CHERRIE A. CHAVEZ

*** ********* *****, ********* ** 34759

Cell # 571-***-****

ad1o51@r.postjobfree.com

Career Objective: Analytical and precise individual looking for a position to investigate, evaluates and resolves complex environment of where I can utilize my 9+years of experienced of medical office, reconciling insurances, resolving account related concerned, and profound knowledge of medical terminology. The goal is to resolve complex coverage and applying established procedures and practices.

Skills/Qualifications: Microsoft Office 2003-2010, HIPPA, Coding programs (CPT-4 & ICD-9), knowledge on Medicare and Medicaid and all other insurances. Outpatient/Inpatient Facility Coding, and Regulations.

Experiences:

Claims Resolution Management Corporation (CRMC) -Falls Church, VA Medical Claims Certified Analyst: February 2016- May 2019

Manages, review and resolves of asbestos personal injury processing claims (40 to 100+ claims per day) assigned and approved by each client trust.

Responsible for researching, analyzing, documenting multiple medical reports and coordinating the resolution of escalated claims related projects issues that requires completion and accuracy of expert knowledge of all systems, tools and claim processes.

Coordinates the identification and resolution of root causes involving configuration, claims and/or contracting activities.

Investigates leads forwarded by trustees on clients and provides quality assurance that segments are set up correctly to ensure claim processing accuracy.

Evaluates coverage, liability, and loss value and resolves claims within prescribed authority.

Tracks litigation expenses on assigned cases and updates files and provides comprehensive reports as needed.

Dominion Cardiovascular Associates, P.C. -Manassas, Springfield, Annandale and Woodbridge, VA

Medical Office Administrator: February 2014- May 2014

Processed statements, insurance paper works, and payments and recorded in patient file.

Answered phone calls to answer questions, make schedule and confirm patient appointments, transfer calls, take messages, performed routine clerical, data entry and data retrieval task.

Check-in patients, collects all personal, medical, and insurance information necessary and input all patient information into computer database and file confidentially.

Assisted with orders and interprets the results of laboratory, determined patient’s needs and processed according to type of case.

Completes client clinical record documentation in a timely manner specific to the clinical services provided according to applicable policies procedures and updated patient records.

Posted payments into system, balance batch and reconciled cash flow.

Provided secretarial services such as copying, faxing, filing and sorting mails.

MedTel International (A subsidiary of Medical Resources Ins.) -McLean VA.

Medical Biller-Senior Team Lead Verifications: June 2006 – May 2009

Reviewed and maintained completed proper insurances eligibility and benefits verifications and liability information.

Review physician notes and obtain necessary clarifications where necessary.

Ensure signatures on all medical records.

Follow up with insurance companies and ensure that all claims come to fruition.

Participated in meeting with the project managers to review goals of the project, handled researched discrepancies issues.

Followed policies and procedures contributed to the efficiency of the business office and acted as the resources of all questions related to the department.

Resolved discrepancies or errors insurance information and verifications entered in system and maintained accurate payer contract information related to the site.

Reconciled daily report of work prior to billing completion of data entry.

Accurately submitted medical claims and statements to receive the correct reimbursement for services that are rendered.

Radiology Imaging Associates -Clinton, MD Medical Biller Specialist: December 2005 – June 2006

Compiled and maintained records of charges for services rendered and ensured all patient demographic information and pertinent paperwork was provided for the site.

Assign appropriate medical codes to all diagnosis and services.

Prepare appropriate claim documents.

Code records by following prescribed coding standards such as ICD-9 and CPT-4.

Review patient records for proper documentation.

Pediatric Associate of Alexandria -Alexandria VA.

Patient Relations Specialist: May 2004 – December 2005

Accountable for all secretarial duties such as collections.

Registered all patients by obtaining pertinent information.

Verified insurances and scheduled appointments.

Answered incoming calls and assisting the billing manager of all duties.

Pembrooke Square Medical Center -Waldorf MD.

Receptionist/Billing: March 2003 – May 2004

Accountable for all secretarial duties such as collections.

Registered all patients by obtaining pertinent information.

Verified insurances, scheduled appointments.

Answered incoming calls and assisting the billing manager of all duties.

Handled collection efforts of all balances.

Total Family Care and Pediatrics -Bowie MD.

Medical Assistant/Receptionist: April 2001 – March 2003

Filed and organized patient’s medical records.

Performed vital signs, viniculture finger sticks and strep throat as ordered.

Answered incoming calls and scheduled appointments, assisted doctors during the procedures.

Education:

Applied Career Training -Arlington VA.

Certified Medical Office Administration: September 2002 – November 2003

Certified of Medical Assisting: September 2000 – November 2001

Oxon Hill High School, Oxon Hill MD

Graduated - 1999

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