Epic software.

Tackled troubleshooting and problem resolution to support end-user technical issues within the Horizon Practice Plus software

Processed and sent monthly invoices to customers on standard billing cycle, including adjustments, credits and corrections. Verify patient’s coverage.

REFERENCES

Marchetta Brown

601-***-****

(Compliance Assessment Manager)

Toni Haynes

601-***-****

(SMRMC)

Follow-up Insurance Representative

Shenetra Sanders

601-***-****

(SMRMC Registration Supervisor)

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