***** ******* ***** ****** ********, CA 91354
Cell: 661-***-**** Email: firstname.lastname@example.org
Seeking a responsible and challenging Managerial position within a growing healthcare organization.
Extensive managerial, supervisory and training experience in the areas of University Physician Billing, Coding, Compliance and Appeals.
Experienced with most payors including Medicare, Medi-Cal, CCS, Commercial, Managed Care, Private, and Workers Compensation.
Certified Professional Coder (CPC) highly skilled in coding: E & M, Spinal Surgery, Orthopedic Surgery, Radiology, Plastic Surgery, Pathology & Laboratory, Pediatrics, Critical Care Management, Anesthesiology, Physical Therapy, Chiropractic, Acupuncture, Oncology, Cardiology, & Neurology.
National Coding Compliance Auditor for professional coding chart review for large healthcare organization.
Coding Instructor in AAPC approved program and Billing Instructor
Professional training and presentation experience, excellent written and oral communication skills, project management and financial management experience, analytical skills, works effectively in a team situation, has natural leadership skills
Microsoft Word, Excel, PowerPoint, Outlook, AS400, Medtrak, Encoder, CPT/ICD-9,
Medi-soft, IComp Works, Athena.
The Ivy Day Spa, Valencia CA 12/01/2015 – Present
Therapeutic Massage Therapist
Performed: Swedish Massage, Pre-Natal Massage, Hot Stone Massage, Deep Tissue Massage, Chair Massage, Aromatherapy, Myofascial Release, Trigger Point Therapy, Reflexology, Sport Massage, Body Treatments, Certified Oncology Massage Therapist, 12 Vacuum Cupping for Trigger Points
Physician Management Group (PMG), Los Angeles CA 12/2014 – 10/2015
Billing Manager (12/2014 – 10/2015)
Supervise a staff of 11 FTE’s encompassing all aspect of medical billing
Supervised a staff of 10 FTE’s specialized in collections obtaining authorizations for surgical and office procedures & E/M’s
Process improvement: Implemented converting paper charge ticket to scanned charge tickets improving clean claims submission by 33%
Created job aids for the Billing Team & Tiger Team, increasing productivity by 20% & decreasing billing and collection errors by 15%
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U.S. HealthWorks, Valencia, CA 6/2009 – 12/2014
Partial Pay Surgical Appeals/Appeals Supervisor (6/2009 – 12/2014)
Complete oversight and management of all Surgical and Ancillary appeals.
Supervise /Train staff of 10 in surgical appeals.
Review EOB’s/EOR’s. Manage surgical appeals projects per CPT/Body Area, Carrier Denials.
Manage patient accounts for partial pay surgical appeals.
Report Carrier/Payer/Bill Review Reductions/Denials regarding Surgical Procedures’ to the Director of Coding & Reimbursement and Director of the RBO.
Carried out all duties of the Safety Commissioner including meetings, records management and facility inspections.
National Coding Compliance Auditor (1/2005 – 6/2009)
Coding Compliance Auditor for over 175 physicians performing E & M chart audits and physician coding education.
Review and Code various surgical charts. Project leader for Worker’s Comp L&I Audits.
Assisted in the Development of the Acupuncture Medically Manage Program. Assisted in Partially Paid Surgical Collections. Interface with clients and Physicians throughout the health Care system in over 5 different specialties including Orthopedic Surgeons.
David Hopp, MD, Los Angeles, CA 1/2004 – 1/2006
Ambulatory Surgical Center; Medical Office
Medical Billing; AR Administrator
Supervise a staff of 12 FTE’s encompassing front and back office operations.
Performed Medical Coding and hands-on oversight of all Billing and Collections for surgical procedures and office visits.
Managed A/P and A/R departments and performed financial analysis and reporting for Chief Financial Officer.
Responsible for the approval of all Medical Supply purchases.
UCLA Medical Surgery Center, Los Angeles, CA 2/1992 – 12/2003
Responsible for daily Coding, Billing, Collections and Data Entry operations, managing a team of 25 FTE’s.
Oversight employees responsible for EOB review, Billing, Collections and managed Appeals Process.
Multi-specialty experience includes; Plastics, Orthopedic, Oncology, Radiology, Pathology and Pediatrics.
Worked closely with Bernard Markowitz, MD for Plastic & Maxillofacial Surgical Authorizations.
Interfaced with Medicare, Medi-Cal, CCS, Managed Care and Commercial Payors.
Conduct in-house Employee Training, Reviews and Disciplinary actions.
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Santa Monica College, Santa Monica, CA
Associate of Arts Degree; Allied Health
Certified Emergency Medical Technician
Certified Therapeutic Massage Therapist
American Academy of Professional Coders
Certified Professional Coder
Deactivated 2017 – Due to leaving Corporate
Professional references available upon request.