Medical Assistant Billing

LEA C. GILL

PHILADELPHIA, PA ***** 267-***-**** *******@*******.***

Healthcare Administrative Professional with a background in supporting a busy medical environment performing risk assessment and adhering to policies and procedures. Experienced in managing and training staff while reviewing processes for accuracy and compliance. Knowledgeable in HIPAA practices, OSHA requirements, insurance certifications and medical coding. Seeking an opportunity to serve a fast-paced hospital system or medical practice.

PROFESSIONAL EXPERIENCE

Einstein Healthcare Network, Philadelphia, Pa 2015 - Present

Accounts Receivable Analyst

Process AR review for Commercial, Medicare and Medicaid insurance claims including Workers Compensation, Independent Medical Examination, and case agreements

Review remittance denials related to coding edits against the fee for service model, capitation coding, DRG grouper rates and contractual percentages reimbursement fee schedules

Verify insurance eligibility, referrals, and handle pre-certifications

Investigate payment disputes and appeals for level of care approvals for inpatient stays; observations and out of network authorization

Reconcile cash collections and post adjustment corrections

Mercy Fitzgerald Hospital, Philadelphia, Pa 2013 - 2015

Emergency Room Patient Access and Admission Supervisor

Scheduled staff based on department budgetary constraints; performance requirements and restrictions

Trained and assessed staff; conducted performance reviews

Implemented policies and procedures for on-call rotations to resolve staffing issues

Enforced rules and regulations in accordance with JCAHO and CMS standards

Reviewed data entry of demographics and insurance information in patient registration for accuracy

Implemented solutions to reduce errors; generated reporting to share with leadership management

Liaised with Patient Financial Services to resolve insurance verification, reimbursement and registration issues.

Wills Eye Hospital, Philadelphia, Pa 2011 - 2015

Oculoplastics Supervisor

Maintained physician scheduling for office hours and surgical cases

Managed front desk operations of registration, insurance and referral information

Initiated and obtained precertification surgeries and radiology requests

Controlled inventory processing for outpatient procedures and ordered supplies

Coordinated physician fellows and residents schedule with Residency Program Coordinator

Rothman Institute, Philadelphia, PA 2007 - 2011

OSHA Coordinator

Implemented of OSHA strategic planning and training of staff members

Created online training modules with PowerPoint presentations for OSHA awareness and annual updates

Created and maintained compliance records and data via the electronic records system for all clinical and non-clinical staff

Monitored all high-profile cases including spinal cord injury research documentation

Committee member for installment and “Go Live” project for the Electronic Medical Records System (EMR)

Conducted annual general inspection and exclusion database reporting for staff

Investigated patient complaints, needle stick protocols, and work-related injuries

EDUCATION

Master’s Degree, Health Administration Anticipated 2021

Peirce College, Philadelphia, PA

Bachelor’s Degree, Health Administration 2020

Peirce College, Philadelphia, PA

Associates Degree, Applied Science 2010

Concentration in Medical Assistant/ Medical Billing and Coding

Delaware County Community College, Media, PA

TECHNOLOGICAL SKILLS

idx epic srs sms NextGen passport meditech picis navinet allscripts cerner med assets empower impact

audra pro trac powerchart artiva Microsoft suite

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