Third Party General Medical
Resume:
Yvonne Vigil
**** ***** **************, ** *****
********.**@*****.***
OBJECTIVE
Communicated with third party payers regarding claims issues and patient's reauthorizations and referralsChecked eligibility and benefit verificationschedule appointments and answer calls
WORK EXPERIENCE
Dedicated Dental: 3400 Wible Rd September 2000 - February 2007
Office manager
Payroll
Handle patient complaints
Supervise front office
Office supplies
EDUCATION
Uei co;;;ege: Online August 2022
Medical billing and coding
Identified any overpayments and/or duplicate payments, and investigated and resolved issues
Certificate of HIPAA rules
Communicated with third-party payers regarding claim issues, patient benefits, preauthorizations and referrals
Comprehensive knowledge of ICD-9 and ICD-10 Diagnostic and Procedural Coding, Current Procedural Terminology Coding, HCPCS Level II Coding and Coding Compliance
Followed up on unpaid claims within standard billing cycle timeframe
Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
Proficient in other general medical administrative duties as required
Reviewed accounts for insurance or patient follow up
Understanding of Medical Insurance, Billing, Collections and Reimbursement
Acquainted with Medicare rules and regulations
Checked eligibility and benefit verification
Comprehension of CPT, ICD-10-CM, HCPCS/Modifiers and Auditing
Familiar with CMS-1500, EOB, SOAP Notes and office procedures
Handled patient or insurance telephone inquiries pertaining to assigned accounts
Knowledge of Anatomy, Physiology and Medical Terminology
Responsible for insurance aging, patient account aging follow-up and resolution
Set up patient payment plans and worked collection accounts
Updated billing software with rate changes
SKILLS
Checked eligibility and benefit verification
Reviewed accounts for insurance or patient follow up
Set up patient payment plans and worked collection accounts
Proficient in other general medical administrative duties as required
Handled patient or insurance telephone inquiries pertaining to assigned accounts
Followed up on unpaid claims within standard billing cycle timeframe
Produced and maintained office procedure and policy manuals
Obtained referrals and pre-authorizations as required for procedures
Communicated with third-party payers regarding claim issues, patient benefits, preauthorizations and referrals
Called insurance companies regarding any discrepancy in payments if necessary
Acquainted with Medicare rules and regulations
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