MICHELLE

MCLEMORE

*** ******* **** #*** ******* Beach, FL 32114 386-***-****

adnb8j@r.postjobfree.com

** ***** ********** **** *****-physician, specialty medical practices. Very familiar with all aspects of medical billing, coding, claims, etc. Skills include:

— Medical billing and coding

— Answer patient financial inquiries

—Word, Excel, MS Office, Misys

— Close of day, month, year

— Able to understand and

effectively communicate insurance

benefits to patients

— Patient Collections

— Cpt-4 ICD-10 HCPCS

— Clean Claim Filing

— Work A/R consistently

— Patient Refunds

— Insurance Refunds

— Insurance Appeals

— Surgery & E/M coding

— Surgery charge posting

— Obtain Benefits / Prior Auth

— Collect surgical/office

procedure pre-payments

— Impeccable Customer

service skills

Professional Experience

DP Mechanical Services — Indianapolis, IN

Office Manager/Service Coordinator, March 2011-Dec 2013 Responsible for overseeing all day to day functions of the office, in order to ensure all runs smoothly.

● Accounts Receivable / Accounts Payable

● Payroll

● Manage all service technicians

● Coordinate & maintain schedule for commercial / residential jobs

● Estimates & proposals for commercial / residential jobs

● Address and resolve customer inquiries

Goodman Campbell Brain & Spine — Indianapolis, IN

Pre-cert / Benefits Specialist, March 2007- May 2010 Served as a key member of a healthcare team for a busy neurosurgical medical practice. Assisted 12 MDs in obtaining benefits and authorizations for surgical and office procedures. Ensuring optimal patient care and a seamless patient experience from office visit to surgery.

● Obtained patient insurance benefits prior to Surgical and Office Procedures. Explained benefits to patient’s, making sure they fully understand before any procedure is performed. Also, allowing us to collect pre-payments from patients to satisfy deductibles, co-ins, etc.

● Obtained all Prior Authorization’s for surgical and office procedures for 12 physicians

● Performed pre-surgery appeals for any denied CPT’s

● Obtained Pre-determination of benefits for any possible non-covered procedures Urogynecology Associates — Indianapolis, IN

Medical Business Office, May 2004 - February 2007

Business Office employee. Showed extreme aptitude for juggling all aspects, and coordinating time correctly, to handle large volume and variety of medical billing, coding, etc.

● Performed all duties associated with medical business office

● Posted all surgical and office procedure charges, as well as, insurance payments

● Review EOB’s, RA’s, Payment Vouchers to make sure insurance company paid claims correctly, based on CPT, DX, modifier, and contracted fee schedule

● Filed all insurance claims, utilizing practice mgmt system claim reports, to make sure clean claim has been filed the 1st time around, thereby effectively reducing “days in a/r”

● ßProcessed patient and insurance refunds

● Responsible for taking all patient financial calls

● Collect surgery/office procedure pre-payments as needed

● Obtain all insurance benefits and authorizations prior to scheduled procedures

● Maintain A/R, by working it consistently and contacting the ins companies regularly

● Run all Finanacial Reports, and review with practice manager & physician Northside E.N.T., INC — Indianapolis, IN

Medical Business / Billing office, May 1995 - May 2004 Served as a key member of a medical business office team, for a busy otolaryngology medical practice. In charge of maintaining financial records, and performing day to day business office duties for for 5 Specialist Physicians and 4 Audiologist.

● Responsible for filing electronic and paper HCFA 1500 to ins co for reimbursement, along w/making sure ins co receives any additional info needed to process claims.

● Insurance Refunds / Patient Refunds

● Rejected Insurance Claims Appeals

● Posting of Insurance Payments to practice management computer system

● Balance of daily, monthly, yearly charges and receipts

● Review accounts for collection, write-off, appeals, etc with physician

● Surgical and office procedure coding

● Surgical and office procedure charge posting to practice management system

● Answer all patient financial inquiries

● Monthly Patient billing and collections

Education

Bethesda Christian High School Brownsburg, IN 46112 – Graduated 1994

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