Customer Service Medical Billing
Resume:
Lavitia Alford
Flexible to work from home or in Office in surrounding office locations. Ability to work on Laptop and have Windows 10 w/Noise Cancelling Headset and two Monitors. Received formal coding training through AHIMA Coding Advantage Classes and Remington College.
Fairlawn, Ohio 44333
*******.*******@*****.***
21 years of experience in Medical billing and Coding Worker's Compensation
Knowledge of UB-04 and CMS-1500 claims, Superbills, and call center customer service functions
Processed Wallcoverings Orders, data entry, promotional sales,
Processed Lab Requisitions by making sure ICD-9-CM, ICD-10 and CPT-4 Codes were accurate then prepared them to be scanned
Followed E/M guidelines for proper reimbursement and medical billing position involved processing of UB-04 claims
More interested in this opportunity as have experience in medical line
Authorized to work in the US for any employer
Willing to relocate: Anywhere
Work Experience
Summa Health Dental Clinic 07/2022 to 08/2022
Remote and Contract position
Insurance and Credentialing Representative. Process all Credentialing requests on CAQH system and Predeterminations and Preauthorization Requests, as well Insurance verification duties.
NOMS Remote-Healthcare 2020-2022 Contract Coder Position. Coder Position
DentalOnePartners Billing A/R, Claims and Collection Services
09/2020-08/2022
Coding Position and Reviewer
Cardinal Health
August 2019 to 2020
I have 16 years’ experience in revenue cycle billing. As well as ICD-10 Coding through Coding Advantage formal training while taking coding classes through AHIMA. CPC eligible.
WORKED VARIOUS TEMP AND PRN ASSIGNMENTS(worked as needed)
Hospice Billing at Caretenders
June 1994 to Present
16 yrs mental health
REMOTE Medical Biller and Coder-TEMP POSITION
Insight Global/Henry Ford Hospital - Detroit, MI
February 2020 to March 2020
Processed UB-04 claims and worked Payors on work Ques on EPIC Hospital remotely while using VMWARE and SKYPE.
Healthsmart Medical Customer Service
Kelly Services
April 2017 to July 2017
Claims Processing both in office and remotely by way of Skype
Medical Coder
Summa Urgent Care and Family Practice
February 2016 to August 2016
Medical Coder Position coding encounters on EPIC and Denials Mgt.,
Speaking to customers and Help Desk Duties
Billing Specialist Supervisor
Clearinghouse and Third Party Administrator Functions
Dr. Mohan Kareti, Pain Management Cent
October 2015 to February 2016
10/2015 to 02/2016
Medical Claims Processing,
Bill Claims to Payer,
Appeals/Denials, Prior Authorizations, ICD-10 Coding, CPT codes and charge entry and Medical Collections,Payment ProcessingClearinghouse and Third Party Administrator Functions with Athenanet.
Billing Specialist
Edwards Healthcare Services
May 2015 to September 2015
Diabetic Supply Company Medical Billing,
Entered claims on Provider Portals, charge entry, and paid Medicaid claims.
Customer Service/Medical Billing Specialist
McKesson
January 2015 to May 2015
Worked for a Third Party Administrator and did denials and A/R.
Productivity Expectations.
Clinical Team Assistant Office Manager
Caretenders
July 2014 to December 2014
Create OASIS, process 485 claims,
Order both office/medical supplies,
Answer all incoming phone calls, drop claims, charge entry, payroll entry, chart filing,
Data enter medications as well as all physician orders and Accounts Payable.
Customer Service/Medical Billing Specialist
Mutual Health Services
December 2013 to July 2014
Customer Service Third Party Billing,
Data entry,
Patient accounts and member/provider services.Data Entry
Health Design Plus
May 2013 to December 2013
Third Party Administrative billing, data entry, claims processing, coding and A/R duties.
Accounts Receivable
Medical Billing and Coding Specialist
United Healthcare - Cleveland, OH
April 2013 to December 2013
04/13 to 12/2013
Ensures timely receipt of claim payments and minimization of unexpected bad debt by monitoring assigned worklists, working with the appropriate clinical, regional and divisional staff to resolve related issues.
Performs Accounts Receivable collection duties as assigned by Billing Group Supervisor, ensuring collection of past due balances to maintain profitability.Sr. Claims Examiner/ Medical Biller/Collector
Summa Urgent Care and Family Practice, Kelly Services, Interim,
June 1994 to March 2012
Clients: Summa Care, Summa Health, Universal American Credentialing, ODJFS, Cleveland Clinic Foundation Credentialing
Marketing Executive Supervisor Remote
Independent Business Ownership Melaleuca, Inc
May 2002 to October 2006
Consumer Direct Marketing, Sales and Promotions of Health and Wellness Products on an earned commission basis. Contacted various customers by making outbound calls to inform them of deals, sales, promotions, order entry manually by filling out order forms or customers could place their own orders via internet or catalogue. Processed and closed all sales with Enrollments, and completed ustomer Agreement forms.
HMO Call Center Rep
United Healthcare of Ohio
February 1998 to August 2000
Call Center Customer service position/ (HMO) Plan, answered heavy inbound phones to serve Healthcare Providers, Brokers, Members in their call center and answered all questions pertaining to HMO PLAN, Processed CMS-1500 claims as needed and confirmed HMO plan, and Reprocessed Denials if needed with usage of ICD-9-CM, CPT-4 & HCPCS codes/DME codes necessary to get claims paid
Durable Medical Equipment billing included in HCPCS codes
Also reprocessed a variety of Denials
Education
Diploma in Medical Billing
Remington College
October 2007 to July 2008
Associate of Arts degree in Applied Sciences
Cuyahoga Community College Metropolitan Campus
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