Medical Billing Dow Chemical
Resume:
LaMonica Coleman
**** ******** ******* ***. ***-*06
Houston, Tx 77077
Email: ******************@*****.***
Contact: 713-***-****
WORK EXPERIENCE
Code Enforcement Trainee
City of Houston-Department of Neighborhoods
January 2022-Present
Respond to neighborhood complaints filed to 311 related to overgrown lots, dangerous vacant buildings, illegal dumping, trash accumulation, junk motor vehicles and other materials or appliances stored in public view.
Enforce the city codes Chapter 10 - Buildings and Neighborhood Protection, and Chapter 39 - Solid Waste and Litter Control.
Conduct on-site residential and commercial property inspections to check for code compliance and violations.
Prepare and serve correction notices and serve violation citations.
Handle phone inquiries and enter data into InFor and TeamWherx powered by Actsoft software
Respond to routine inquiries from the general public, civic groups, contractors, technical professionals, and businesses.
Assist in maintaining files of records, reports and record documentation of inspections and enforcement activities.
Submit daily report to the Supervisor, Assistant Chief, Chief, and Division Manager via Microsoft applications (Outlook, Excel, Word)
Field Supervisor
Pandemic Containment Coordinator Assistant
(City of Houston Contract Employee)
April 2019-December 2021
Manage 16-18 temperature screeners at 25-30 City of Houston facilities.
Retrieve supplies from the Human Resources department at 611 Walker to deliver to assigned City of Houston sites
Travel to assigned City of Houston sites daily to deliver personal protective equipment (PPE) such as masks, gloves, hand sanitizer, wristbands, and thermometers to temperature screeners
Assist City of Houston Building Managers and Directors with the development of the site assignments and temperature screener work schedules to ensure adequate coverage to City of Houston entrances
Maintain and inspect temperature kiosk equipment
Follow up on work order requests submitting by building managers
Assist management with weekly Kronos payroll and DocuSign timesheets process
Receive and review time off submissions from temperature screeners
Mentor and train new hires and existing temperature screeners
Email daily excel spreadsheet report to management
Review temperature screener DocuSign timesheets weekly
Implement social distancing protocol when conducting temperature screening
Maintained confidentiality of personal medical information learned or obtained during the screening process in compliance with HIPPA
Longshoreman
October 2019-March 2020
Organize, clean, and picked up all trash on docks
Worked on container ships at heights, below decks, and in any weather conditions
Attach slings, hooks, and other devices to lift cargo
Assist in loading and unloading of ship cargo and guide loads from docked ships
Inspect and properly pack cargo to ensure adequate protection and compliance with hazardous material regulations
Painters Helper-Fire Watch
Mobley-Safway (Vopak job site)
Laporte, Tx
January 2017-April 2017
Retrieve permits to paint tanks
Shovel sand and grit
Climb 100 ft. tanks while wearing a harness to complete prep work on stairs and top of tank
Sand, caulk, tape, and paint pipes and tanks
Operate and monitor generators
Document employees who enter and exit confined work spaces inside of tanks
Retrieve work permits for job sites
Complete daily Job Safety Analysis reports
Mix Paint
Fire-watch
Cajun IDC (Dow Chemical job site)
Freeport, Tx
January 2015-April 2015
Pick up trash on job site
Flagger for crane operators and riggers during large pipe deliveries
Lead safety meeting stretching exercises
Climbed pipe structures while wearing a harness to remove hazardous flammable materials
Roll- up welding leads, lighting and air hoses.
Grind and buff pipe for pipe fitters
Compete daily Job Safety Analysis forms
A/R Specialist
Orthopaedic Associates
Houston, TX
February 2019-June 2019
Initiate appeals, claims adjudication, submit corrected claims
Inspect and process complex medical claims
Post deductibles, allowed amounts, balances, and payments according to Explanation of Benefits
Review & retrieve explanation of benefits from online provider portals (Navinet, Availity, Optum, etc.)
Submit medical records, proof of timely, primary insurance EOB's, and corrected claims via mail, email, and/or fax to insurances for reconsideration
Revenue Cycle Representative
Village Family Practice
Houston, TX
September 2018-February 2019
Initiate multi-level practice collections and reimbursement services in a prompt and efficient manner
Resubmit CMS 1500 claim forms with appropriate HCPCS/ICD-9 & ICD-10 codes with approval from the provider
Exhaust all possible collections efforts prior to past filing or appeal deadlines
Review medical records to submit reconsiderations, clinical appeals, and letters of medical necessity to payors
Report payor or practice specific trends or issues to management
Post deductibles, allowed amounts, balances, and payments according to Explanation of Benefits • Process bad debt, patient credits, collections credit cards payments
Review EOB’s to confirm contractual adjustment, discounts, and allowances have been applied accurately
Patient Account Specialist II
Christus Health
Houston, TX
June 2018-September 2018
Initiate hospital collections and reimbursement services
Research and resolve coding errors on CMS 1500 and UB-04 claims
Process A/R insurance rejections utilizing Excel spreadsheets
Post deductibles, allowed amounts, balances, and payments according to Explanation of Benefits
Review EOB’s to confirm contractual adjustment, discounts, and allowances have been applied accurately
Contact insurance carriers to follow up on claims
Painters Helper-Fire Watch
Mobley-Safway (Vopak job site)
Laporte, Tx
January 2017-April 2017
Retrieve work permits for job sites
Complete daily Job Safety Analyst reports
Climb 100-foot tanks while wearing a harness to sand, caulk, tape, and paint
Fill generators with gas
Mix Paint
Reimbursement Specialist
Round Table Medical Consultants
Houston, TX
June 2017-December 2017
Verify completion of patient care reports to include patient demographics, personal insurance information and completion of all required signatures
Enter patient information to include charge entry into the billing system
Manage electronic storage of patient care reports, PCS forms, correspondence, etc.
Follow-up on outstanding Cigna AR
Initiate reimbursement, collection and follow-up on all Cigna unpaid or denied emergency room claims
Appeal, resolve, and research unpaid Cigna insurance claims while identifying trends or recurring denials and make necessary changes to resolve outstanding issues
Resolve billing errors by working rejection reports
File supplemental or secondary insurance claims
Submit medical records to Cigna
Inspect claims for coding and billing errors
Perform ongoing analysis of medical record charts for the appropriate coding compliance.
Billing & Collections Specialist
SpectraCell Laboratories
Houston, TX
March 2016-August 2016
Bill Commercial, Medicaid, & Medicare claims for outpatient laboratory services on CMS 1500 claim forms with appropriate HCPCS/ICD-9 & ICD-10 codes
Contact insurance carriers via telephone, online, and/or email to verify eligibility, benefits, and claim status
Inspect rejected claims in clearinghouse to make necessary corrections for EDI resubmission
Update patient demographic and insurance information as necessary
Identify system errors or trends
Accurately document patient accounts to provide an audit trail of actions
Submit claim balances to secondary insurance providers according to coordination of benefits
Submit medical records, proof of timely, primary payor EOB's, and corrected claims to insurance carriers
Process A/R insurance rejections utilizing Excel spreadsheets
Post deductibles, allowed amounts, balances, and payments according to Explanation of Benefits
Review & retrieve EOB's from online provider portals (Navinet, Availity, Optum, etc.)
Submit reconsiderations, appeals, and letters of medical necessity to request reimbursement
Claims & Reimbursement Rep
Kelsey-Seybold Clinic
Pearland, TX
May 2002 to January 2015
Medical billing and collections
Schedule, confirm, and cancel Disease Management, City of Houston employee physicals, and corporate account appointments in a call center environment
Obtain authorizations and referrals for inpatient and outpatient services
Inspect returned checks and perform back out process of both providers return checks and refunds received
Perform post provider audits, complete all provider adjustments, and complete provider invoices received, billing audits and credit balance reviews
Inspect, audit, and process complex medical claims to identify and correct billing and coding errors
Review and apply credit adjustment, contractual adjustments, and write offs according to fee schedules
Request operative reports and medical records to appeal Medicare, Medicaid, Managed Care and commercials
Identify & resolve provider credentialing issues
Page physicians after hours for doctor to doctor consultations, doctor to patient calls, and newborn notifications utilizing Call Track and Hip Link software.
Attend offsite meetings to negotiate corporate account contracts with senior level executives
Create logs using excel spreadsheets to track corporate account drug screen results
Perform quality review audits on patient accounts to ensure that correct protocols were being adhered to with accuracy
Obtain pre-authorization, initiate appeals, coordination of benefits and eligibility of Indemnity, PPO, Workers' Comp and Manage Care Plans.
EDUCATION
Medical Billing & Coding Certificate of Completion University Of Texas Physicians (August 2011)
ADDITIONAL INFORMATION
SKILLS
Microsoft Word, Excel, PowerPoint, Access, & Project, Centricity, Bright Tree, Athena, Epic, and IDX Software Knowledge of HIPAA Laws, FMLA, Medical Terminology, Manage Care, Medicare, Medicaid, and Commercial Insurance
STRENGTHS
Strong verbal and personal communication skills.
Accuracy and attention to details.
Organization and prioritization skills.
Contact this candidate