Medical Billing Data Entry

CHRISTINA LEE

*** ********** **., ******, ** ****8

H: 251-***-**** / C: 251-***-**** • ***********@*****.***

PROFESSIONAL PROFILE

Motivated and customer service-oriented professional with a strong understanding of the importance of accurate claims processing. Adept at shifting priorities and bringing flexibility to dynamic situations. Follows policies, procedures, and guidelines to assure consistent quality. Maintains and ensures patient privacy and confidentiality.

Able to organize and manage multiple projects and tasks.

Possesses accurate and efficient data entry ability and sound problem-solving and decision-making skills.

Skilled at establishing priorities, meeting deadlines, and working unsupervised.

Possesses 10+ years of healthcare industry experience as Insurance Billing Specialist and Office Manager / Receptionist.

KEY QUALIFICATIONS

Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs

Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers

Electronic Health Records (EHR) Electronic Medical Records (EMR)

Managed Care (HMO, PPO, POS) Workers Compensation

Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04)

Front Office Operations Medical Office Procedures Scheduling

Medical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10-CM, HCPCS, CPT)

EDUCATION

Ultimate Medical Academy

Associate of Science Degree – Medical Billing and Coding, 2014

Diploma – Medical Billing and Coding, 2013

UMA Certificate of Academic Excellence, Gold List (4.0 GPA)

Increased typing speed, Increased Medical Terminology knowledge

University of South Alabama- Mobile, AL 2002-2005

College Coursework Completed (Chemistry Major)

Murphy High School, Mobile, AL

Graduated 2002 with Honors, 4.5 out of 5.0 and was a member of the National Honor Society

Was elected for Who’s Who (National Association for students who demonstrate above

average academics and extracurricular activities that involve your community

AP Chemistry I and II, AP Biology, AP Physics, Anatomy and Physiology, Organic Chemistry

Participated in the Chemistry Club

PROFESSIONAL EXPERIENCE

Performant, Inc., Remote 06/2021 - 01/2024

Healthcare Documentation Auditor

Performed timely and effective reviews to assess documentation and billing accuracy for post and prepayment claims on behalf of Government, and Commercial Payers.

Reviewed medical records for services billed and validated required documents and information was contained within the records submitted for various service types as required by clients, Applied local coverage determination (LCD), national coverage determination (NCD), and commercial payer policy to services in review.

Documented and articulated review findings and referenced the appropriate policies and rules in audit platform and as rationale language, Supported findings during the appeals process if necessary.

Worked collaboratively with the audit team to identify vulnerabilities and/or cases subject to potential abuse, partnered with clients, CMD colleagues, and other contractors on improving policies, provider education, and system edits if necessary.

Kept abreast of changes in technology and regulatory issues that may affect our business and clients, Suggested ideas that may improve audit workflows, assisted with QA functions as applicable, participated in development of Review Guidelines and meetings as necessary, Cross trained in other departments as applicable, maintained required quality and productivity standards, performed other duties as assigned

The Onin Group / Saad Healthcare, Mobile, AL 01/2014 – 01/2021

Insurance Billing Specialist

Collected, posted, and managed account payments with Microsoft Office and Homecare Homebase software.

Prepared and submitted clean claims to various insurance companies electronically.

Reviewed medical codes for accuracy using HCSPCS.

Performed various collection actions including contacting patients by phone to correct and resubmit claims to third party payers.

Answered inbound phones and handled files, faxes, and documentation.

Elements Therapeutic Massage, Mobile, AL 11/2008 – 01/2012

Office Manager / Receptionist

Ensured the efficient running of all office functions, including the handling of payroll, phones, Accounts Payable, Accounts Receivable, collections, and general accounting procedures.

Cared for all issues and disputes arising among employees and ordered supplies the company needed to perform its daily operations.

Maintained vendor relationships and provided important information to all pertinent employees to ensure smooth business operations.

Greeted clients, acting as the primary point of contact for the company, while seamlessly handling all front-office duties, including filing documents, organizing materials, and maintaining track of documents.

Obtained HIPAA certification.

References Available Upon Request

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