Medical Biller Account Representative
Resume:
Anne Kapsoff
Medical Biller
Carson City, NV ****1
ad1s21@r.postjobfree.com
Leadership
Management
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Charge Poster
InnovateU - Reno, NV
June 2021 to Present
Post charges for PCP, PT, Nursing Home visits and Pediatrician. Also Insurance verification and update patients accounts with current insurance. Correct claim rejections from claim processing systems. Call patients for account balances
A/R Coordinator
Gastroenterology Associates - Reno, NV
June 2020 to June 2021
Answer billing questions from patients. Take Credit Card payments on patient accounts. Bill out Primary dual procedure claims. Code and bill out Anesthesia procedures. Call on denials to Insurance Companies. Call on status of claims. Appeal for medical necessity. Check on Insurance websites for status or denials. Appeal for medical necessity on Insurances websites PFS Account Representative/Medical Biller
Tahoe Forest Hospital District - Truckee, CA
April 2019 to June 2020
Work denials for Medi-Cal & Commercial Denials
Update Modifiers on certain procedure codes. Verify procedure codes are correct per the Medi-Cal, California Health & Wellness Manual & the rules for Commercial Insurances Submit documentation with CIF form in regards to denial's of procedure codes by Medi-Cal Contact California Health & Wellness and BC Partnership Plan in regards to denial of procedure codes on claims
Appeal for denied Procedure Codes to BC Partnership & any Commercial Insurances Correct denial Procedures codes on California Health & Wellness Bill Medical Claims to all Medicaid plans
Work in EPIC Billing system
Account Representative/Contract Position
RPM Billing LLC - Reno, NV
January 2019 to April 2019
Review correspondence from Insurance companies. Review modifiers and Procedure codes on Medical Claims before billing to Medicare. Update Modifiers on Medicare claims after denial of procedure codes. Verify eligibility with Medicare with the new Medicare ID's. Submit Medical Claims to Medicare and Rebill Medicare Claims
Work in EPIC Billing System
PFS Insurance Rep
Navigant Consulting, Inc. - Lewisville, TX
January 2017 to December 2018
Verify patient Insurance coverage
Call Insurance Companies to obtain claim status and obtain reason claim has been denied Further research on the reason the claim has been denied Obtain the supplies needed to appeal claim or to send claim to the correct provider Contact patient’s if we need any help or other information that was not obtain originally or more information to help fight for reimbursement
Contact the Facility to have claims updated with correct information on claim for payer to pay on claim Resubmit claims to payer for reimbursement
Use DDE system to obtain claim status and CWF for Medicare patient’s in Georgia Senior Biller/Independent Contractor
Business Advisors MD - Plano, TX
May 2016 to December 2016
• Verify claims are coded correctly before submitting claims through Gateway EDI
• Post ERA’s and paper eob’s
• Print out EOB’s from Dropbox
• Work rejections and denials for family practice office
• Correct denied claims and rebill with correct documentation and original claim number
• Process sleep study claims
• Send out statements. Take patients billing questions and take patient payments Post patient payments to patient accounts
Worked in E-Clinical Works, Advanced MD System
Account Representative
HCS/Aprima - Richardson, TX
August 2015 to March 2016
• Ensure proper coding and placement of Modifiers on Medical claims before processing
• Post Insurance payments from Paper Batches and ERA'S
• Call on claim status or check through websites from our Worked Status's
• Call patients if we are needing any Insurance information or if the Insurance is requesting information from the Patient
• Bill corrected claims to Insurance company with primary claim number from EOB
• Verify Patient Statements before they are sent out PFS Insurance Rep/Commercial /Cigna/TPA
Banner Health System - Phoenix, AZ
February 2014 to August 2015
• Ensure proper administration and filing of Commercial in WR Region: CO, WY, CA, NV
• Ensure authorizations are correct for procedures performed
• Appeal claims to Cigna and or TPA's if authorizations are incorrect or claims billed different than what procedure was originally authorized
• Verify why claims are pending. Find out from Insurance Rep what is needed from patients to help process claims. Speak with patients about the pending claims
• Bill corrected claims to Insurance company with primary claim number from EOB Medical Biller/Coding
New Image Family Medicine LLC - Phoenix, AZ
October 2011 to December 2013
• Enter patient demographic and Insurance Information
• Read procedure notes to verify if procedure performed is correct for the visit
• Code claims with the correct diagnosis or treatment performed on day of visit
• Bill claims out to Government/Medicaid/Commercial Insurances
• Run EDI reports, post payments to patient accounts and send patient statements
• Run A/R for month end and run month end reports for Doctor Medical Biller/Coding/Payment Posting
EDI Practice Management - Phoenix, AZ
January 2009 to September 2011
• Open envelopes from Physician offices, sort superbills by dates of service
• Verify demographic information and enter demographics, Insurances into system
• Code superbills and verify services performed for Date of Service
• Bill claims to Government/State Medicaid/Commercial Insurances
• Post Insurance payments and post EDI payments
Medical Biller/Authorizations
Better Breathing LLC - Sparks, NV
July 2008 to September 2008
• Verify patient demographics and enter demographics into system. Enter Insurance into system
• Call Insurance for authorizations on Durable Medical Equipment
• Bill claims to Government/State Medicaid/Commercial Insurance plans Education
Associate in CMCS
Career College of Northern Nevada - Sparks, NV
November 2003 to March 2005
CMCS
CCNN - Sparks, NV
2003 to 2005
Skills
• Customer Service
• Health Insurance
• Practice Management
• eClinicalWorks
• Medical Billing
• EDI
• Epic
• Primary Care Experience
• EMR Systems
• Medical Coding
• CPT Coding
• ICD-10
• Medical Records
• Medical Office Experience
• ICD-9
• Patient Care
• Adobe Acrobat
• Insurance Verification
• Medical Terminology
• Medical Scheduling
• ICD Coding
• Microsoft Excel
• Microsoft Word
• HIPAA
• Phone Etiquette
• Transcription
• Documentation review
• Microsoft Office
Assessments
Electronic Medical Records: Best Practices — Completed May 2020
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Completed
Attention to Detail — Completed
May 2020
Identifying differences in materials, following instructions, and detecting details among distracting information.
Full results: Completed
Medical Billing — Highly Proficient
March 2020
Understanding the procedures and forms used for medical billing. Full results: Highly Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
Computer Skills
• Knowledge in Word, Excel, Outlook, Adobe Acrobat
• MediSoft, Medical Manager, E Clinical Works, Aprima, Advanced MD, SoapWare, MS4 Medical Software, EPIC Medical Systems
Billing Knowledge
• Private, Commercial and Third Party Billing, Hospital Billing, Medicaid Insurance, Medi-Cal, California Health & Wellness, BC Partnership Plan
• Infusion, Ob Gyn, Internal Medicine, DME, Primary Care Office
Contact this candidate