Lisa M Penha

***** ** **** ******

Winter Garden, FL 34787

401-***-****

ada1j9@r.postjobfree.com

Objective

To obtain an administrative/data entry position in a challenging business environment that will draw upon my background and experience while providing opportunity for advancement in the Healthcare Industry

SUMMARY OF SKILLS AND ACCOMPLISHMETS

Assertive, articulate and conscientious professional with excellent communication and customer relation skills within the technical field. Highly skilled background in data entry, claims research and report generation. Quick learner with the ability to identify and resolve problem situations in a timely and efficient manner. Strong multi-tasking abilities with excellent organizing, prioritizing, and time management skills.

Electronic Billing

Reliable and Team Oriented

Claims Analysis

Knowledge of HIPAA regulations

Medical Coding and Billing

ICD-9, CPT, HCPCS

Electronic Medical and Health Records

Medical Manager

Medicaid/Medicare, 3rd Party Billing

Strong knowledge of medical terminology,

anatomy, and physiology

Education

2011-2012 Lincoln Technical Institute, Lincoln, Rhode Island Medical Coding and Billing Diploma

Attendance 98.7%, GPA 3.92

CCA Certification – Pending

Certifications

Certified in proper procedure of Restraints

First Aid/ CPR Certified by American Heart Association

Med Passing Certification through Avatar Inc.

CMS Certified

ICD-10 Certification - Pending

Experience

2017-2019 Coastal Medical

● Patient Registration Advocate

● Job Summary: Completes registration, pre-registration and scheduling functions for patients as well as obtains specific information to generate financial and demographic records to insure maximum reimbursement.

● Perform pre-registration, registration and insurance verification for new patients

● Contact patients to secure a set of critical data elements such as: demographics, insurance, payment method and clinical data (if applicable)

● Understand, verify and communicate insurance benefits to patients during the registration process

● Display characteristics of injury, empathy, courtesy and respect during all patient interactions

● Interact with patients over the phone (and via other channels) demonstrating the ability to listen, maintain rapport and show empathy while using proper telephone etiquette including good grammar, articulation and speech clarity.

● Enter personal health information in the Electronic Health Record (EHR) as necessary

● Comply with federal and local confidentiality laws, including HIPPA, insuring patient privacy

● Obtaining and verifying credit card on file information

● E-clinical system

● Generate and send out company contact letters to the patients 2012-2017 Rhode Island Hospital

● Coding Specialist II/Coding Billing Specialist

● Radiology Coding

● ED Coding

● Pre-registration

● Obtaining Pre-authorization

● Entering Patient demographics

● Research coverage and data information

● Internal/external calls to patient and appropriate personnel

● Verify medical coverage

● Review protocol to match scheduled exam, making sure medical necessities are met

● Pull authorizations through various insurances, contact physician offices, contacting patients, and intradepartmental communications

● Clearing accounts after all appropriate processes are in place

● Maintain and meet quality and productivity standards

● Determine appropriate code assignments

● Review outpatient clinical documentation to exact data and assign appropriate codes in accordance with ICD-9/ ICD-10 and CPT

● EPIC System

2005-2010 Bank of America,East Providence, RI

Customer Call Center Representative

● Assist customers with issues on their accounts

● Respond to customer inquiries

● Online banking

● Assist with opening accounts, and ordering checks 1988-2004 Blue Cross and Blue Shield of Rhode Island, Providence, RI

(Health Care Provider)

Precertification Support Specialist (1995-2004)

Claims Processor (1988-1995)

● Provided clerical and operational support to the clinical staff

● Screened and referred internal/external calls to appropriate personnel

● Researched claims/coverage data and responded to customer inquiries and complaints

● Generated necessary correspondence including letters, reinsurance forms, and surveys

● Performed all data entry functions and ensured 100% accuracy

● Entered patient demographics for admission

● Processed all benefit claims and account changes References Available Upon request

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