Data Entry Medical Billing
Resume:
Melissa Garcia
Special attention to detail, Productive and very reliable
Colorado Springs, CO 80923
*********@*****.***
Work Experience
Medical Claims & Billing Specialist
Arthritis Associates of Colorado Springs - Colorado Springs, CO February 2021 to Present
• Responsible for all primary clams Bills all ins carriers per contractual and cms regulations daily for the only 5 rheumatologists in Colorado Springs.
• Researches and processes insurance denials, unpaid claims or underpaid claims reviewing documentation and insurance/contract/coding guidelines. This process includes written appeals when appropriate and/or contacting the insurance.
• Understands insurance plan coverage's, authorizations, benefits and benefit limitations, demonstrates ability to calculate allowable and patient liabilities
• Understands basic remit and remark codes and demonstrates knowledge of resolving simple claim denials
• Research, trend and resolve claim denials.
• Responsible for assisting with billing secondary claims and EOBs that need follow Owner/Administrator
Always There Home Care
April 2014 to June 2020
Proudly created, owned & operated a well-known Class B license home care company while following local, state & federal guidelines. Company was successful, with more the 40 employees and 75 plus clients throughout Colorado Springs, Monument, Fountain, Falcon, Woodland Park & Cascade. Obtained licensure with CDPHE & CMS. Entirely responsible for all functions of company to include creating and maintaining company policies, recruiting, payroll, accounts payable and receivables, marketing, managing client care and all employees, scheduling, filed necessary operational documents for various state and federally as required. Operations reached profits of 450,000 annually. The company has 5 star ratings through many websites.
Admissions Coordinator/Scheduler
Visiting Nurse Association
December 2010 to March 2014
with Insurance Verification: Responsible for all incoming patient referrals for a fast-growing home health agency that provides service throughout Colorado Springs, Woodland Park, Monument, Pueblo, Callahan. Verify patient insurance, data entry of intake information
& coding (McKesson Software), coordination of services with various disciplines & strategizing staff according to skills & zip codes. Develop quality relations with various referral sources including hospitals, MD offices, nursing homes, SNF's etc., and to include various office/field staff. Maintain company's services growth logs & documentation. Responsible for all the in-coming agency faxes
& ensuring proper placement & protocols, to include notifying staff of various labs, orders etc., Responsible for all HHA/PCP/Homemaker scheduling to include client satisfaction. This position also requires strong staff support & troubleshooting. Provided scheduling for entire company to include CNA's, RN's, therapists. Maintained the email hub for entire office staff throughout each day to ensure appropriate delivery.
Administrative Assistant/Medical Records & Insurance verification Complete Home Health Care - Colorado Springs, CO
January 2008 to December 2010
Complete Home Health Care since January 2008- December 2010 Medical Records: Responsible for the management of all medical records. On going development and implementation of new up to date ideas to continually improve medical records department of 150+ active clients. Competent in knowledge of HIPPA regulations to include preparation/distribution of private information for other health care entities, clients, lawyers, etc. Responsible for creating new charts and breaking down of old charts, purging charts & filing information into patients chart with accuracy. Conduct quality assurance & regular chart audits. Prepare & scan charts for of site storage system. Medical Administration: Data entry in (WEB CARE software) to create 485 plan of care for all new intakes. Knowledge of medical terminology to interpret RN/Physician reports/orders. Input OASIS information that is mandated by state healthcare plans to include Medicaid/Medicare. I acquired knowledge of various home health guidelines. Assist medical staff as needed. Answer phones and assisted clients in a professional manner as needed. I Processed payroll including auditing timesheets to correspond with physician's orders for plans of care & track the branch visits weekly. Assist office manager by maintaining physicians' signature is to date as mandated on all orders. Order and maintain medical & office supplies for the medical/office staff through on line vendors. I was responsible for documentation / distribution of daily stand up meetings for the clinical staff. Obtain
& verified insurance authorizations with various insurance companies to include tracking of allotted visits. Track orders from/to physician's office with follow up as needed. Complete/obtain PARS for state mandated programs. I was the Certified Company Instructor for BLS/CPR through American Heart Association. Recently prepared records & assisted Branch manager with audit for state Medicaid audit
& OIG audit.
Certified Nurse Aide (CNA)
Nursing & Therapies of Colorado, Inc - Colorado Springs, CO June 2006 to January 2008
Pediatric home care CNA. Followed state and federal guidelines while providing superb care for special needs children. I Developed a schedule and ensures consistency for the children I worked with. I also implemented anything that the team of nurses and multiple therapist to ensure the success for each child. I maintained first aid and Cpr along with CNA license. Paraprofessional
School District 11 - Colorado Springs, CO
C.N.A & Paraprofessional
Colorado, Inc
August 2002 to July 2007
Worked as a pediatric C.N.A in home healthcare setting. Paraprofessional I worked with special needs children for school district 11's educational system implementing NCLB laws through CEU training. Ability to work with multiple therapists, Nurse, teachers, etc. following state & federal health care regulations and assisting of "Plan of Care management" to help individual's reach obtainable goals. Licenses & special training: Certified by state of Colorado Administrator, Certified by state of Colorado Paraprofessional program.
Reference & letters of recommendation available by request 5
Assistant Manager
Gran Inc - Colorado Springs, CO
May 1996 to May 1998
Assistant Manager: Management for a large apartment complex. Leased apartments, provided background and credit checks to ensure good tenants. Billing & collection of the monthly fees, ensuring that maintenance, housekeeping, grounds personal complete and maintain the complex in timely manner. manage all rent payments. Responsible for preparing legal documents for local attorneys on RIT, collections and other necessities. I lived on site and provided I call for emergencies and lockouts. I assured in major renovation project and sale of company. I was also one of two employees that were kept by the new company after sale of the complex. General: Efficient and organized. Experience Quickbooks, Zero, A/R, A/P, payroll, database management. Knowledge of various office equipment to include Xerox, 10 key, postal meter, and cash registers, etc. Computer knowledge includes Microsoft Windows, Works, Excel, Outlook, Boss, McKesson, CAREMEDX WEBCARE, Rent Roll 2000 and other custom programs. Skills
• Home Health
• Rehab
• Special Needs
• Medical Office Experience
• McKesson
• Property Leasing
• Medical Terminology
• Auditing
• 10 Key Data Entry
• Medical Records
• Senior Care
• Office Management
• Quality Assurance
• Time Management
• Customer Service
• Typing
• QuickBooks
• Internal Audits
• HIPAA
• Accounts Receivable
• Insurance Verification
• Medical Scheduling
• Medical Billing
• Clerical Experience
• Microsoft Windows
• ICD-10
• ICD-9
• Management
• Vital Signs
• Medical Coding
• Accounting
• Anatomy Knowledge
• Microsoft Excel
• Microsoft Word
• Accounts Payable
• Microsoft Outlook
• Recruiting Accounting Skills: Bookkeeping -- Familiar May 2020 Calculating and determining the accuracy of financial data. Full results: https://share.indeedassessments.com/attempts/ dbd8034083cdd80b12792bbc7bcacae1eed53dc074545cb7 General Manager (Hospitality) -- Highly Proficient May 2020 Solving group scheduling problems and reading and interpreting P&L statements. Full results: https://share.indeedassessments.com/ share
• to
• profile/0815d17bab712bbc735d3d9658e6609beed53dc074545cb7 Work Style: Reliability
-- Proficient April 2020 Tendency to be dependable and come to work. Full results: https:// share.indeedassessments.com/attempts/ f2a75edec3b835cc10f12df99461e83ceed53dc074545cb7 Active Listening -- Proficient May 2020 Actively listening and appropriately responding in conversations. Full results: https://share.indeedassessments.com/ share
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• profile/261d194f9246087e28cb16d891c67a77eed53dc074545cb7 Attention to Detail -- Proficient March 2020 Identifying differences in materials, following instructions, and detecting details among distracting information. Full results: https://share.indeedassessments.com/attempts/ eb9d80b43c7fa120edfdd7cdd0573dd3eed53dc074545cb7 Receptionist -- Expert May 2020 Using basic scheduling, attention to detail, and organizational skills in an office setting. Full results: https:// share.indeedassessments.com/ attempts/1149ebd1fcd2cc14a0f61f445f1792e7eed53dc074545cb7 Administrative Support -- Familiar May 2020 Using basic scheduling and organizational skills in an office setting. Full results: https://share.indeedassessments.com/ attempts/674cb43dd614451e95d785ef13602247eed53dc074545cb7 General Manager (Hospitality)
-- Highly Proficient May 2020 Solving group scheduling problems and reading and interpreting P&L statements. Full results: https://share.indeedassessments.com/share
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• profile/ f390b5a48a24a2683381e0d1e6d6f4ffeed53dc074545cb7 Customer Focus & Orientation -- Highly Proficient May 2020 Responding to customer situations with sensitivity. Full results: https:// share.indeedassessments.com/ share
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• profile/828b1dd1334ac88d853eddabd6b28842eed53dc074545cb7 Attention to Detail -- Proficient March 2020 Identifying differences in materials, following instructions, and detecting details among distracting information. Full results: https://share.indeedassessments.com/ attempts/ eb9d80b43c7fa120edfdd7cdd0573dd3eed53dc074545cb7 Front Desk Agent
(Hotel) -- Highly Proficient May 2020 Selecting hotel rooms based on verbal requests and identifying errors in hotel data. Full results: https://share.indeedassessments.com/ attempts/65440807ee7f0fd70e0b078d1abb6552eed53dc074545cb7 Administrative Support Professional Fit -- Proficient May 2020 Measures the traits that are important for successful administrative support professionals. Full results: https://share.indeedassessments.com/attempts/ d20ae94aded6470d38e731b793335abeeed53dc074545cb7 Verbal Communication -- Proficient April 2020 Speaking clearly, correctly, and concisely. Full results: https://share.indeedassessments.com/ attempts/0736a0d101e9d47bd8e8cbcbcc913fbeeed53dc074545cb7 Customer Service -- Completed May 2020 Identifying and resolving common customer issues. Full results: https:// share.indeedassessments.com/share
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• profile/ b09bc6ff94c51b618a940b6e2c460c0feed53dc074545cb7 Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
• Sales
• Administrative experience
• Front desk
• Cash handling
• Public Relations
• CPT Coding
• EMR Systems
• Physiology Knowledge
• Emdeon
• Epic
• Software Troubleshooting
• Microsoft Powerpoint
Certifications and Licenses
AED Certification
CPR Certification
BLS Certification
Assessments
Medical Receptionist Skills — Highly Proficient
May 2020
Managing physician schedules and maintaining accurate patient records Full results: Highly Proficient
Customer Focus & Orientation — Highly Proficient
March 2020
Responding to customer situations with sensitivity Full results: Highly Proficient
Attention to Detail — Proficient
March 2020
Identifying differences in materials, following instructions, and detecting details among distracting information.
Full results: Proficient
Dental Receptionist Skills — Proficient
April 2020
Managing practitioner schedules and maintaining accurate patient records Full results: Proficient
Work Style: Reliability — Proficient
April 2020
Tendency to be dependable and come to work
Full results: Proficient
Written Communication — Proficient
April 2020
Best practices for writing, including grammar, style, clarity, and brevity. Full results: Proficient
Following directions — Proficient
January 2021
Following multi-step instructions
Full results: Proficient
Administrative support professional fit — Proficient May 2020
Measures the traits that are important for successful administrative support professionals. Full results: Proficient
Work motivation — Highly Proficient
June 2020
Level of motivation and discipline applied toward work Full results: Highly Proficient
Front desk agent (hotel) — Highly Proficient
May 2020
Selecting hotel rooms based on verbal requests and identifying errors in hotel data Full results: Highly Proficient
Administrator — Proficient
April 2020
Personality and problem-solving skills.
Full results: Proficient
Receptionist — Expert
May 2020
Using basic scheduling, attention to detail, and organizational skills in an office setting. Full results: Expert
Management & leadership skills: Planning & execution — Highly Proficient April 2020
Planning and managing resources to accomplish organizational goals. Full results: Highly Proficient
General manager (hospitality) — Highly Proficient
May 2020
Solving group scheduling problems and reading and interpreting P&L statements Full results: Highly Proficient
Protecting patient privacy — Highly Proficient
March 2022
Understanding privacy rules and regulations associated with patient records Full results: Highly Proficient
Principles of accounting — Completed
April 2020
Preparing financial records according to federal policies Full results: Completed
Verbal communication — Proficient
April 2020
Speaking clearly, correctly, and concisely
Full results: Proficient
Customer service — Completed
May 2020
Identifying and resolving common customer issues
Full results: Completed
Working with MS Word documents — Expert
March 2020
Knowledge of various Microsoft Word features, functions, and techniques. Full results: Expert
Scheduling — Highly Proficient
April 2020
Cross-referencing agendas and itineraries to avoid scheduling conflicts. Full results: Highly Proficient
Medical billing — Proficient
April 2022
Understanding the procedures and forms used for medical billing Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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