Rutu Patel

Email: adu0zh@r.postjobfree.com Mobile: 201-***-**** Address: Parsippany NJ

CERTIFIED PROFESSIONAL CODER

● 7+ years of excellent experience in the healthcare industry.

● Outstanding customer communication and leadership skills.

● Comprehensive understanding of compliance, safety according to HIPPA/OSHA regulations.

● Follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO

● Expertise to work with hospital’s quality procedures in accordance with CLIA / JACAHO and CARF regulations.

● Code and report according to ICD-10_CM and CPT guidelines.

● CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues.

AREAS OF EXPERTISE

Medical Skills: CPR/AED, pH Meter, Drug Screening, EKG, Phlebotomy Urinalysis, Spirometry Glucometer

Technical Skills: MS Office, Excel, Medical Transcription and Medical Office Management

(EMR)

Software skills - Navinet,Optum,ECW,Practice Fusion, EHR,Dr.Chrono PROFESSIONAL EXPERIENCE

Collection Specialist(CPC) 2020-2021

Shree Hari Medical Group

● Resolving invoice discrepancies and submitting claims to insurance companies.

● Collaborate with management to ensure deadlines are met on time.

● Correction and re-submission of rejected or denied claims.

● Responsible for assisting with account revenue and account receivables.

● Submission of claims and follow up with carriers, use of Navinet and other electronic claims submission portals.

● Pain Management /Orthopedic Surgeries Claims experience with No-Fault, Workers' Compensation, NY & NJ PIP claims, OON Commercial Insurance, including appeals, follow-ups, and aging reports.

Collection Specialist(CPC) 2019-2020

Datta endoscopic Back Surgery and Pain Center

● Look through patients ’charts to determine which procedures and services have been performed.

● Abstracting, coding, and interpreting outpatient services for professional and or facility billing.

● Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations.

● Utilizes the physician query process to obtain/validate missing information and/or discrepancies for clarification of documentation for accurate code assignment.

● Follow up with insurance companies for any denial of surgeries, anesthesia, injections, or office visits received on any given date.

● Validate that all coding and billing entries are accurate and complete before punching them into the system.

Medical Billing and Coding 2017- 2018

Dr katy Belov,Internal Medicine Family Practice Ridgewood,NJ

● Process ERA vouchers and check payments for multiple payers.

● Process patient payments & review ERA denial from insurance.

● Day to day balancing of all posted receipts and deposits.

● Research, audit, and investigate proper payment of claims and patient accounts and update patient insurance information, including memo entry for billing documentation.

● Access to check patient transaction & Payment posting thru Navinet & Optum website.

● Knowledge of Medical Terminology,CPT Codes, Modifiers & ICD 10 Diagnosis Codes.

● Follow up on Insurance for EOB & Rejection Claims & Initiate appeals when necessary. Certified Medical Assistant, 2015- 2017

Bergen Primary Care Associates, NJ

● Demonstrated proficiency in taking patients' medical histories and vital signs, as well as performing ancillary procedures such as urinalysis, EKG and spirometry.

● Drew and labeled patients’ blood for testing, ordered lab tests in ECW/EMR system and prepared specimen bags for lab processing. Called lab for results when necessary

● Communicated lab results and other pertinent medical information to patients

● Educated patient on surgical/diagnostic procedures and medication

● Administered injections and medication as directed by the physician.

● Answered phones and excellent customer service & compassion for patients.

● Prior authorization & Pre certification understanding of multiple insurance participation.

● Responsible for obtaining precertification for all tests and procedures that are performed in the office.

Patient Access Representative, 2013 - 2014

Bergen Regional Medical Center, Paramus, NJ

● As a representative, I collected demographic data and insurance documents from patients as well as screening them for Charity Care.

● Resolved problems by communicating with other staff members and patients.

● Notified patients of hospital regulations and collected money when necessary.

● Discharged patients from the ER and transferred admitted patients to various units in the hospital.

● Provided empathic patient care by maintaining exceptional customer service. EDUCATION

● Medical Assistant/Pharmacy Technician/Phlebotomy Technician Ho-Ho-Kus School of Business and Medical Sciences, Hackensack, NJ 2010

● BS (Accounting) MS University, India 2004 (90 US credits translated from World Education Services)

MEDICAL CERTIFICATION

● Certified EKG Technician, National Association for Medical Certification (NAMC) 2015

● Certified Medical Assistant, National Association for Medical Certification (NAMC) 2015 • Certified Phlebotomy Technician, National Association of Certified Technicians (NACT) 2014

● Pharmacy Technician License, New Jersey State Pharmacy Board 2012

● Certified Professional Coder (CPC Thru AAPC) 2018

● Certified outpatient coder (COC in process)

MEMBER:

• Member, National Association of Certified Technicians

• American Academy of Professional Coders

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