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Service Representative Medical

Location:
Dallas, GA, 30157
Posted:
December 23, 2020

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Resume:

Amiee Coriano, RHIA, CMAA, CBCS

adiw1w@r.postjobfree.com

Cell: 229-***-****

I have over 15 years’ experience in the healthcare field including working in orthopedics, Physical therapy, Speech Therapy, Occupational Therapy, wound care and HBO. I have assisted hospitals and physicians with their RCM, RAC audits, claim appeals, and CDM.

WORK EXPERIENCE

Owner

AMC Medical Consulting, LLC- Acworth, GA- January 2017- Present

·Conduct meeting with clients to discuss any issues and progress on the account

·Create training materials

·Write Policies & Procedures

·Post Payments to accounts

·Process claims

·New Client Implementation including EDI set up

·Credentialing for clients

·Prepare Service Agreements for clients

·Assist with coding and billing inquiries from clients and staff members

·Update clients and staff with any revisions on coding rules, codes, billing guidelines

·Follow up with payers to ensure the reimbursement is in accordance with the client’s contract

·Invoice clients for payment per contract

·Run and work aging reports

·Send statements to patients

·Audit centers to verify authorizations are being documented correctly

·Train new employees

·Assist with EMR implementation.

·Support all client staff in verification, billing, charge and denial issues

·Management of unpaid claim listings including processing appeals.

·Maintain LCD, NCD, Policies on all services provided by the physician and/or facility for all payors by region or state

COO/Compliance Officer

Comprehensive Revenue Recovery, LLC - Bethpage, NY - May 2016 to January 2017

·Conducted meeting with clients to discuss any issues and progress on the account

·Hired/Trained new Employees

·Created training materials

·Wrote Policies & Procedures

·Posted Payments to accounts

·Process claims

·New Client Implementation including EDI set up

·Credentialing for clients

·Prepared Service Agreements for clients

·Assisted with coding and billing inquiries from clients and staff members

·Updated clients and staff with any revisions on coding rules, codes, billing guidelines

·Followed up with payers to ensure the reimbursement is in accordance with the client’s contract

·Invoiced clients for payment per contract

·Managed FTE and part time employees

Account Representative

Medical Management Solutions - Tarrytown, NY - August 2014 to December 2015

·Conduct meetings with the client to discuss issues and progress on the account

·Run and work aging reports

·Send statements to patients

·Collect payments from patients on outstanding balances

·Assist in training new employees

·Write training materials for the client and new employees

·Appeal denied claims with insurance carriers

·Send weekly logs to client with outstanding issues

·Address any email and phone correspondence from the client

·Send medical records to insurance carriers as requested

·ICD-10 Implementation training

Insurance verification Specialist

Candescent Healing LLC - Tarrytown, NY - June 2011 to January 2014

·Verified member’s benefits

·Obtained authorizations/predeterminations for HBO/Wound Care

·Advised facilities of patient’s benefits and approvals/denials

·Audited centers to verify authorizations are being documented correctly

·Trained new employees

·Assisted with EMR implementation.

·Supported all Center locations staff in verification, billing, charge and denial issues

·Management of unpaid claim listings including processing appeals.

·Maintained LCD, NCD, Policies on HBO & Wound Care services for all payors by region or state

·Wrote training materials for employees and clients

Provider Service Representative/Credentialing Coordinator

Orthonet - White Plains, NY - February 2007 to August 2010

·Verified member's insurance benefits, provider information, authorizations and claim status.

·Advised providers and members of authorization process. Informed health plans of appeal status,

·authorizations, and claim status.

·Verified Provider Contracts for Credentialing

·Advised provider's on contract status

·Assisted with credentialing audits as needed and directed by management.

·Prepared application packets for prospective providers as needed.

·Inputted provider's application for contracting.

·Served as administrative liaison under direction of the Credentialing Supervisor in preparing credentialing files for review.

·Assisted with mailings and projects as necessary.

·Developed an understanding of NCQA credentialing protocols and provided necessary information to customers contracted with Orthonet.

Registrar

Phoebe Putney Memorial Hospital - Albany, GA - March 2006 to July 2006

·Registered and verified insurance on all patients.

·Obtained eligibility for newborns for Medicaid.

·Received money on accounts for private rooms.

·Organized all required information for clinical services, billing, and account follow-up.

·Communicated information to the patient as required by JCAHO, HIPPA guidelines and CMS.

·Collected required insurance copayments, deductibles from patients when applicable.

Customer Service Representative

1st Franklin Financial – Albany, GA- June 1998 to October 2004

·Responsible for the input of all loan documents including data entry of all customer applications and dealer information.

·Accepted loan payments

·Collected current month accounts

·Maintained current month account fewer than fifteen percent.

·Collected 30-day accounts

·Acquired new loans

·Collected P&L accounts

·Pulled credit reports for all loan applications

EDUCATION

Certification in Health Information Administration

Georgia Regents University-2013 to 2014

BA in Health Service Administration

Monroe College - Bronx, NY- January 2010 to January 2011

A.A.S. in Medical Office System Management

The College of Westchester - White Plains, NY- 2007 to 2008

Certificate in Medical Transcription

Albany Technical College - Albany, GA-January 1995 to January 1996

SKILLS

Billing, Coding, Auditing, Credentialing, LCD, NCD, Managed Care, Wound Expert

LINKS

http://www.linkedin.com/pub/amiee-coriano/13/27a/a77/CERTIFICATIONS/LICENSES

RHIA

July 2015 to March 2018

GROUPS

AHIMA

June 2014 to Present

AAPC

May 2016 to Present

NAPW

July 2016 to Present



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