Kathleen James

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

Deltona, FL ***38

386-***-****

ad3arq@r.postjobfree.com

Professional Summary

Education

Florida Technical College: Deland Florida -- Allied Health Management Billing and Coding Certifications Graduate June 2019

National Certified Insurance and Coding Specialist, October 2019 Florida Technical College: Deland Florida – Associate of Science, Medical Billing and Coding Specialist, Honors, Graduate January 2020

MEDICAL BILLING SPECIALIST – COLLECTOR – ADMINISTRATIVE ASSISTANT Well-qualified, self-employed medical biller with excellent communication skills demonstrated by 20 years of experience in healthcare. Provided medical billing management and services for several physicians’ offices. Reliable multi-tasker with internal medicine, chiropractor, gastroenterology, diagnostic testing, speech, occupational therapy, physical therapy and dermatology billing experience. Thoroughly familiar with government, commercial and private insurance carriers’ policies and billing requirements. Expertise in verifying patient insurance, processing claims to insurance clearinghouses, posting payments and claim denials. Proficient in Medisoft, Medical Manager, Lytec, Medley, E-Clinical, Medware, Kareo and Word. EHR/EMR software Practice Fusion and E-Clinical.

Skill Highlights

Proven knowledge of HMOs, Medicare and Medicaid, Extensive billing experience in Gastro, Dermatology, Internal Medicine, Diagnostic Imaging, Speech, Chiropractor, Occupational and Physical Therapy, Working knowledge in Managed Care Contracts, ICD-10 Coding, CPT and HCPCS Coding, HHM and Medisoft billing systems, E-Clinical, Practice Mate, Office Ally and HER, HIPAA compliance, Exemplary customer service, maintaining strict physician and patient confidentiality, Exercises good business judgment, Team player with positive attitude, Strong collections background with Insurance and Patient balances. Including writing appeals and reconsideration letters

Professional Experience

ARISE SOLUTIONS - Remote Customer Service Specialist - October 2019 to present Provides virtual customer service from a cloud-based platform for Fortune 500 businesses. Researches, navigates and locates answers for customers. Contact clients to understand and address their needs, complaints, or other issues with the products or services. Responds efficiently and accurately to clients and customers explaining possible solutions and ensuring that the they feel supported and valued. MEDICAL BILLING SPECIALIST- Complete Local Specialty Care- September 2016 to July 30, 2018 Operated E Clinical Software for medical billing and collections. Posted Insurance Electronic EOBS and Patient Payments. Utilized Navicure Clearinghouse to correct rejected claims. Customer service support for the patients. The duties included making appointments and processing Insurance and patient payments. Also serviced the Insurance and patient Collection accounts. Evaluated EOBs to determine if an appeal was required for reconsideration, and multiple office related responsibilities. TEMPORARY OFFICE SERVICES – October 2015 to August 2016 – Provided temporary administrative support for Landrum and Kelly Services, Northwest Florida. OFFICE MANAGER - MEDICAL BILLING

AMARAL CHIROPRACTIC CENTER - CORAL SPRINGS, FL, January 2014 to March 2015 Supervised four employees and managed the day-to-day operation of the center in accordance with set policies and guidelines.

● Efficiently directed flow of an average of 20 patients per day, minimizing patient wait time.

● Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information. Received, organized and maintained all coding and reimbursement periodicals and updates.

● Processed an average of 120 invoices per week.

o Analyzed and interpreted patient medical and surgical records to determine billable services. Researched medical reports to apply appropriate ICD-10, CPT-4 and HCPCS codes. o Examined the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnosis codes, patient identification and provider signature. o Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. o Correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative. Thoroughly reviewed remittance codes from EOBS/AR's. o Completed appeals and filed and submitted claims. o Thoroughly investigated past due invoices and minimized number of unpaid accounts Posted charges, payments and adjustments into medical manager system. Submitted refund requests for claims paid in error. Carefully prepared, reviewed and submitted patient statements.

● Kept abreast of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes and financing options. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.

● Established and maintained positive relationships with government regulators, residents, and families, other area health care providers, physicians and community at large. Observed strict confidentiality and safeguarded all patient-related information.

MEDICAL BILLING – KAT’S BILLING SOLUTIONS, INDEPENDENT - 2004 - 2015 Successfully processed invoices for doctors’ offices and laboratories listed below. Invoice process is as above.

● Dr. Aryama Sharma - Plantation, FL, March 2004 to March 2015

60 invoices per week

● US Path Labs/Onsite Dermatology, Boca Raton, FL, March 2004 to April 2009

300 invoices per week

● All Aboard Therapy – Vero Beach, FL, March 2009 to November 2013

350 invoices per week

● Ageless Medicine - Lauderhill, FL, March 2010 to March 2015

200 invoices per week

● Pathology on the Go – Pompano Beach, FL, March 2011 to July 2014

150 invoices per week

● Heart Disease Specialist Dr. Jeffrey Sutton - Lake Worth, FL, March 2008 – March 2010

100 Invoices per week

● Dr. Stacie Ginsberg, Coral Springs, FL March 2008 – March 2009

120 Invoices per Week