PROFESSIONAL EXPERIENCE

Eden Senior Healthcare **/2018 to Present

Coding Specialist

Analyzes and interprets information in the medical record and assigns the correct code(s) utilizing ICD-10-CM and/or CPT classification system to the diagnoses/procedures of medical records according to the coding guidelines

Evaluates medical record documentation to ensure that diagnostic and procedural codes and other relevant documentation accurately reflect and support the visit or procedure

Reviews medical records for accurate charge capture (posting) and for completion of all pertinent procedures

Accurately reviews medical records and determines diagnoses to be completed and sequenced according to documentation and coding guidelines

Coding analysis for 5 SNF / Long Term

Advocate Healthcare Group/MWH 11/2016 to 11/2018

Full Cycle Billing Specialist

Followed up on 50-75 denied claims/day utilizing the CMS-1500 Form

Performed full cycle billing for 20 physicians in Cardiology

Insurances worked included; Medicare, BCBS, Medicaid, Tricare, Workers Compensation, Aetna, Humana, Cigna and other carriers

Reviewed and corrected CPT and ICD-10 claim denials

Filed claim appeals

Posted payments from insurance companies and placed outbound calls to follow up on payment issues

The Medical Care Group LTD/AMITA Medical Care Group 10/2013 to 03/2016

Full Cycle Billing Specialist

Reviewed and corrected physician claim denials, filed claim appeals, assisted offices with insurance questions or patient billing issues

Performed full cycle billing for 20 physicians

Insurances worked included; Medicare, BCBS, Medicaid, Tricare, Workers Compensation, Aetna, Humana, Cigna and other carriers

Posted payments from insurance companies as well as carried insurance companies regarding payment issues

Posted patient payments via phone or email

Digestive Disease Associates of the NS 03/2007 to 01/2015

Full Cycle Billing Specialist

Reviewed charges on EMR and filing them electronically

Reviewed claims reports to make sure they went free of errors

Posted payments from insurance companies and patients

Performed analysis of accounts past 30 days past dues and also reviewing accounts to make sure everything was process and paid appropriately

Performing closing of the day and end of month and reviewed insurance contracts

Handled all collections, denials and appeals

Sent statements to patients to assist with explanation of bills

Glen Endoscopy Surgery Center 01/2005 to 04/2007

Billing Specialist

Performed billing for 10 physicians in the facility with involvement of billing on UBO4 Forms, working on practice A/R and closing of monthly reports

Billed and posted payments of all major insurance companies including Medicaid and worker compensation

Performed account analysis for any unpaid claims

Handled all collections, denials and appeals

Maintained patient’s accounts, which included sending patient’s statement

Orthopedic Surgery Specialist LLC 03/2003 to 01/2005

Billing Specialist

Billed all major insurances, including Medicaid and worker compensation

Posted payments and sent patient statements

Melvin P Katz MD 10/2001 to 02/2003

Billing Specialist

Billed to all major insurances, along with posting of payments to patient’s accounts

Assisted with front area duties such as schedule patients, answering incoming calls and filing

Assisted doctor with casting and other procedures done in office and took vitals

SOFTWARES

EPIC

Medinformatix

Pointclickcare

Centerial

Medical Manager

Medical Medsoft

IDX Power Works

Optima

PointClickCare

Tiger

Centricity

Aprima

My Ability

OminiCare

SKILLS

Bilingual (Spanish/English)

EDUCATION/CERTIFICATIONS

AAPC

Certified Professional Coder, 06/2018

Oakton Community College

Certification in Billing and Coding, 12/2016

Contact this candidate