Entry Level Medical Insurance

Berlyne Louis-Jacques

Miami, FL *****

************@*****.***

Phone# 786-***-****

Summary:

Highly professional and organized with strong experience and team working skills along with the effective communication abilities, computer proficiency, and knowledge of medical terminology with a Bachelor degree of Science in Administration Specialized Healthcare Service Administration field career prior to Medical Insurance Billing & Coding. Strong diagnostic skills corresponding to Healthcare administrator, Healthcare executive, or Medical and Health Services Manager with capacity of entry level position such area as hospital, medical or dental clinic, group medical Practice, managed care organization, third-party, long-term care facilities, insurance companies, Home health agencies, governmental health, public and private sector agencies with management skills and business use in today complex system that emphasized to expand more knowledge.

Education:

Barry University - Miami, FL August 2015- December 2019

Bachelor of Science in Administration Minor Healthcare Service Administration

National School of Technology - Miami, FL July 2005-December 2006

Diploma in Medical Insurance Billing & Coding

North Atlantic Regional - Lewiston, ME August 2002-June 2005

High School Diploma

Experience:

HCA Florida Biscayne Bay Orthopedics - Miami, FL December 2022-December 2023

Revenue Cycle Charge Entry Billing Coder HIM: Accuracy of patient charge entry into the Billing system and assists with collecting and recording co-pays (cash and/or charge). receive and review charge documents for accuracy and coordinates with front office staff on all payment/billing issues. Enter charges into practice management system. balance Charge Summary to tickets keyed before finalizing/updating charges in the system extract information from medical records, operative notes, hospital admissions, consults, progress notes and discharges to ensure completeness and accuracy identifying quality issues with registration and scheduling activities and release claim from the Doctor’s database software.

Ideal Personnel Agency / Medipath Pathology - Miami, FL June 2022-September 2022

Biller Finance account insurance supply: Handling billing processes and insurance within a hospital, clinic, or similar facility for different specimens. Properly coding services, procedures, diagnoses, and treatments. Preparing and sending invoices or claims for payment. Correcting rejected claims. Tracking payments. Billed electronically.

All Medical Personnel Agency/ Medical IVF - Hollywood, FL March 2022-June 2022 Medical Biller Processor Specialist: Monitors & receipt o charge documents to ensure that they

Are received from assigned medical offices and IVF centers in a timely manner. Advises reporting senior when charge batches are missing or delayed, so that follow-up action can be initiated with the responsible Medical Office Manager Returns inaccurate or incomplete encounter forms to medical offices for correction, when necessary and in significant conflict with established coding policies and procedures. Inputs charges into the billing system from reviewed encounter forms and other charge documents. Participates in the implementation of procedures to improve the quality and quantity of work processed by the Billing Services team.

Ascendo Agency/ Miami Dade Housing Specialist - Miami, FL September 2021-December 2021 Housing Specialist: Identifying and accessing housing resources. Created Individualized Housing Plans. Assisted clients in completing housing applications. Found placement for clients in transitional housing while waiting for approval permanent.

National Billing Institute - Boca Raton, FL March 2021-August 2021

Clinical Assistant Office Billing Specialist: Proficiency with Kareo Practice Management software billing systems for multiple insurance and 10 key calculators. Familiarity with CPT and ICD-10 Coding regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds if necessary. Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion. Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. Billing. Medical record for medical practices, clinics, hospitals, and urgent care, facilities to maximize revenue through continuous follow through in all aspects. Keeping track of submit both electronically claims and on paper as required. check clearinghouse ad updated correct information perform audits, and fixed all known denials, no response, rejections before resubmitting claims electronically for Medicare and other commercial insurance. Business administration and operations. Data analysis.

Jackson Memorial Hospital - Miami, FL October 2017-february 2020

Account Receivable Support Service Analyst Legal: Provide Service team management daily with correspondence, invoices to process correctly and distributed accurately. All correspondence and payment documentation received from insurance company and the bank to be processed into patient accounts receivable. Received lockbox and cashbox daily from data control to manually enter and scan to patients account from different site database area hospital software. Completed daily minimal errors procedure archival data compliant error free for submitted timely compliance. Received daily legal invoices from attorney office for settlement per upon request with another task assign.

Ideal Personnel Agency/ Gastro Health - Miami, FL March 2017-July 2017

Medical Biller Data Entry Specialist: Entry of demographic and billing information in multiple hospital and laboratory interfaces. Entry of all required billing information that appears on requisitions and laboratory reports. Problem solves by correct claim errors from the edit report on EWE'S clinic software Billing and paper bill related to data entry errors. Sorts out problem requisitions, organized, typing and strong 10-key data entry skills. ICD9/ICD10 coding regulation of medical terminology Diagnoses. And reloaded complete any missing information before claims submission.

University of Miami Hospital - Coral Gables, FL August 2009-March 2017

Medical Insurance Finance Billing Coder Collector: Correct front-in registration error coverage management demographic. Bill and collect with UB04, medical terminology, CPT4 codes, ICD9 codes and Third-Party Payer requirements and reimbursement rules with Knowledge of contracts that are in force rules guidelines that govern collections activities. Follow-up with underpaid, unpaid, denial facilities claim for worker's compensation, commercials, Managed care, and government Medicare. follow-up and keep tracking clearinghouse, web portal for denial, rejection, no response, cash drive, and upon medical record request from the payer setting center functions collection billing activities based on the adjudication EOB and correspondence. Communicate by phone, fax, email for resolution before refilled claim electronic or by paper. Evaluated fee scheduled guidelines adjustment contractual before write offs. Work AR aging by weekly. UB04, medical terminology, CPT4 codes, ICD9 codes and Third-Party Payer requirements and reimbursement rules. Knowledge of contracts that are in force for hospital, physicians and the rules and guidelines that govern collections activities.

All Medical Personnel Agency /Jackson Memorial Hospital - Miami, FL June 2009- August 2009. Patient Account Finance Analyst: In Charge for all BCBS plans payers. Manage and track incoming payments, check account statuses from web portal or over the phone. Identify discrepancies on regularly to update accounts receivable. Follow-up with unpaid billing reports to guarantee accuracy and resolve any errors. Review AR account aging weekly. Corrected claims and rebill electronically. And provide medical request per request or any other information.

Complete Collection South of Florida Inc - Fort Lauderdale, FL April 2006- June 2008

Clerical Administrative Data Analyst: Creating invoices and billing materials to be sent directly to patient for unpaid balance. Informing patients of any missed or upcoming payment deadlines. Finding financial solutions for patients who may need assistance. Sort and file document. Analyze information and processes. Solve any problems related to the activities in the office. Retrieved explanation of benefit and medical record, UB92/1500 form from the system database inform and Ipr for billers and collectors per request. Responsible for return mails, before distributed to different department memo enter in the system. Received incoming call & release message to different supervisor department. Look-up for insurance payment from database unpaid, paid and patient to be post. Data entry documents Scan, fax receipt insurance correspondence received forward to supervisors for their team.

Injury institute of Florida - Miami, FL October 2005 to April 2006

Medical Office Secretary: Provide personal assistant to medical staff. Dealing with incoming and outgoing mail. Answering phone calls and arrange appointments.

Write letter and medical notes. Ensure medical samples are properly labeled. Filling and typing reports. Prepare patient charts, verify insurance, check patient in& out, order medical Supply, prepare bills, fax.

Skills/Knowledge:

Resolve problem and maintains patient's confidential records, copies, and file documentation.

Experience dealing with a diverse group of individuals when providing pertinent/general medical/clinical information.

Work independently set priorities and organizes work to meet deadlines and established processes regulations and policies. In the accomplishment of duties performing patient support work and scheduled medical appointments in clinical setting. And knowledge of multiple task.

Analyzes situations to determine what decisions can be made or if advice of higher authority is needed.

Operate computer programs and system in order to modify, enter, and retrieve patient identification information into or from reports, scheduling systems, and/or electronically.

Communicate carefully and professionally in person, electronically, by phone, in and in writing with internal and external.

Ability communicate and collaborate with a wide range of medical clinicians across multiple disciplines psychologist, medical doctors, social workers, psychiatrist, physician assistants, nurse practitioners, nursing staff, clinical pharmacists, Medical billing insurance coding, Healthcare administrator to accomplish team goal setting to ensure medical care to patients encountered.

Advanced knowledge of medical terminology due to the technical nature of language, technical patient health care portals, community models, and coordinated care administrative functions include appointments cycles, outpatients referrals, provider availability, follow-up care, overbooking.

Computer knowledge proficiency with Microsoft word, Outlook, Excel, Office,

Power point, desktop publishing

Computer knowledge proficiency with Microsoft word, Outlook, Excel, Office,

Power point, desktop publishing

Computer knowledge proficiency with Microsoft word, Outlook, Excel, Office,

Power point, desktop publishing

Computer Knowledge: Microsoft Word, Outlook, Excel, Office, PowerPoint, Office, Desktop Publishing.

Knowledge of Medical Terminology Anatomy and Physiology: CPT Code, ICD9-ICD10, UB92, UB04 and 1500 Form

Software: Kareo- IDX-EClinicalWorks -Vision- Pamar- Epic- Edm- Cerner- Dropbox- Siemens Envision- Nthrived- Miracle Power Charts- OnBase-Ucharts- Ulearn- EHR Billing- Medisoft- Medicare DD System- Triange-Softrex- Micros and Medisoft Edr.

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