CRYSTAL GOLDEN

*** **** **** ***,● Longwood F.L,*2750 ● 407-***-**** ● adqs8f@r.postjobfree.com

Summary of Experience

● Advanced computer skills in MS Office Suite,and various medical applications/system Medi tech program Cerner and Eclinicals.

● Nine (11)year experience in the medical field in admissions,scheduling,insurance verification and medical records department.

Key Skills

• Office Management

• Teambuilding &Supervision

• Staff Development &Training

• Policies &Procedures Manuals

• Retail

• Customer service

• IT support

● Transmitting electronic billing

● Maintaining collection agency informatio

● Utilizing the latest unique billing

procedures of each funder as updated by

OD

● Demonstrates an awareness and sensitivit

to the service population’s cultural and

socioeconomic characteristics

● Customer Service experience a

credit/Collection experience

• Report &Document Preparation

• Spreadsheet &Database Creation

• Accounts Payable/Receivable

• Bookkeeping &Payroll

• Verification of insurance coverage and obtaining authorization for treatment

• Records Management

• Meeting &Event Planning

• Inventory Management

• Scheduling of outpatient testing and procedures

• Medi tech program

• Cerner and Eclinicals

• Electronic Health Records (HER)Software

Adapt Behavioral Services 2013 to present

Revenue Specialist

● Ensuring that denied valid claims get paid and providing review and intervention billing cycles such that the rate of denials is reduced

● Contacting and routinely following up in a timely manner with funders to reconci claims which had previously been denied.

● Providing feedback/retraining to Billing/Compliance Specialists regarding billin errors/procedures in a constructive and timely manner.

● Verifying accuracy of monthly Medicaid/HK eligibility batch checks in a timely manner

● Verifying benefits and authorizations process for unique funder circumstances.

● Verifying legitimacy,generating and mailing out client bills monthly

● Updating billing software system to reflect funder changes and resolved denials Billing/Compliance Specialist 2013

● Ensuring that client records are compliant with regulatory standards and Adapt policies,that authorizations for services are obtained,that services are billed corre and that clinicians are following Adapt policies.

● Indirect supervision of assigned Primary Clinicians and Licensed Evaluators

● Updating client database to reflect documentation due dates and new client information

● Providing feedback/retraining to assigned clinicians regarding documentation an Adapt policies in a constructive and timely manner

● Checking client records for completeness,correctness,and compliance with Adap policies

● Entering client information and billing for services that meet compliance standard into billing software prior to weekly designated deadline Head of Health Information Systems,Deland,F.L.

Front Office Secretary

2011 to 2012

Elder Healthcare

• Prepare release of medical records and ensure HIPPA guidelines are followed throughout documentation requests process upon requesting and forwarding of records.

• Perform support services for the physicians to include data entry and review of lab values and providing notification of critical values.

• Prepare orders for radiology and lab tests upon request and obtain referrals utilizing data link when required.

• Other clerical duties entail notification to nurses for medication refill requests,gather co-pays,schedule appointments.

• Phone messages for Doctors.

• Check patients in and out at appointment time.

• Management of medical records and converted office to paperless utilizing E-Clinicals program.

• Trained employees on various software programs to include electronic filing procedures and assist the IT support in trouble shooting when problems occur.

• Interact with patients and doctors on Daily Basis. Office Manager,Deland,F.L.

Office Manager/Secretary/Office Clerk

2009 to 2011

JG Ceiling

• Responsible for coordinating all office functions to include bookkeeping

• Billing/collections and payroll,preparation of accounting reports of expenditures and preparation of profit and loss statements to be forwarded the accountant.

• telephone calls

• Ordering supplies and standardizing procedures for a small construction office.

• Interact Daily with suppliers and customers

Health Information Services,Medical Record Technician II 2001 to 2009

Florida Hospital Deland

• Process daily admissions and emergency room records,post transcribed reports,retrieve medical records for continuation of patient care and chart reviews,

• Copy medical records,retrieved records for SDS,answer telephone calls responding to requests,perform permanent filing as well as miscellaneous filing of loose reports and other assigned clerical duties to include,but not limited to,assembling of inpatient charts

• Surgery schedules,performed the document preparation,scanning quality control,and validation of emergency room,ambulatory surgery,observation,inpatient medical records

• Responsible for covering the front office

• Processes the requests received via phone/fax for medical records utilizing release of information guidelines

• Medical programs meditech and cerner

• Made sure physicians signed charts on time.

Key accomplishments:Helped medical records to go paperless with the Cerner program. Scheduling

• Scheduling of outpatient testing and procedures

• Verification of insurance coverage

• Obtaining authorization for scheduled treatments. Patient Registration

• Register emergency room and outpatient procedures,

• Compiling of chart information and creating file folder

• Verification of insurance coverage and obtaining authorization for treatment,verification of correct ICD 9 codes

• collecting co pays and other cashier duties

• Break down the charts for medical records.

Results.Earned a reputation for maintaining a positive attitude and producing high-quality work and great customer service.

Education

Daytona State College (concentration in Nursing)

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