Medical Billing Customer Service

SUMMARY EXPERIENCE AND ACHIEVEMENTS

Veterans Administration Hospital (VA) Boston: Customer Service and Clinic Administration. Trained to move to Medical Billing and Coding by taking medical courses as listed under EDUCATION AND CERTIFICATION at AHIMA and AAPC. The courses included medical terminology, ICD-10 coding, knowledge of insurance payers, Patient registration, eligibility, authorization, insurance verification, management of revenue-cycle, for example, follow-up of rejections and denials, timely submission, appealing claim denials. After completing the education, I passed national Certification exams in Medical Billing (Certified Professional Biller, CPB) and Medical Coding (Certified Coding Specialist, CCS).

Metabolix Patent Paralegal and support of General Counsel, including independent management of 3rd party payers. Audited monthly charges and prepared appeals of questionable charges and recovered significant overcharges through effective written and oral communication skills.

Certifications: Certified Professional Biller (CPB), Certified Coding Specialist (CCS), Paralegal

PROFESSIONAL EXPERIENCE

KNF&T Agency and Robert Half International: Temporary administrative coverage 2019 - present

VA Boston Health Care System (VA) Medical Support Assistant 2014-2017

Provided customer service, scheduling medical referrals and follow-up appointments, registration, check-in, and recording clinic results in EMR; Resolving non-medical phone and patient portal inquiries (C.P.R.S.);

Provided administrative support to clinics, including entering and verifying patient demographics and insurance in the EMR;

Drafting and editing correspondence, filing, faxing copying, drafting and editing documents, and other general office work;

Trained Veterans and Staff to use patient portal, to schedule or change appointments, print medical records, etc. Veterans using the patient portal save high cost of mailing appointments and medical records;

Metabolix Legal Assistant/ Patent Paralegal - Partial duties listed below 2001-2012

Billing duties below performed independently, starting three years prior to hiring a patent counsel

Managed 3rd party payer accounts, including: Researched payer contracts, Implemented contracts and set up internet software;

Reviewed invoices monthly for charge errors and reconciled billed charges;

Prepared and submitted written monthly appeals with supporting documentation to resolve questionable charges.

Recovered significant reimbursements;

Developed searchable Excel database of company patents with capability for summary and evaluation of costs; entered and verified data, Wrote User Manual.

EDUCATION AND CERTIFICATION

American Academy of Professional Coders (AAPC)

National Certification: Certified Professional Biller (CPB) valid to March 2023

Professional Billing Certificate Program: Government and Private Insurance, including insurance verification, revenue cycle, follow-up of rejections and denials, appealing claim denials, timely submission, EOBs, RAs,

American Health Information Management Association (AHIIMA)

National Certification: Certified Coding Specialist (CCS) in ICD-10 valid to July 2023

Professional Coding Certificate Program: included Medical Terminology

Northeastern University

Paralegal Certification 2003

Mathematics Major, Computer Science minor – completed through junior year

COMPUTER PROFICIENCY Partial Listing

Microsoft Office: Word, Excel, Outlook, Powerpoint, Access, Sharepoint

Web-Based billing CPA and CPI billing

Electronic Medical Records: C.P.R.S., VISTA, 3M Coding and Reimbursement System (CRS),