Barbara Hughston

**** *** ****** **** *****, GA *9861 229-***-**** adttoc@r.postjobfree.com

PROFESSIONAL PROFILE

Customer service oriented professional with healthcare industry and administrative experience. Able to provide timely and accurate data to ensure reimbursement for patient services and communicate effectively with co-workers, patients, and staff. Follows policies, procedures, and guidelines to ensure quality. Maintains and safeguards patient privacy and confidentiality.

Experience includes working in a hospital setting.

Demonstrates independent work initiative, sound judgment, and attention to detail.

Builds trust and respect by consistently meeting and exceeding expectations.

Strong written and verbal communication skills.

Microsoft Office Applications - MS Excel, MS Word, MS PowerPoint.

Typing Speed: 50 WPM.

KEY QUALIFICATIONS

Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers Electronic Health Records (EHR) Electronic Medical Records (EMR) Managed Care (HMO, PPO, and POS) Workers Compensation Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04) Front Office Operations Medical Office Procedures Scheduling Medical Terminology Anatomy & Physiology

HIPAA Compliance Medical Coding (ICD-10-CM HCPCS CPT) EDUCATION AND PROFESSIONAL DEVELOPMENT

Ultimate Medical Academy Associate of Science Degree - Medical Billing and Coding, 2021 Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate PROFESSIONAL EXPERIENCE

Continuum Global- Tallahasse, GA

08/2021- Present

Teamlead

● Handle escalation calls from members with problems on a claim. Rectify the issue with the claim.

● Help mentoring agents on issues and handling with claims.

● Check for pre-authorizations if needed for certain procedures. Use CPT codes to verify.

● Handle appeals for member

● Answer the supervisor line when needed to assist with calls for members.

● Monitor agents with their calls

Customer Service Representative

● CSR for members with Aetna Medicare and Traditional Insurance

● Handle members accounts, claims, questions about benefits of plan.

● Handle any complaints and appeals from members and provider office.

● Call on members behalf to rectify Dr bills

● Handle any premiums that are giving by members.

● Give cost of what their deductible, co payment, co insurance for procedures.

● Look up CPT and ICD-10 codes to see if procedure will be covered.

● Assist members locating providers with in their network.

● Research members specific plans to the coverage available to the member.

● Research reason why claims were denied, see if claims need to be reworked. Ultimate Medical Academy - Jakin, GA 03/2020 -

07/2021

Full Time Student

Remained self-directed, motivated, and accountable for personal actions.

Came prepared for class and completed assignments on time.

Navigated new technology, utilized available resources, and set realistic expectations. Full Time Parent - Vidalia, GA 12/2010 - 12/2016

Homemaker

Ensured household duties were completed and managed household budget.

Coordinated medical care, meals, and social activities.

Remained deadline-oriented and reliable while adjusting priorities and managing time wisely. Meadows Regional Medical Center - Vidalia, GA 01/2003 - 12/2010

Administrative Assistant / Secretary

Answered inbound phone calls, completed physician credentialing, and kept up with licenses for each state.

Created and edited documents and charts, documented information, updated paperwork, and managed filing system.

Operated office equipment, scheduled appointments, and maintained files and correspondence. Medical Records Technician II

Assembled inpatient charts for physicians, kept track of medical records, and added reports to patient charts.

Accepted inbound calls, operated office equipment, and retrieved inpatient charts as needed.

Released medical records to authorized individuals after verifying patient information. Emergency Room Administrative Assistant

Entered medical codes for injections, entered data into computer, and verified accuracy of documentation.

Took minutes during meetings, operated office equipment, and answered inbound calls and caller questions.

Directed patients to different areas of hospital and assisted in various departments when needed.

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