Customer Service Representative
Resume:
Marie Manzella
Palm Coast, FL 845-***-**** ************@*****.*** www.linkedin.com/in/marie-manzella-564b782ab/
Customer Service Representative
Dedicated Customer Service Representative with a robust background in medical coding and extensive experience in healthcare administration. Known for exceptional communication skills that foster effective teamwork, even in remote settings, and for consistently ensuring timely and accurate charge ticket processing. Adept at managing patient accounts, resolving billing inquiries, and optimizing revenue through precise coding and claims processing, bringing a comprehensive understanding of medical terminology and billing systems to enhance service delivery.
Key Skills
Exceptional Customer Service and Support Medical Coding and Billing Patient Account Management ICD-CM and CPT Coding Claims Processing and Reprocessing Regulatory Compliance (HIPAA) Multitasking and Time Management Problem-solving and Resolution Data Entry and Record Maintenance Team Collaboration and Coordination Software Proficiency (eClinicalWorks, Cerner/Firstnet, Microsoft Office Suite)
Professional Experience
Nuvance Health Systems, Remote 2015 - 2024
Certified Professional Coder (CPC) and Charge Specialist - Emergency Department 2022 - 2024
Accurately coded and charged emergency department services, ensuring compliance with regulatory standards, and optimizing reimbursement for Nuvance Health Systems.
Assigned and completed facility charge tickets with precise ICD-CM and CPT codes using HIM 3M/Encoder, ensuring accuracy based on clinical findings from Laboratory, Radiology, and Pathology reports, as well as clinical studies.
Reviewed and input accurate CDM codes for Emergency Department charge tickets using Cerner/Firstnet, optimizing billing processes and accuracy.
Conducted thorough reviews of patient charts to verify visit reasons, modes of arrival, clinical interventions, ancillary services, critical care times, nursing assessments, trauma activations, E&M levels, and dispositions, ensuring comprehensive documentation.
Verified CDM procedure codes for alignment with appropriate CPT and ICD-CM codes, maintaining coding accuracy and compliance.
Enhanced charge ticket accuracy by effectively communicating with healthcare personnel across multiple departments within Nuvance Health Systems.
Processed patient charts from four hospitals in NY and CT, ensuring all work adhered to HIPAA compliance and government guidelines.
Charge Specialist - Emergency Department 2015 – 2022
Managed and optimized the charge capture process in the Emergency Department, ensuring accurate and timely billing, compliance with regulatory standards, and coordination with clinical staff
Utilized Cerner/Firstnet to review and input proper CDM codes for charge tickets in the Emergency Department.
Reviewed patient charts to ensure accuracy: visit reason, mode of arrival, clinical interventions, ancillary services capture of critical care, time, final selection of nursing assessment, trauma activations, E&M level, disposition.
Confirmed CDM procedure codes that are aligned with proper CPT and ICD-CM codes.
Received patient charts from four hospitals within NY and CT, completing all work within HIPPA Compliance and government guidelines.
Certified Professional Coder certification required.
HealthQuest Medical Practice, LaGrangeville, NY 2010 - 2015
Patient Account Representative - Faculty Practice
Managed patient accounts, including billing, collections, and account reconciliation, while providing exceptional customer service and ensuring compliance with financial policies
Completed patient registration, patient eligibility, claims, and aging reports in eClinicalWorks (ECW) software.
Handled heavy customer service calls: Communicated with insurance billing departments to finalize claims and answered customer billing questions/dilemmas.
Reprocessed appealed or denied claims with accurate coding in accordance with ICD CM and CPT guidelines, ensuring successful payment resolutions.
Utilized Gateway and EDI to process claims efficiently, managing and optimizing revenue from claims and charges.
Certifications
Certified Professional Coder (CPC) American Academy of Professional Coders 2024
Completed 36 Continuing Education Units each year since 2013
Certified Billing and Coding Specialist National Health Association 2023
Completed Continuing Education credits each year since 2010
Contact this candidate