Medical Billing Collection Manager

CAREER OBJECTIVE

Quality-focused and multi-skilled professional with ample experience managing business operations, combined with proven experience increasing revenues, streamlining workflow and creating dynamic team environments to increase productivity seeking career advancement opportunities in the medical field with a winning medical organization.

§Proficiencies: MS Office; MS Excel; MS Word; MS PowerPoint; Typing Speed: 40 WPM

§Skills: problem solving skills, decision-making skills, attention to detail, data entry (experience using 10-key number pad), written and verbal communications (letters, emails, presentations, face-to-face communications)

QUALIFICATIONS

Centers for Medicare and Medicaid CMS 1500 CMS 1450 (UB-04) Tricare

Co-Payments Deductibles HIPAA Compliance Meaningful Use ICD-9/ICD-10

Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway

EOBs Payment Posting Revenue Cycle Management Scheduling

Insurance Verification Insurance Billing Procedures Insurance Claim Processing

Manage Care (HMO, PPO, and POS) Government Payers Third Party Payers Worker’s Compensation

Medical Billing Medical Coding ICD-9-CM HCPCS CPT Introduction to ICD-10 Medical Terminology

Practice Management Medical Office Procedures Anatomy & Physiology

Reimbursement Methodologies Fee Schedules Outpatient / Physician Inpatient / Facility

PROFESSIONAL EXPERIENCE

Self- Employed - Los Angeles, CA 03/2013 – Present

Worker's Compensation Consultant

§Advise clients of the lien issues in a case, and make recommendations for settlement.

§Secure payment for the clients over the phone, email and fax upon agreement from 3rd party.

§Collaborates with attorneys, medical personnel, and adjusters to gain information for billing claims management and serves as a resource to defense counsel in the Workers’ Compensation billing claims litigation process

§Coordinates and facilitates billing claim process by acting as a liaison between the insurance carrier/third party administrator, medical provider, broker, site management and the injured employee.

§Manages and oversees assigned 6-12 claims a week on an on-going basis to achieve established goals and objectives.

§Applying knowledge of Current Procedural Terminology, ICD-9 Codes, HCPCS coding as well as RI Workers Compensation Rules and Regulations, Fee schedule and treatment protocol.

Consolidated Medical Specialists - Alhambra, CA 02/2011 - 03/2013

Collection Manager

§Oversaw collections and monitored cash flow.

§Prepared medical exhibits for lien trials before the Workers' Compensation Appeals Board.

§Wrote legal briefs for lien trial and appeared for lien trials.

Bristol A/R - Pasadena, CA 10/2002 - 10/2010

Manager

§Accountable for 10+ collectors who assisted in recovering the maximum from the accounts receivables.

§Made Workers' Compensation Appeals Board appearances in order to litigate problem files.

Primemedix - Culver City, CA 06/1992 - 08/2002

Medical Billing

§Negotiated Workers' Compensation liens with insurance carriers and defense attorneys.

§Represented doctors at the Workers' Compensation Appeals Board.

§Set liens for trial if not able to settle with defendants.

§Tried cases before administrative law judges.

§Sent demand letters to insurance adjusters and resubmitted bills and liens for payment.

EDUCATION

Ultimate Medical Academy

Associate of Science in Medical Billing and Coding, 2017

Fully accredited, accelerated program providing instruction in medical billing and ICD-10, CPT and HCPCS coding for diseases, surgeries and medical procedures. Program content includes electronic health record (EHR) systems, accounting methods, and processes for preparing and submitting healthcare claims. Research, professional writing, critical thinking and communications skills are emphasized throughout the program.

UCLA Extension, Los Angeles, CA

Workers' Compensation Law, 1992

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