Ra’Mesha Ormand, CPC

*** ***** ***** ***

North Las Vegas, NV 89032

Cell: 702-***-****

Email: ad128a@r.postjobfree.com

Professional Summary

Experienced medical biller with over 15 years of medical billing and coding knowledge, expanded my professional growth to Supervisor and Lead positions used in a professional office and facility setting. Fast paced, people oriented, extremely hard worker, friendly, goal driven, and a team player seeking a position that best fit my knowledge, skills, abilities and customer service.

Skill Highlights

Knowledge of HMOs, PPOs, Medicare, TPAs and other private party insurances including Attorney liens.

55 WPM, MS Word, Outlook, Excel, Communication and strong multi-tasking skills, Leadership skills

HIPAA compliant. Knowledge of all healthcare regulations.

Analyzes trends to solve issues and maximize reimbursements.

ICD-10 /CPT Charge Entry Coding Specialist

Various EHR/EMR software experience (Advanced MDs, e-MDs, Practice Fusion, Centricity, G-Med, Health Co, Apex, Intergy, MD-Suites)

AAPC Certified Professional Coder

Professional Experience

Clinical Neurology Specialists March 2019 to Current

Las Vegas, NV

Medical Biller and Coder

- Reviewed daily documentation and carefully analyzed outpatient neurodiagnostic testing and office consults and visits for 5 providers and 2 locations. Abstract reports and translate appropriate diagnosis codes, procedures and HCPCS codes and post to claims for insurance, lien, and workers comp payers. Participate in webinars and department meetings for updates on CMS regulations and policy changes. Provide estimated financial responsibilities to assist patient’s with properly scheduling and being prepared for testing’s, conduct semi annual chart audits to ensure compliance and justifiable billing practices. Review CCI edits and problematic claims issues. Upload and send electronic and paper claims daily via clearinghouse within timely limits, Notarize record request from outside attorney’s and legal requestors. Participate in daily financial deposits consisting of cash, checks, and credit card electronic transfers for both locations, Stay compliant with company security risks and awareness assessments.

Las Vegas Radiology / Cardiology January 2018 to February 2019

Las Vegas, NV

Billing Supervisor

- Oversee billing and liens department with 11 employees to supervise. Implemented structure and standards. Handle all escalated billing issues and concerns from Insurance payors, patients and Attorneys. Kept credentialing, CAQH, Hospital Re-appointments and contracts updated as well as Provider’s professional licenses. Enforced compliance and abided by all healthcare regulations. Invoiced lien batches to multiple funding companies, analyzed trends, focused on maximizing revenue and cash flow. Ensure that activities of the billing and authorizations department are conducted in a consistent manner. Trained and educated operations manager on finding trends that impacts revenue, made weekly cash to deposits to business bank. Analyze and divide A/R follow up amongst billing staff, balance cash collections daily from 3 servicing locations. Corrected allowable fee schedules from governmental and commercial payers. Make sure NCCI edits and LCDs are adhered to on claim filings and CPC charge entry. Produced a variety of financial reports for the owners.

Synergy Cancer Center of Nevada December 2016- December 2017

Las Vegas, NV

Medical Billing Supervisor

-Entered Oncology and Hematology charges daily for chemotherapy infusions, iron infusion, port flushes, and all patient level of office visit as well as professional hospital charges. Updated injected medications utilizing the CMS ASP pricing file quarterly and thoroughly investigating the correct units and accurately billing on claims with NDC codes documented for payment processing. Set up payment plans for patients, worked aging reports weekly and analyzed and resolved problems working special projects for unpaid claim occurring in A/R reports and aging outside of the reimbursement and revenue cycle aging. Obtained EOB’s and ERA’s and posted payments, completed appeals and corrected claims, faxed/mailed medical records request, Updated provider forms as necessary, and worked closely with Practice manager. Balanced lock box bank deposits against systems and reports, mailed certified documents oversee front desk and collections.

Ambulatory Surgical Center January 2017 to July 2017

Las Vegas, NV

Billing Lead

-Enter surgical procedure charges for gastroenterologist facility. Post insurance, patient, and other TPA payments. Work rejected claim denials daily. Balance lockbox, mail, and counter deposits daily. Analyze reports for fee schedule payments, resolve patent disputes. Approve payment plans for procedures, Create work batches semi-monthly. Oversee billing department and handle all escalated billing issues and concerns. Verify benefits and correct allowable fee schedules from governmental and commercial payers. Send claims via UB-04 and HICF CMS 1500 claim form electronically and paper submission to various payers and follow up on A/R aging appropriately. Make sure NCCI edits and LCDs are adhered to on claim filings and back up for insurance verifier, referral rep and authorization staff.

Sunset Clinic May 2013 to Dec 2016

Henderson, NV

Billing Supervisor

- Posted payments from Insurance, Patients and other organizations for all four locations of practice. Thoroughly review and obtained EOBs and ERAs to ensure proper payment posting and denials. Appeal denials, under paid claims, submitted requested documents to payers and corrected claims as needed.

-Entered billable charges from EMR medical chart notes for services provided within patients’ visits. Acquired and examined diagnosis codes for related procedures performed and billed proper age related and compliant CPT/HCPCS to ensure clean claims to payers.

Scheduled and set up payment plans, collected past due account balances, took payments by phone, and reviewed and resolved stale dated accounts and claims.

-Work A/R weekly, properly analyze and send Stale and non-payment accounts to collections.

-Review billing staff payments, adjustments, make sure of balancing and review appeal follow up. Deposit mailed payments, produce daily batches, and monitor clearinghouse and work rejections.

- Created SOPs for Billing and Front desk employees and trained new employees on front desk daily functions including, verifying eligibility using electronic sources or phone verifications, obtaining prior authorizations, answering busy phone lines with confidence, scheduling, cancelling and confirming appointments. Made sure daily audits were accurate and clerk collected accurate copayments for each visit. Created memos and protocol updates as necessary. Oversee 4 clinics, 5 medical billers and front desk and authorizations staff. Coordinated protocols and implemented standards and structure.

Quest Diagnostics Inc. October 2005 to February 2013

Las Vegas, NV

Patient Billing Rep II / ICD-9 Coder

-Thoroughly investigated past due invoices and minimized number of unpaid accounts. Demonstrated analytical and problem-solving effectiveness. Examined diagnosis codes for accuracy as related to test being performed. Scheduled patient appointments. Accurately entered procedure codes, diagnosis codes and patient information into billing software to send out clean claims to insurance carriers. Collected copays, deductibles and Out-Of-Pocket expenses. Billed patients, insurances and other private pay organizations invoices for services rendered. Answered multiple phone lines, insured quality customer service and patient satisfaction.

Bank of America August 2004 to September 2005

Las Vegas, NV

Senior Teller

-Ensured a high level of trust with customer funds by securing and monitoring Checking, Savings, IRAs, Mortgages, Credit Cards, Lines of Credit and all other loans and federally secured accounts.

Communicated with customers in person, supervisors and banking managers and assistant managers through a variety of means-regarding how to handle and resolve complaints, balanced cash from secured vault. Entered information into the financial database, updated records, verified transactions, printed statements as requested by customers, examined incoming materials such as foreign currency, money orders, counterfeit securities, checks, cash and coins. Authorized overrides for teller transactions over assigned set limit, serviced and handled small business-merchant accounts.

Medco Health Solutions September 2003 to August 2004

Las Vegas, NV

Pharmaceutical Customer Care Rep.

-Answered multiple incoming phone lines maintaining PHI, accuracy and customer care to ensure quality control expectations. Handled billing questions, web support help, ordered medications for patients, refill requests, Physician requests and resolved insurance issues. Input data and updated patients’ personal information. Appropriately followed HIPAA regulations and guidelines.

Family Doctors Associates April 2001 to June 2003

North Las Vegas, NV

Front Office

-Answered busy phones lines, scheduled, canceled and confirmed appointments. Verified insurance eligibility, collected co-payments, deductibles and obtained prior authorizations for certain medical procedures Physician orders. Input data for patient demographics using electronic and hard copy medical charts and records. Prepared medical records requested for patients, hospitals, labs, insurances and other healthcare facilities. Filed charts, fax requested documents, prepped patients before seeing Physicians and provided patient satisfaction.

Education and Training

Southern New Hampshire University 2015 to 2021

Manchester, NH, US

Bachelor of Science- Healthcare Administration and Management

Cheyenne High School 2003

North Las Vegas, NV, US

High School Diploma

References available upon request.

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