Medical Billing Customer Service

NICOLE WOOMER, CCS

Gallitzin, PA 814-***-****

*************@***.***

MEDICAL BILLING AND CODING

QUALIFICATIONS SUMMARY

Medical Billing and Coding professional seeking an entry-level role in the healthcare field. Specializes in customer service with knowledge of ICD-10 CM, CPT, and PCS coding procedures. Experienced coding operative reports in a coding practicum internship. CCS certified.

EDUCATION

DeVry University, Chicago, IL

Medical Billing and Coding Certificate March 2019 Dean’s List Fall 2017 and Fall 2018

3.5 GPA

CORE COMPETENCIES

• HIPAA Guidelines • Customer Service • Legal Guidelines

• Administration • Medical Terminology • ICD-10 Coding • HIM • Ethical Guidelines • Healthcare Reimbursement

HEALTHCARE COURSEWORK

Medical Terminology

• Origins of medical words including prefixes and suffixes used in medical terminology

• Definitions and descriptions of each body system function

CPT, CM, and PCS Coding

• Guideline interpretation, abstract clinical data, assignment of appropriate medical codes

• Importance of documentation and AHIMA’s Standards of Ethical Coding

Human Anatomy and Physiology

• Functions and structures of the human body

• Anatomical terminology, the organization of the body and the relationship of chemistry to anatomy and physiology

MEDICAL CODING EXPERIENCE

DeVry University, Chicago, IL January- March 2019 Coding Practicum Internship

• Responsible for surgical coding of all inpatients, outpatient, diagnosis, and ambulatory surgical procedures

• Reviewed 15-23 operative reports within a constricted time period

• Demonstrated the ability to work independently and within a group

• Analyzed patients’ accounts to coordinate and execute patient concerns

PROFESSIONAL EXPERIENCE

Blair Gastroenterology Associates, Altoona, PA November 2020-Present

Full-Time Revenue Cycle Specialist

Process insurance claims on a daily basis. Process bills to patients monthly for services provided. Check all claims and invoices for accuracy

Assist patients with insurance problems and explain billing questions. Counsel patients regarding overdue or delinquent accounts

Working Insurance and Patient Aging including follow up with insurance companies to address problems with timely payment for claims and contacting patients to make satisfactory payment arrangements on outstanding balances.

Balance insurance and patient charges and/or payments on a daily basis in computer system.

Handle appeals to insurance companies on denials on a timely basis

Verification of patient insurance benefits

Assist with daily reconciliation of receipts and preparation of daily bank deposit with all monies collected

Stay current with respect to requirements of all insurance companies; keep practice appraised of these issues

Monitors the status of denials, appeals, and claim errors by using folders/work queues and conducting routine, periodic follow up on previously researched claims items. Monitors, reviews, and suggests revisions or updates to existing forms, documents, and processes required to facilitate timely billing and collections.

Ensures completeness of claims by following national, local, and internal billing requirements promoting prompt and accurate submission and payment. Maintains awareness of current regulations. Initiates practices that support current regulations.

Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT codes

Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations

Follow up with the provider on any documentation that is insufficient or unclear or search for information in cases where the coding is complex or unusual

Receive and review patient charts and documents for accuracy and ensure that all codes are current and active

Working with records of patients who are hospitalized (Inpatient and Outpatient)

oReviewing the patients documents

oSafely storing data

oAssigning codes to diagnoses

oFollowing all confidentiality protocols

oEpic

oBrightree

oCentricity

oWaystar

Billing and coding for injections

oRemicade

oEntyvio

oStelara

oAvsola

oInflectra

Laurel Medical Solutions, Ebensburg, PA October 2019- November 2020

Full-Time Billing Specialist

• Receiving and sorting incoming payments with attention to credibility

• Managing the status of accounts, balances, and identifying inconsistencies

• Issuing bills, receipts, and invoices

• Obtain written orders and other required documentation from physicians and other referral sources as needed

• Follow up with outstanding documentation as needed

The Chop Shop, Cresson, PA January 2017- September 2019 Full-time Manager

• Answer phones in a professional manner providing answers, transferring calls, and taking messages

• Set up meetings and appointments with customers and clients

• Enter client information into computer system for easy reference, use Microsoft word, access, and excel

• Managing salespeople, payroll, managing retail products, cleaning and upkeep of the salon, administrative duties

Contact this candidate