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Medical Health

Location:
Dayton, OH
Posted:
February 20, 2020

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Resume:

Carrie Birkle

513-***-**** adbv0s@r.postjobfree.com

Objective: Health Information Professional with a record of creating and implementing processes to maximize efficiency in workflow thus reducing administrative cost.

Experience

Ensemble Health Partners

Sept 2015 to present

oTeam-Lead for follow-up on medical insurance claim payments for commercial payers, workers’ compensation and Veterans Administration utilizing EPIC systems.

oA/R follow-up for Mercy Occupational Health invoices utilizing Systoc software.

oAuditing, training and mentoring of staff and new hires.

Western Hills Interventional Pain, Cincinnati, OH

January 2014 to October 30, 2014

oBilling Manager responsible preparation and submission of electronic and paper claims, posting of payments and denials along resolving billing discrepancies.

oMaintained computerized medical record and billing system (Advanced MD).

oImproved functionality of system and reduced denials by adding documentation templates for providers so critical data elements were collected.

oMaintain provider Credentialing and CLIA certifications.

oHiring, terminating employees and consultants monitoring and submitting payroll.

CCHMC, Cincinnati, OH

Summer of 2012 to January 2014

oAssigned ICD9 & CPT codes for surgical procedures and anesthesia claims.

Concentra Urgent Care, Norwood, OH

A clinic specializing in urgent care, pre-employment health screenings, workers compensation and DOT physicals

oMaintained documentation and correspondence for a very large occupational health client.

oResponsible preparation and submission of electronic and paper medical claims along resolving billing discrepancies.

oSubstitute for clinic directors as needed

Shriners Burn Hospital, Cincinnati, OH 1999-2005

oTransitioned hospital from a proprietary “Shrine Coding” system to ICD-9 coding.

oOverhauled coding manual for entire Shriners Hospital network

oImplemented one electronic medical record system combining 2 antiquated systems.

oPrepared and participated in JCAHO Accreditation.

oCompiled RVUs for physician production reporting

oProvided hospital statistics for Quality Improvement efforts.

Choice Care/Humana HMO 1987-1999

oUtilization review and case management for high dollar accounts.

oMaintained physician credentialing files.

oPrepared and participated in NCQA Accreditation.

oConsulted on appeals and self-funded employer accounts.

oServed on provider education team focusing on documentation requirements.

Education

University of Cincinnati BS in Health Information Management achieved in 2007

Certification

CPC

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