Medical administration
Resume:
Edison, NJ *****
adrye4@r.postjobfree.com
Sonia N. Webb
SKILLS
Bilingual (Spanish), Translation, Phlebotomy, Medical Records (paper charts and EMR Systems), Medical terminology, Medical Coding, Insurance Verification, Microsoft Office (Outlook/Word/Excel), Typing (35 WPM). EXPERIENCE
Carteret Comprehensive Medical Care, Edison, NJ— Cash/Payment Applicator Sept. 2018 - Feb. 2022
● Updated all deposit amounts into excel spreadsheet on a daily basis.
● I saved/updated deposit folders with all remittances related to the day's deposit and/or $0 remits received for the day.
● I completed payment posting electronically and manually for Medical Insurance, PIP/WC, patient payments, and legal related payments. The posting process also included a review of each claim within the remittances for any non-postable payments, non- postable adjustments, forwarding balances noted within the remit, and recoupments applied by the payer. Each claim was also verified for accurate reimbursement
(depending on the plan reimbursement, MNRP and/or FH/RC).
● Reviewed any denied claims and/or codes received within the mail/paper payments, electronic payments, and $0 remits and noted each code/claim.
● I maintained an excel sheet for all payments that had been mailed directly to the patient.
● I reconciled each deposit day once payment posting was completed. And at the end of every month/ the 1st of every new month I provided a monthly reconciliation which was part of the month’s end process.
● I provided support to management and collectors in the office by completing any adjustments and/or transfers.
● At the end of every day, I provided a detailed spreadsheet to management. This excel sheet provided the deposit total for that day, an exact total for all payments posted for the day, and the total of payments pending (to be posted). Bio-Reference Laboratory/GeneDx, Garfield, NJ— Genetic Testing Authorization Specialist Jan. 2016 - Sept. 2018
● Verified health Insurance benefits and eligibility for patients who had recently been ordered genetic testing by their physician.
● Contacted insurance companies and completed a thorough investigation on their policies for prior and retro authorization requests.
● According to the insurance company's policies, I would then initiate the retro authorization request for any genetic test that was ordered. I also followed-up on each request (by phone or fax) until a determination was made.
● All approvals and/or denials were then scanned in the patients account. Cliffside Medical LLC., Cliffside Park, NJ— Medical Biller and Coder Feb. 2014 - Dec. 2015
● I gathered all paper charts of any patient seen the day prior and prepared them billers/coders review.
● I reviewed and analyzed each encounter, along with any other documentation and applied diagnosis and procedure codes accordingly.
● I prepared and submitted clean claims to their corresponding insurances electronically and by paper/mail.
● Reviewed correspondence (either from insurances or a letter from a patient) and completed any request noted. These tasks varied from collecting a number of charts for an audit that was pending, to simply reprinting and mailing a new statement to a patient.
● Electronically and Manually Posted Payments received from Health Insurances and Patients.
● I reviewed denied codes or claims, investigated denials, and completed any needed corrections, such as, adding a missing modifier, re-submitting a claim and attaching any requested medical records, or by contacting the insurance company directly to discuss a denial that was incorrectly applied.
● Verify Health Insurance benefits for patients and/or providers.
● I provided assistance to patients either by phone or in person and resolved any issues or concerns they might have. Whether discussing a statement billed by our office they had recently received, explaining an explanation of benefit (EOB; THIS IS NOT A BILL) and/or helping patients understand their health insurance plan (this can be very confusing).
● An Insurance Aging Report and Patient Aging Report was processed/prepared by the manager and handed to us (each biller) to review and work, this was completed every month.
● I also reviewed patient accounts holding outstanding balances and after contacting the patient, a discussion on resolving the balance was completed. Depending on the outcome of that conversation, a payment would be taken over the phone, payment plan would be placed and agreement mailed to the patient by end of day, and/or the account would be then prepared for collections and reported to Experian, if statement limit was reached.
Bergen Family Practice of North Jersey, Ramsey, NJ — Medical Administrative Office Assistant Sept. 2005 - Feb. 2014
● Greeted and checked-in patients at time of arrival. Also collected copays paid in cash, check and/or credit, and posted payments in each corresponding account.
● Answered phone calls and assisted the caller according to their need.
● Completed Letters of Medical Necessity, along with Appeal Letters for our Physicians review.
● Updated, verified and assisted patients with completing forms. These forms varied from New Patient Registration forms, helping in translating
(Spanish) Insurance information sent to the patient (they just needed help understanding).
● I assisted our manager with preparing agendas, posting materials, and maintenance of the office.
● I contacted Health Insurances for benefit information (when needed), to obtain Authorizations and/or referrals for procedures/radiology/medications.
● I contacted pharmacies when the physician questioned, denied, or approved medications for patients.
● Assisted in drawing blood, whenever help was needed.
● Reconciled all monies taken throughout the day (copays). EDUCATION
Lincoln Technical Institute, Paramus, NJ— Medical Coding and Billing Aug. 2012 - Aug. 2013, Paramus, NJ
Graduated this certification program holding a 4.0 GPA. Health Care Training Institute, Union, NJ— Patient Assistant Technician July. 2009 - Oct.. 2009, Union, NJ
Certified Patient Assistant Technician
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