Medical Billing Customer Service
Resume:
Barbara Donaldsoni
Houston, TX 77025
Cell: 504-***-**** - ad32pg@r.postjobfree.com
Skilled professional with administrative experience in a medical setting. Knowledgeable of medical terminology, medical billing, medical Coding (ICD-10 & CPT Coding) and payroll.
Strong administrative skills
Types 50 words per minute
Detail Oriented
Team Player and Self-Motivated Employee
Work Experience:
Job Title: Financial Review II - Kelsey-Seybold Clinics
Houston, TX 77024
June 2014 to present
Responsibilities: Customer service patients after medical services are provided, explain how their insurance(s) policy paid and the patient’s responsibility, follow-up on bad debts with collection agencies, called and talk with patients concerning unpaid balances and advise to payment arrangements, open and close cashiers at the begin and end of work day, report on surveys daily, and end of month close out for 1st floor encounter files.
Job Title: Patient Account Representative - Cymetrix
Lewisville, TX 77062
October 2008 to May 2014
Responsibilities: Process medical claims that includes contacting patients by telephone or by mail to complete medical claims confirm claim status with insurance companies and manage denials for appeals.
Job Title: Patient Relation Rep - Sarasota Memorial HealthCare System
Sarasota, FL
February 2007 to October 2008
Responsibilities: Accurately entered patients' demographics into database, obtained correct prescription for services rendered, filed insurance claims, verified eligibility, managed denials, posted payments, maintained database and created reports. Also, scanned patient data into electronic medical records, communicated with patients, physicians and insurance companies to obtain necessary information and correct CPT/ICD9 codes using modifiers as needed.
Job Title: Accessioner / Data/Order Entry Operator - Labcorp
New Orleans, LA- Baton Rouge, LA - Dallas, TX - Sarasota, FL
August 1995 to March 2008
Responsibilities: Processed specimens for storage and transportation (Cyto, Histo, Micro and Chem), split specimen, converted orders into test codes, performed medical billing, tracked and provided reporting of specimens.
Job Title: Information Analyst / Administrative Assistant - Physicians Hospital
New Orleans, LA 70025
May 2000 to February 2002
Responsibilities: Provided computer support (teaching/training new techniques and new systems) throughout the facility, worked as a liaison with caseworkers, hospitals, doctor offices, EMS, families and other facilities for admissions, transfers, and discharges. Assisted with human resources and payroll functions. Also supported the Director of Nursing with all clerical needs and support.
Job Titles: Data Coordinator/ Medical Secretary - East Jefferson Hospital
Metairie, LA 70001
January 1990 to April 2000
Responsibilities: Collected quality assurance data on physicians for credentialing purposes, maintained physicians' files, prepared reports, minutes, and coordinated monthly meeting.
Job Title: Guest Relation Services – New Orleans SuperDome
New Orleans, LA 70024
August 1990 thru August 1995
Responsibilities: Escorted guest to seats and accepted tickets as guest entered the building manually counted tickets for head count and minimum security work (searched bags / clothing for food, drinks, knives, guns, records, cameras etc.)
Education:
Certificate in Medical Billing/Coding
Certificate in Secretary Science
High School Diploma
SKILLS:
Medical Terminology
Typing (50 - 55wpm)
Medical Billing
Medical Coding (ICD-9 & CPT Coding)
Payroll
Insurance Verification (Medicare, Medicaid, Private)
Patient Registration (Admission, Transfer, Discharge)
Account Payable/Receivable
Data Entry (Alpha/Numerical)
Human Resources (Credentialing, Policies & Procedures)
Meeting Preparation
Minutes Preparation
PC Proficient (Word, Excel, Publisher, Outlook, Internet, Access, Email, PowerPoint)
General Office Procedures (Phone, Fax, Copier, etc.)
Education
A.
Associates Degree or 2 years Claims Payment Analyst experience in lieu of education.
B.
Experience with Microsoft products (word and excel.)
Experience
A.
3 years of Facility Claims Adjudication experience in a HMO,PPO, or TPA environment.
B.
5 years’ experience as Claims Payment Analyst and demonstrated ability to process complex professional and facility claims.
Licenses
A.
N/A
B.
Special Skills
A.
Demonstrated understanding of DRG pricing methods, Outpatient Prospective Payment System Mechanics, Outliers and Case Rate Payment Mechanics.
Knowledge of CMS rules and regulations. Skillful in medical terminology, CPT and ICD9 Coding and billing.
Demonstrate strong working knowledge of Payor Contracts, Utilization Review procedures (specific to authorizations).
Able to interpret and apply contracts, fee schedules and reimbursement methods.
Ability to understand and/or interpret regulatory guidelines (i.e. TDI, CMS, HIPAA, etc.) Strong knowledge of Claims Services and Claim Review Processes.
B.
Other
A.
Self-directed and able to absorb new material quickly
Contact this candidate