Felicia Bethune, CPC, CPMA

* *** ******

Haverhill, MA 01830

551-***-****

Summary

Hard working Medical Billing and Coding Specialist looking for an organization to grow with.

Employment

MEDICAL BILLER October 2020- Present

Pediatric Associates of Greater Salem

Responsible for follow up on delinquent claims, working a realistic number of claims per day. Majority of the claims followed up on were submitted to various carriers electronically. Charge out patient visits for 9 pediatricians, 4 nurse practitioners', and 5 mental health providers. Obtaining authorizations for the mental health providers. Provide education to providers regarding changes in coding requirements.

MEDICAL BILLER/CODER November 2014-Sept 2020

Sports Medicine North Orthopedics Peabody, MA

Responsible for follow up on delinquent claims, working a realistic number of claims per day. Majority of the claims followed up on were submitted to various carriers electronically and paper, however I handle worker’s compensation accounts. Knowledge of how to interpret a contract to determine appropriateness of reimbursement and appeal claim as necessary. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. Transitioned to surgical coder in 2016. Coding surgeries for 9 orthopedic physicians.

FOLLOW-UP REPRESENTATIVE January 2014- November 2014 Princeton Health Care System

Maximize reimbursement received for Princeton HealthCare System for services rendered, through accurate and timely billing and thorough follow up on all accounts. Maximize patient satisfaction by accurate, timely and respectful responses to all customers. -

MEDICAL BILLING/COLLECTIONS SPECIALIST January 2013- Nov 2013 Surgical Specialist at Princeton Princeton, NJ

Responsible for follow up on delinquent claims, working a realistic number of claims per day. Majority of the claims followed up on were submitted to various carriers electronically and paper. Knowledge of how to interpret a managed care contract to determine appropriateness of reimbursement and appeal claim as necessary. Extensive contact with insurance carriers of all types, as well as communication with patients regarding out-of-pocket amounts. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. MEDICAL BILLING & CODING INSTRUCTOR March 2012-Oct 2014 Mercer County College West Windsor, NJ

Responsible for presenting courses through lecture and hands on participation to students. The goal in teaching the students in current methods of diagnosis and treatment using the ICD-9 and CPT coding book. This position is per diem. MEDICAL BILLING & CODING INSTRUCTOR August 2010-Jan 2013 Harris School of Business Hamilton, NJ

Responsible for presenting courses through lecture and hands on participation to students. The goal in teaching the students medical terminology is to make sure they understand the words used in the medical profession to describe the human body in health and in illness, and in current methods of diagnosis and treatment using the ICD-9 and CPT coding book. In the second course the students simulate situations using computerized software by inputting patient information, scheduling appointments, and handling billing electronically. BILLING/OFFICE MANAGER November 2009- July 2010

Forensic Psychology & Neuropsychology Services, P.C. Hamilton, NJ Primary responsibility was billing and collections of insurance companies and attorneys' offices. Financial clearance of new patients. Ensuring that retainer agreements, authorizations and fee schedules are current and appropriate for each case. Tracking number of approved visits/session/units. Making sure we do not go over CAPs. Weekly A/R reports. Answering phones and taking messages. Oversees front desk. Taking daily deposits to bank. Review the practice expenses and suggest streamlining costs on monthly basis. Ordering supplies for office as well as clinical and marketing supplies. Responsible for maintenance of clinician credentialing. Training of staff in administrative aspects of practice. Administrative supervision of staff in consultation with the Director. Maintenance of policy and procedure manual as well as employee handbook.

MEDICAL BILLER/RECEPTIONIST January 2006-February 2009 Syed S. Ahmad, MD. PA. Lawrenceville, NJ

Billing insurance companies for office visits for 3 doctors, 13 nursing homes, 5 hospitals, and Gastroenterology procedures. Answer 6-line switchboard, use voice mail system, greeting patients, and taking appointments. Audit delinquent accounts ensuring all recovery efforts have been made before assigning bad debt. MEDICAL ASSISTANT/RECEPTIONIST March 2005- January 2006 Dr. Joan Mariyampillai Caldwell, NJ

Advise customers of account status, request payment on delinquent accounts, and updated customer information. Answer 2-line switchboard, used voice mail system, greeting patients, and set appointments. Audit delinquent accounts deemed uncollectable ensuring all recovery efforts have been made before assigning bad debts.

CUSTOMER SERVICE REPRESENTATIVE May 2003- September 2004 Horizon Blue Cross Blue Shield of N.J. Newark, N.J. Provided accurate responses to customer medical claim inquiries. Updated coordination of benefits files. Adjusted claims that required special attention which helped reduce callback volume.

CUSTOMER SERVICE REPRESENTATIVE March 2001- May 2003 Medco Health Solutions Parsippany, N.J.

Provided accurate responses to customer prescription/plan inquiries. Refilled prescription already existing in customer files. Maintained accurate files summaries. Compiled billing and claim issues for insurance carriers. Exceeded call volume by 50% resulting in promotion to special projects unit in the Lab. Contributed in the design of a new system, ESD.

Education

Certificate, CPMA 2016 AAPC

Certificate, CPC 2013 AAPC

H.S. Diploma, College Prep 1991-1995 Clifford J. Scott High School East Orange, N.J.