Medical Records Managed Care, Biller
Resume:
Bobbie McCluskey
PROFESSIONAL SUMMARY
● **+ years of Claims and Authorization experience
● Well-rounded with experience working for provider and managed care organization
● Extensive knowledge in insurance verification, prior authorizations, claims, benefits eligibility, medical billing and coding, medical office processes, Medicare, and commercial insurance
● Proficient in using Microsoft Office Programs and EMR, HIM, Cerner, Google Suite
● Proficient with ICD-9, ICD-10, CPT Coding, EHR data, Availity, Sage PROFESSIONAL EXPERIENCE
CMC Management Remote
March 2021 current
Patient Acct Rep
● Answering and assisting clients with any issues they may have
● Collecting money, setting up payment plans, entering payments July 2018 - July 2021
Associated Surgeons - Grover Beach, CA
Authorization Coordinator
● In charge of HMO, managed care authorizations for a busy surgery office
● Verifying patient-eligibility, coordinating benefits, and facilitating insurance coverage, as well as addressing patients' concerns regarding authorization
● Processing claims follow up, benefits, and verifying insurance
● Scheduling appointments and handling billing and coding
● Answering phone calls from patients and doctors
July 2012 to May 2018
21st Century Oncology - San Luis Obispo, CA
Clinical Receptionist/Insurance Authorizations/Medical Records
● Scheduled for 2 doctors
● Screened calls for 12 employees in a very busy radiation office
● Scanned medical records, updated patient records and new patient consults
● Verified insurance eligibility, benefits, co pays, through Sage
● Answered all billing and financial questions,
● Ordered supplies and upkeep on all equipment.
● Front Desk, phones, faxes, back up, MA, disability, FMLA forms, EMR August 2008 to June 2010
Arcadian Management - San Luis Obispo, CA
Intake Coordinator/Insurance Eligibility & Verification
● Handled all Managed Care HMO Authorizations
● Worked with nurses from remote locations to patient claims approved or otherwise
● Gathered information about the patient and create patient records
● Made appointments and scheduled procedures for patient medical treatments
● Answered questions related to services and made referrals when necessary February 2008 to August 2008
Galileo Surgery Center - San Luis Obispo, CA
Front Desk Receptionist
● Registered surgical patients
● Handled billing
● Answered inbound and outbound calls
EDUCATION
High School Diploma or GED
Harry Ells High School - Richmond, California 1972 EHR certified in Medical Records,
Boston Reed College
February 2012 to September 2012
MA Certificate, Injections, Venipuncture in Medical Assistant, Computers Golden State Business College - Visalia, CA
February 1996 to September 1996
References:
Susan 805-***-**** co-worker
Miranda Hall HR Manager 805-***-****
Kim Hayashi Office Manager 805-***-****
The operator quit last week so the phone may ring for awhile. Please don’t talk to anyone but those 2.
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