Medical Biller Coder
Resume:
TETYANA KISELOVA
Brooklyn, NY 11204-1001
E-mail: ****************@*****.***
CAREER OBJECTIVE
EDUCATION
CERTIFICATIONS
2020
2017
SKILLS
EHR Software
Computer’s
Professional
Special
EXPERIENCE
December 2018-present
May 2017-December 2018
January 2017- – April 2017
December 2015-December 2016
March 2003 – November 2015
1985-2002
To obtain a remote medical CODER/ BILLER position in health care institution.
Bramson ORT College, New York, NY
M.S. in Mathematics
Chernovitsky National University, Ukraine
Medical Coder Certificate from AAPC
Medical Biller Certificate from AAPC
TCM, Health Fusion, Practice Fusion, Eclipse, CureMD, DrChrono, AdvancedMD, Kareo, Meditech, Epic, WebPT, portals-NaviNet, Availity, UHC, Fidelis, Connex MC, Cigna, EmblemHealth
Proficient with Microsoft: Word&Excel&Access&PowerPoint&Outlook, Google applications, Quick Books, OCR, SQL, WordPress, Social communication program, Troubleshooting, Photoshop, other
Medical insurances federal and commercials, practice management, medical terminology and anatomy, NCCI, NCD/LCD, medical coding& billing guidelines, CPT, ICD, HCPCS, documentation requirements, medications and reimbursement guidelines, encoder
Troubleshooting, communications, teaching, customer service, critical thinking, analyze and abstract data, problem-solving skills, time management and organizational skills.
NY Arthritis Clinic PC, Brooklyn, NY
Medical Biller/ Coder (Family /Internal medicine, Rheumatology, Pain management, Rehabilitation medicine, Infusion & injection treatment, MRI & US diagnostic)
•Review and validate patients’ insurance and demographic information to ensure accurate billing
•Obtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.
• Review medical documentation from physicians and other healthcare providers and defining its correspondence to official guidelines and standards. Ask additional information if needed.
•Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.
• Analyze and interpret medical information, medical diagnoses, coding/classification systems, to ensure accuracy for reimbursement a specific payer policy and guidelines.
•Review and audit medical record documentation accurately to reflect healthcare coding and to substantiate appropriate service reimbursement. Conveying coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation.
•Prepare, review, and submit professional claims to insurance companies electronically or via paper CMS-1500 form.
•Prepare and submit claims to secondary payers
•Place outbound calls to insurance companies, patients, doctors’ offices and/or facilities as needed.
•Answer billing and insurance questions from patients and staff.
•Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondence.
•Research unpaid claims through internal and external contacts
• Notate billing system each time the account is worked by placing a detailed comment on each account.
•Posting / collections
•Send statements to patient on a regular basis
•Resolve outstanding accounts utilizing applications and websites as tools to retrieve claims status, medical documentation, and billing guidelines to substantiate corrected claim submissions, written appeals.
•Accounts receivable management; Responsible for aging of accounts (Insurance)
•Utilizes Microsoft Excel and Practice Management software to sort, filter, summarize and identify various accounts, insurance’s payments
•Compare and review superbills by system generated, to clinical documentation to ensure that all charges for procedures and services rendered have been accurately documented and captured.
•Create, analyze business support advanced reports by services: E&M service, pain management, infusions/ injections, CCM, PT, skin procedures, Ultrasound/MRI, lab, microsurgery.
•Administration and Troubleshooting support for office devices, EHR system and office software.
Rio Consulting Service billing company, Brooklyn, NY
Medical Biller/ collector/ credentialing (Family /Internal medicine, Pain management, Rehabilitation medicine, injections, MRI & US diagnostic, Cardiovascular, Allergy, Sleep medicine, Orthopedic, Chiropractic, hospital inpatient E&M)
•Review and validate patients’ insurance and demographic information to ensure accurate billing
•Obtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.
•Prepare, review, and submit insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form
•Prepare and submit claims to secondary payers
•Place outbound calls to insurance companies, doctors’ offices and/or facilities as needed.
•Answer billing and insurance questions from office staff.
•Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondence.
•Research unpaid claims through internal and external contacts
• Notate billing system each time the account is worked by placing a detailed comment on each account.
•Posting / collections
•Review and work with the insurances EOB's or RA reports
•Contact with insurance companies on unpaid or denied claims. Resolve issue and resubmit claims.
•Create insurance or patient aging reports using the medical practice billing
•Collections insurance's payments for billing reports for provider's offices
•Credentialing and enrollment for new insurances
•Clearing house relations: enrollment for new insurances, electronic submission claims and posting ERA, setting accounts, correction claims, analyze reports.
9th Street Vision Center, Brooklyn, NY.
Medical biller/ collector (Ophthalmology billing)
•Review and validate patients’ insurance and demographic information to ensure accurate billing
•Obtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.
• Review medical documentation from physicians and technicians and defining its correspondence to official guidelines and standards. Ask additional information if needed.
•Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.
•Prepare, review, and transmit claims using billing software to government and commercial insurances
•Place outbound calls to insurance companies, patients, doctors’ offices and/or facilities as needed.
•Answer billing and insurance questions from patients and staff.
•Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondence
•Collection all payments
•Posting payments
•Identify and bill secondary or tertiary insurances
•Review and management patient's accounts for balance due and working with aging reports
•Research and appeal denied claims
•Set up patient payment plans and work collection accounts
•Update billing software with rate changes
•Prepares patient statements for charges not covered by insurance and mailed statements to patients on a regular basis.
•Updates cash spreadsheet, runs collection reports
Ashley Billing Services Inc., Brooklyn, NY
Medical Biller/collector
•Review and validate patients’ insurance and demographic information to ensure accurate billing
•Obtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed
•Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-9) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.
•Prepare, review, and transmit claims using billing software to government and commercial insurances
•Collections and analyzing remittance reports
•Accounts receivable analyst
Max Medical PLLC, Brooklyn, New York.
Receptionist, Administrative Assistant, Medical biller (Pain management/Musculoskeletal/ Rehabilitation/Neurology and Neuromuscular/Orthopedic center)
•Performed daily medical secretary duties
•Review and validate patients’ insurance and demographic information to ensure accurate billing
•Obtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.
•Performed technical support for medical office software and database
•Managed office ads
•Performed administrative support for office website
•Managed office medical records and business forms documentations
•Provided technical support front desk software and workstations
•Prepared medical templates for office medical programs
•Daily duties as administrative assistant to general office manager
•Managed electronic medical records
•Performed a medical balance test and created additional program for it (medical necessary);
•Performed a programming support for EMR program
•Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-9) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and prepared electronical superbills
Chernovitsky Institute of Information Technology, Medical College, Ukraine
Programmer-Engineer, Teacher of Mathematics and Information Technology
•Taught undergraduate Mathematics courses and Information
Technology courses to students with various college majors
•Provided technical and software support for the learning
process
•Created educational computer programs for medical
institutions
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