adu7wx@r.postjobfree.com

347-***-****

Jesus Moran

EducaƟon-

Kaplan College- Billing and Coding Course 2010-2011 AAPC ApprenƟce Level CerƟficaƫon- CPC Coding CerƟfied - Member Id# 01851497 Skills

One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of a health records.

Bilingual: English and Spanish Proficient

U.S. CiƟzen- Fully Covid Vaccinated

CPT, ICD-10, ICD-9

Ability to use health informaƟon technology and various office soŌware products used in MRT

(Coder) posiƟons (e.g., the electronic health record, coding and abstracƟng soŌware, etc.)

CMS-1500,NF-2 Form,C4-2 Form

Ability to manage prioriƟes and coordinate work to complete duƟes within required Ɵmeframes and the ability to follow-up on pending issues

Commercial Insurance, Workers CompensaƟon/No Fault Insurance

Medicare/ Medicaid

Ability to apply knowledge of medical terminology, human anatomy/physiology, and disease processes to accurately assign codes to inpaƟent records based on health record documentaƟon

60 Words Per Minute/ 10 Key touch

NegotaƟon Skills, with No fault Lien cases/ Workers comp. Out of Network Claims-Appeals / RebuƩals

Up to date Aging report- progress

Work Experience-Responsibility's

2/1/21-Current Nassau Open MRI Pc

Medical Biller and Coder- No Fault/Workers Comp - Work 40 Hours Week

Managing Account Revenue/Aging

CreaƟng Insurance Portals

2/5/19- 4/15/19 LEP Services

CollecƟon Specialist- Workers Comp - Work 40 Hours Week

Following up on denied claims and appealing- Following Workers Comp Medical Treatment Guidelines ( Chiro Claims/ Durable Medical Claims)

Following up on filed Hp1 forms for both arbitraƟon cases denied via C8.1 and administraƟve award HP1 claims

11/2018 – 2/4/2019 MD-Reports 1110 South Ave, Staten Island, NY 10314- Medical Biller and Coder - Work 40 Hours Week

Scrubbing/Submiƫng Claims

Reviewing Aging report- Addressing denials and posƟng payments

Addressing balance concerns with paƟents and seƫng up payment plans with paƟents

Finding denial trends and seƫng up protocols to avoid them 02/2016 – 11/2018 Spine and Pain Consultant 1360 Hylan Blvd Staten Island, NY 10305 Revenue Cycle Analyst - Work 40 Hours Week

Managing billing company to make sure claims process accurately, addressing denials

Verifying Commercial (In and Out of network benefits), Workers Comp (follow MTG guidelines) and No fault insurance (No fault benefits)

Maintaining a complete spreadsheet of all payments received from Insurance companies and AƩorney's (lien, ArbitraƟon, Medical record payments)

NegoƟaƟng SeƩlement's with 3rd Party companies (Commercial Insurance)

NegoƟaƟng No fault Lien Claims

03/15/15 – 2/2016 Isurply 612 Jericho Turnpike, New Hyde Park, NY 11040 Medical Biller and Coder - Work 40 Hours Week

Verifying Insurance Claim informaƟon and medical benefits

Bill out Durable Medical Equipment in a Ɵmely maƩer

Enter Demographics

Address denials received from insurance company’s

Follow up on pending insurance companies with AƩorney’s/ Workers comp board 03/11- 2/1/15 Associated Lien Services 15335 Morrison St. 300 Sherman Oaks, CA 91403

Lien Account Specialist - Work 40 Hours Week

Verifying Insurance coverage for workers compensaƟon claims, calling insurance adjusters/defense aƩorneys for Claim status, Claim #’s, Check #’s, Court Dates and seƩlement’s.

Entering demographics along with balance’s due with penalty’s / interest

NegoƟaƟng Liens and liƟgate Workers CompensaƟon claims: ChiropracƟc, Acupuncture, Orthopedic, Internal medicine, DiagnosƟc study’s and Optometrist.

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