Physical Therapy Biller, Medical Biller and Coder
Resume:
Martha Robles-Stahl
************@*****.***
Phoenix, AZ 85032
Provide and apply my knowledge in a meaningful position that will allow me to coordinate all of my skills and to expand and share my knowledge. As a self starter I’m able to learn systems quickly and efficiently.
Authorized to work in the US for any employer
Work experience
Medical Biller and Coder
Integrated Orthopedics of Arizona - Scottsdale, AZ
December 2022 to April 2024
1.Billing Physical Therapy claims, adding appropriate modifiers
2.Posting payments for Physical Therapy accounts
3.Answer patients incoming calls - Clinic and Physical Therapy
4.Correcting PT accounts.
5.Monthly Statements
6.Review Clinic accounts for proper coding, office visits, surgeries, injections, etc etc,
Billing/AR Collections - Contract Work
Robles Medical Billing, LLC - Phoenix, AZ
September 2015 to Present
Certified Professional Coder
09/01/15 - Present
AM - Employment Billing/AR Collections - Contract work
Full aspect of Billing and Collections
Electronic Billing
Insurance follow-up
Appeals
Coding
Patient Billing - Statements
ICD10 Proficient
Analysis skills
Run AR reports
Pre-Arrival/Insurance Verification Specialist
CHS Corporate - Tennessee
February 2021 to March 2022
Remote/Work From Home
Create patients account
Pre-Register patients (from provided hospital schedule)
Enter procedure/procedures on account and code each service. Use CPT CODES.
Verify patient’s insurance - Online or calling insurance.
Confirm/Obtain benefits, calculate if any patient liability prior to service for upfront collections.
If Self Pay create estimates. Offer MDSAVE and also create Good Faith Estimate (GFE) for new No Surprise bill.
Call patient verify demographics and attempt to collect any patient balance due.
Medical Records Sorter II
MSLA (OptumServe)Add location
January 2018 to May 2018
Evening employment to (Telecommute)
Create an Electronic File (E-File)
Retrieving an E-File from the Shared Drive
Case File (C-File) Essential Documents
Creating a C-File with Adobe
Creating Dividers
Saving C-File
Labeling documents
File Sizing
Resizing a File
Milestone
Network Drive (O:Drive)
Case File Cover Page
Creating a C-File Cover Page
Cover page Documentation
Uploading C-Files to Ecap
Authorizations and Referral Coordinator
UHC Military & VeteransAdd location
May 2016 to January 2018
Evening employment
Respond to Incoming Provider and Enrollee referrals/authorizations
Provide excellent Customer Service to both Providers and Enrollees.
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
Receives Care Coordination notification cases for non-clinical assessment/intervention and provides appropriate triage
Processes out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products
Processes notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues
Determines benefit coverage issues based on employer group contracts
Sets up/documents/triages cases for (CCR) Clinical Coverage Review
Ensures all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable
Verifies appropriate ICD-10 and CPT coding usage
Assist with faxes and emails.
Moderate work experience within own function.
Some work is completed without established procedures.
Basic tasks are completed without review by others.
Supervision/guidance is required for higher-level tasks.
Other duties as assigned by manager and/or director.
Billing Manager
Adalberto C. Gonzalez, MD PC - Phoenix, AZ
November 2014 to August 2015
Fulltime
Full aspect of Billing and Collections
Electronic Billing
Insurance follow-up
Appeals
Coding
Office Manager/Patient Coordinator
Robles Aesthetic Center - Phoenix, AZ
July 2012 to November 2014
Monday, Wednesday and Friday
Oversee day to day operations
Quotes to patient's wanting surgery
Accounts Receivable
Scheduling appointments
Scheduling surgeries
Liaison between surgery centers
Keep Doctors files up to date
Staff training
Coding Plastic Surgery
Insurance billing
Front Office Coordinator/Surgery Scheduler
Adalberto C. González, M.D., P.C - Phoenix, AZ
April 2012 to November 2014
Tuesday and Thursday
Open/close office
Answer incoming calls
Schedule/cancel appointments
Audit Billing company for correct billing and reimbursement
Coding - Spine co-surgeon fees
Insurance Follow-up
Collection calls
Patient Service Representative Lead - Full Time
Chiricahua Community Health Centers, Inc - Bisbee, AZ
November 2010 to March 2012
Open/close office
Answer incoming calls
Schedule/Cancel Appointments
Submit Prescription renewals to Medical Assistants, Nurses or Doctors
Reconcile daily cash
Make daily deposits
Check in patients
Create billing encounters for daily appointments
Train new Patient Service Representative's and answer any questions they might have
Create working schedule for PSR's with Patient Service Representative Coordinator
Review patient accounts and advise patient of outstanding balances
Verification of Insurance eligibility.
"Manager on duty" when Clinic Manager is absent or has scheduled time Off
Collect co-pays upon registration of patients
Education
High School Graduate
Some College
Accounting
IT
Skills
Typing
Auditing
Medical Records
Search engines
Medical Collection
See below - 10 years
ICD coding
Medical collection
Microsoft Word
Multilingual
Communication skills
EMR Systems
Anatomy Knowledge
CPT Coding
Accounts receivable
Cash handling
Revenue cycle management
Medical Scheduling
Office Administration
Google Search - 10 years
Training & Development
Spanish
Medical Coding
Research
CPT coding
Accounts Payable
Receivables
EDI
Microsoft Powerpoint
Firefox - 10 years
Systems Analysis
Medical billing
Windows
Documentation review
Medical Office Experience
Microsoft Access
ICD Coding
Hospital Experience
Clinic
Medical coding
Anatomy knowledge
Phone Etiquette
ICD-9
Negotiation
Communication skills
Coding
eClinicalWorks
Analysis skills
ICD-10
Clerical experience
HIPAA
EDI
Patient observation
Medicare
Supervising experience
Contract negotiation
Insurance Verification
EMR systems
Medical records
Microsoft Office - 10 years
Data Entry
Hospital experience
Cerner
Analysis Skills
Behavioral health
Medical Terminology
Medical terminology
Classroom experience
Clerical Experience
Microsoft Excel
Microsoft Outlook - 10 years
ICD-10
Windows
Accounting
HIPAA
Accounts Receivable
Medical Billing
Medical office experience
Cash Application
Physiology Knowledge
Triage
Laboratory Experience
Transcription
QuickBooks
Languages
English/Spanish - Fluent
Certifications and licenses
Certified Professional Coder
December 2014 to Present
Certified Coding Specialist
Medical Billing Certification
Assessments
Business math - PROFICIENT
January 2020
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Protecting patient privacy - PROFICIENT
February 2022
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Protecting patient privacy - PROFICIENT
June 2022
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Medical billing - PROFICIENT
October 2022
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Attention to detail - PROFICIENT
October 2022
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Medical billing - PROFICIENT
November 2022
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Medical billing - PROFICIENT
October 2023
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Protecting patient privacy - PROFICIENT
October 2023
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