Kim Rogers

P.O Box ****

Grayson, GA *****

404-***-****

E-mail: ad2nr2@r.postjobfree.com

OBJECTIVE

Motivated medical billing and coding specialist with over 24 years of experience in health operations management, billing, and coding. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding. Highly skilled in analyzing and validating patient information, diagnoses, and billing data. Demonstrate leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals.

WORK HISTORY

K.M.B, LLC Duluth, GA

Sr. Medical Billing/Coder and Credential Coordinator, 10/2010- Present

Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management. Examine patients’ encounter forms to verify diagnosis codes and reconcile codes against services rendered. Accurately input procedure and diagnosis codes into billing software to generate invoices. Use electronic charge and capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on time. Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances. Document patient data and medical records and perform routine medical record audits to comply with insurance company requirements. Specialize in HMO, PPO, Medicare, Medicaid and all commercial Insurance billing.

Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.

Atlanta Gastroenterology and Associates, Atlanta, GA

Coder and Appeals Coordinator, 8/06 to 10/2010

Duties include researched and investigated claims thoroughly for 42 doctor’s process

appeals/claims for redetermination of Medicare, Commercial and Medicaid insurance claims.

Medical insurance claims follow-up.

Served as a liaison between claims processors, subscribers, providers, legal departments and

outside contractors conducted detailed investigation to determine information required for

subrogation decisions Interpreted factual and legal research of current laws and applicable State

Insurance Lawn regarding subrogation planned, prioritized and completed multiple tasks as

delegated by the appeals supervisor.

Beverly Healthcare, Conyers, GA

Medicaid Billing and Coder Specialist II, 12/05 – 8/06

My duties include Medicaid nursing home billing. Maintain all Medicaid and Insurance billing accounts and recovery for four large facilities. Obtain member information to update reimbursement issues.

Perform weekly follow- up on problem accounts to keep timely factors resolved.

Knowledge of Georgia Medicaid billing and Mass Medicaid billing. Coding claims for nursing home facility to prepare for electronic billing. Billing Medicare claims and Identify Rev codes. Running reports on batches. Daily and month end closing. Medical insurance claims for HCFA andUB’s

Aim Health Care Services, Nashville, TN (Contract)

Regional Account Manager, 02/04- 07/05

My duties include Reimbursement and Medicaid and Insurance Billing, Financial Reporting

unpaid and denied insurance claims. Secondary billing appeals and contractual adjustments.

Assisting physicians and hospital business office working with insurance companies.

Performing on-site credit balance reviews in the hospital sector. Coding claims for hospital procedures.

Billing Medicare. Daily and month end closing also responsible for reviewing, analyzing and

recovering overpayments made to providers.

Integrated Medical Specialist Stockbridge, Ga

Billing Manager/Contract, 4/02- 12/05

My duties include posting payments, posting charges, for large load of cancer patients.

Assisting Patients with problem accounts. Handling follow-up and billing for Medicare, HMO and

PPO insurance. Electronic billing and rebilling to all insurances. Data entry, adjustments and

refunds. Handling appeals to Insurance companies. Downloading from Medi-soft. Coding claims for

anesthesia, surgery and office procedures. Billing Medicare. Running reports on batches.

Daily and month end closing on all accounts. Electronic filing claims.

Mag Mutual CBO Duluth, Ga

A/R Specialist III, 1/00 – 4/02

My duties include posting payments, posting charges, for 7 different large doctor facilities.

Assisting patients with problem accounts. Handling follow-up for Medicare, Medicaid, and HMO

and PPO Insurances. Billing and rebilling claims for Medicare, Medicaid and all other Insurance

companies. Downloading from HL7 and using medical manger. Running batch reports.

Daily and month end closing on all accounts.

EDUCATION

Ultrasound Diagnostic School

Diploma: Medical Insurance Coding, New York, New York, Distance Learning – 1999

Certificate: Billing and Coding Specialist– 2000

Special Skills

Microsoft Word, Word Perfect, Microsoft/ Excel, access, AS400, Medisoft, Century, medical mgr 900 hr course comprised of theoretical and practical of essential medical assisting skills including: clinical skills lab procedures, administrative duties, health insurance processing, billing, medical terminology, anatomy and physiology. Coding for hospital and doctor offices. Nursing Home billing. Medicaid Billing. Telemed billing and coding, provider credentialing, ICD10 coding. Various medial billing and EMR systems.

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