Medical Billing Data Entry
Resume:
MEGAN MARIE ROSALES
Vista, CA ***********@*****.*** 760-***-****
PROFILE
Over 12 years of experience in the medical billing industry. I am a skilled professional with an abundance of knowledge within the billing & collections field, obtained through study & work experience. Graduated in 2007 from Kaplan College with courses taken such as; Anatomy, Medical Terminology, Insurance Claim Processing, Insurance Coding of Inpatient & Outpatient. I have worked in every aspect of the medical billing field from billing & collections clerk to managing a billing team. I am a hard worker who has a great passion for medical billing & coding.
SKILLS & ABILITIES
Proficiency in medical billing, coding & collection within several specialties including; Obstetrics, Urology, Infectious Disease, Orthopedic Surgery, Otolaryngology, & Maxillofacial Surgery
Ability to assign CPT/ICD-10/HCPCS codes by abstracting data from the medical record
Knowledge of medical modifiers & how to utilize them for maximum reimbursement,
Experience with surgery scheduling
Exceptional ability to multitask & work under pressure
Experience with all insurance types including; HMO, PPO, POS, EPO, Medicare, Medicaid, DOD, & Work Comp
Skilled with business correspondence & professional communication
Expertise of handling insurance denials & appeals
Experience with QuickBooks, Microsoft Work & Excel, 10-key by touch, & proficient with data entry
EDUCATION
CPC, CERTIFIED PROFESSIONAL CODER, STATE OF CA – 2012
MEMBER OF AAPC – AMERICAN ACADEMY OF PROFESSIONAL CODERS
ESCONDIDO ADULT SCHOOL, ESCONDIDO, CA - 2011
CERTIFICATE - MEDICAL CODING & TERMINOLOGY
MARIC COLLEGE, VISTA, CA - 2007
DIPLOMA - MEDICAL ADMINISTRATIVE & INSURANCE SPECIALIST
FOOTHILLS HIGH SCHOOL, SAN MARCOS, CA - 2005
DIPLOMA
EXPERIENCE
MEDICAL BILLER III, MILLENNIUM HEALTH
JANUARY 2020 – CURRENT
MANAGE ALL COLLECTIONS ON AR FOR LIABILITY CLAIMS FOR THE COMPANY. DUTIES INCLUDE; RESEARCHING LIABILITY PAYERS TO UPDATE TELCOR WITH CURRENT ADDRESS & INFO, DAILY CLAIM REJECTIONS, DENIAL TRENDS, WORKING INSURANCE A/R, WORKING INSURANCE CLAIM DENIALS & APPEALS BUCKET, REVIEWING & SOLVING INSURANCE DENIAL TRENDS, ASSESSMENT OF CHARGES FOR CORRECT CPT OR CODE SET FOR THAT PAYER OR STATE, & PATIENT CALLS & CUSTOMER SERVICE.
ACCOMPLISHMENT – I STEPPED UP TO MANAGE MORE TASKS WHEN MY DEPARTMENT DOWNSIZED & I NOW MANAGE ALL COLLECTION ACTIVITIES FOR OUR NATIONWIDE COMPANY.
AR BILLING SPECIALIST, ALLSCRIPTS (FORMERLY CHMB)
AUGUST 2015 – JULY 2019
ACCOUNT MANAGER TO MULTIPLE PHYSICIAN CLIENTS. DUTIES INCLUDE; CLAIM SUBMISSION AND WORKING CLEARINGHOUSE DAILY CLAIM REJECTIONS, FOLLOW UP & MANAGEMENT OF PATIENT ACCOUNTS, DIRECT CONTACT WITH PHYSICIAN OFFICES, CODING REVIEW AND DENIAL TRENDS, WORKING INSURANCE A/R, WORKING INSURANCE CLAIM DENIALS & APPEALS, REVIEWING & SOLVING INSURANCE DENIAL TRENDS, ASSESSMENT OF CHARGES FOR CORRECT CPT, HCPCS, & ICD-9 CODING, MODIFIER APPLICATION FOR MAX REIMBURSEMENT, & CPT & ICD-9 CODING AS NEEDED.
ACCOMPLISHMENT – I WAS AN ASSET TO MULTIPLE AR TEAMS HELPING WORK AR AND CLEAN UP PROBLEM ACCOUNTS.
ACCOUNT MANAGER, PRACTICE DEVELOPMENT STRATEGIES
MAY 2014 – OCTOBER 2014
ACCOUNT MANAGER TO 6 PHYSICIAN CLIENTS, DUTIES INCLUDE; DAILY CLAIM FOLLOW UP & MANAGEMENT OF PATIENT ACCOUNTS, ASSISTING CLIENT OFFICES WITH QUESTIONS & INQUIRIES, WORKING INSURANCE A/R, WORKING INSURANCE CLAIM DENIALS & APPEALS, REVIEWING & SOLVING INSURANCE DENIAL TRENDS, ASSESSMENT OF CHARGES FOR CORRECT CPT, HCPCS, & ICD-9 CODING, MODIFIER APPLICATION FOR MAX REIMBURSEMENT, & CPT & ICD-9 CODING AS NEEDED.
ACCOMPLISHMENT - MASTERY OF MULTI-TASKING & WORKING WELL IN A HIGH VOLUME ENVIRONMENT.
BILLING SUPERVISOR, M8W SERVICES INC.
JANUARY 2013 – APRIL 2014
BILLING SUPERVISOR TO BILLING & COLLECTIONS DEPARTMENTS, PROCESSING OF ELECTRONIC BILLING FOR KAISER CLAIMS, MANAGEMENT OF INSURANCE A/R, ICD-9 & HCPCS CODING, VETERANS ADMINISTRATION POINT OF CONTACT FOR BILLING & COLLECTIONS, & WORKING INSURANCE CLAIM DENIALS & APPEALS.
ACCOMPLISHMENT - BRINGING A BACKLOGGED COLLECTION DEPARTMENT TO A CURRENT STATUS.
BILLING & COLLECTIONS REP/SCHEDULER, POWAY SURGERY CENTER
NOVEMBER 2009 – OCTOBER 2012
STARTED IN THE BILLING & COLLECTIONS DEPARTMENT; WORKING THE INSURANCE A/R, PATIENT COLLECTIONS, BILLING, PAYMENT POSTING, & WORKING DAILY DENIALS & APPEALING AS NECESSARY. I THEN SWITCHED DEPARTMENTS AND WORKED AS A SCHEDULER & CREDENTIALER. DURING MY EMPLOYMENT I OBTAINED MY CPC CREDENTIAL & BEGAN CODING ALONGSIDE THE ADMINISTRATOR, ASSIGNING CPT & ICD-9 CODES BY ABSTRACTING DATA FROM OPERATIVE REPORTS.
ACCOMPLISHMENT - CROSS TRAINED IN EVERY POSITION IN THE BUSINESS OFFICE, WHERE I BECAME AN OPTIMAL TOOL & ASSET TO THE COMPANY.
BILLING & COLLECTIONS SPECIALIST, SAN DIEGO ORAL FACIAL SURGERY
MAY 2008 – OCTOBER 2009
PERFORMED ALL BILLING & COLLECTION FUNCTIONS FOR AN ORAL & MAXILLOFACIAL SURGEON; FOR OFFICE, OUTPATIENT SURGERY, & HOSPITAL CLAIMS. WAS IN CHARGE OF VERIFICATION OF BENEFITS, OBTAINING AUTHORIZATIONS, PREPARATION OF DAILY REPORTS & DEPOSITS, PRESENTATION OF ALL FINANCIAL ESTIMATES, & WORKED INSURANCE & PATIENT COLLECTIONS.
ACCOMPLISHMENT - INCREASED MONTHLY REVENUE BY ORGANIZING & OPTIMIZING COLLECTION PROTOCOL.
REFERENCES
LETICIA PEREZ, OFFICE MANAGER
2027 DAVID DR
ESCONDIDO, CA 92026
********@***.***
KRIS CERONE, RHIT, INSTRUCTOR
996 SURFBIRD WAY
OCEANSIDE, CA 92057
**********@***.***
ILENE AMADOR, FRONT OFFICE LEAD
753 AVENIDA AMIGO
SAN MARCOS, CA 92069
***********@*****.***
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