Front Office Medical Billing

JOY KEY

*** ******** ***** ***** ****, NC ***** 336-***-**** ******@*****.***

PROFESSIONAL PROFILE

Proven problem-solver with 18+ years combined managerial and healthcare industry experience and an ability to adapt to new situations and learn new processes and procedures with ease. Reliable, hardworking, and dedicated team player who works well under pressure and effective communication skills.

Able to multi-task and work effectively with a large volume of information.

Highly organized and capable of prioritizing workloads to meet deadlines.

Front office skills with the ability to identify and address customer needs.

Ability to use appropriate ICD-10 codes from doctor notes to enter on the encounter to submit charges.

KEY QUALIFICATIONS

Anatomy & Physiology ~ Government Payers ~ Medicare ~ Medicaid ~ Tricare

Electronic Medical Records ~ Third-Party Payers ~ Worker’s Compensation

Managed Care (HMO, PPO, POS) ~ Office Management ~ Insurance Claim Processing

MEDISOFT Proprietary Software ~ Insurance Billing Procedures ~ Data Entry

Typing/Filing Documents ~ Co-Payments ~ Deductibles ~ Scheduling Appointments

Answering Phones ~ ~ Knowledge of- Epic software & E-Clinical Works software- ~ HCPCS ~ CPT

ICD-9 & 10-CM ~ Medical Terminology ~ HIPAA Compliance ~ UB-04

EDUCATION

Ultimate Medical Academy Associate of Science Degree - Medical Billing and Coding, 2012

Ultimate Medical Academy Diploma – Medical Billing and Coding, 2012

Member of the American Academy of Professional Coders (AAPC)

RELEVANT PROFESSIONAL EXPERIENCE

Novant Health - Winston-Salem, NC 2013 - 2020

Revenue Cycle Insurance Specialist

Ensures reimbursement through efficient, accurate and timely billing process for effective accounts receivable management.

Work pre-billing report for assigned payers in preparation for month end close.

Generates claims for submission to payers in accordance with established schedule.

Utilizes technology to manage clearinghouse and payor accept/reject submissions and reports timely.

Reviews A/R reports and researches unpaid claims. Takes necessary steps to collect unpaid claims and address credit balances. Provide reports to the Patients Account Manager as needed.

Process correspondence and telephone calls from all payors regarding claims.

Complete appeals on underpaid claims to the payer.

Identify, prepare, and submit patient account adjustments to Revenue Cycle Manager and post in system once approved.

Assist as needed with payer authorizations and verification as required and completed documentation in system.

Protects the confidentiality of patient and organization information through effective controls and supervision of billing operations

Vein Clinic of North Carolina - Winston-Salem, NC 2013 - 2020

Insurance Specialist/ Medical Billing & Coding

Check all incoming patient demographics to make sure PCP, referring doctor, and general information is all into the charts and filled out thoroughly and accurately.

Enter all out patient charges on the encounters daily with ICD-10 & previously used ICD-9 codes and submit charges daily.

Receive and process payments from patients and insurance companies and verify insurance and eligibility.

Demonstrate self-motivation, initiative, honesty, integrity, and attention to detail.

Run end-of-day reports from patient encounters to billing charges daily.

Handle insurance denials, appeals and medical requests from other facilities or from other insurance companies.

Formulate front office schedules, train new hires and process eligibility on all new patient's daily.

Set up financial agreements for patient's in the office.

Go through patient's charts daily to ensure HIPAA and all demographics and insurance information is accurate.

Orthopedic Specialist of the Carolinas - Winston-Salem, NC 2012 - 2013

Medical Receptionist

Serves patients by greeting and helping them, scheduling appointments, and maintaining records and accounts.

Welcomes patients and visitors in person or on the telephone and answering or referring inquiries.

Optimizes patients’ satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone.

Keeps patient appointments on schedule by notifying provider of patient’s arrival, reviewing service delivery compared to schedule, and reminding providers of service delays.

Ensures availability of treatment information by filing and retrieving patient records.

Maintains patient accounts by obtaining, recording, and updating personal and financial information.

Old Towne Family Eye Care - Winston-Salem, NC 2012 - 2012

Front Office Clerk

Managed front desk activities including greeting clients, scheduling appointments, generating estimates, collecting payments, and communicating with clients.

Handled daily accounting procedures and acted as liaison between medical staff, clients, and vendors.

Marks & Morgan Jewelers – Winston Salem, NC 2010 - 2011

Kay Jewelers – Asheboro, NC 2003 - 2010

Store Manager

Oversaw profit margins and control discounting, expenses of store, payroll & repair department.

Conducted employee performance evaluations to determine progress and developmental needs.

Assisted and counseled employees to assure highest standards of efforts and output.

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