Patricia A. Hoover

**** **** ******

The Colony, TX adupzi@r.postjobfree.com

Cell: 469-***-****

Skills: 15 yrs. + in coding and billing. Knowledgeable in CPT, ICD-10, Modifiers, and E/M- Commercial, Government. Worked with off-shore staff to assist in coding, billing and appeals. Background in Trauma, General Surgery, Orthopedics [general and trauma], Imaging, Spine, Neurosurgery, Anesthesia, and Pain. Assisted staff and providers in proper coding and documentation. My strengths include the critical thinking skill that is necessary to audit records, resolve reimbursement issues, and communicate to both staff and medical professionals.

Billing Software : AdvancedMD, Advantx, NextGen, eClinicalWorks [ECW], Centricity

EMR: Hcare, Meditech, MediMobile, Cerner

Coding tools include EnCoder Pro, Codify, Codelink.

Knowledge of payor websites – Optum, Availity, Noridian, Tricare, Waystar, AIM, Evicore, Med Solutions

Billing/AR Specialist AT&C Revenue Services LLC Feb 2022- May 2022

Billing/AR for ASC – Medicare, Medicaid, Work Comp, Commercial

Appeal claim denials and payment shortages

File corrected claims via electronic process

Assist patients with claims issues

Coding/Billing/AR Sr. Specialist Arietis Health August 2020 – Feb 2022

• Supervise offshore coders/AR team for 20+ trauma surgeons - Inpatient and surgeries

• Assist AR team with appeals and corrected coding issues

• Check claims status for all payors types via phone/IVR and websites

Coding/Billing/AR MPower Health March 2019 – August 2020 March 2019 – Aug 2020

• Spine Coding for six [6] Spine/Neurosurgeons. Inpatient and surgeries

• Assist AR team with appeals and corrected coding issues

• Prepared/maintained charge entry spreadsheets for coded procedures, each provider. • Reviewed ERA denied claims

Coding/Billing/AR Direct Orthopedic Care– California Division Oct 2017 – March 2019

• Code/Bill for 3 surgeons/PA’s – Ortho office, x-rays, fracture care, injections, surgeries

• Physical Therapy billing

• Work ERA/EDI rejections in Trizetto – appeals – on-line, phone and by mail • Refunds

Independent Contractor Dallas/Ft.Worth Dec 2016 – Oct 2017

Audit spine, ortho, pain, podiatry, ENT claims prior to electronic submission.

Review physician EMR to support medical necessity.

Payment auditing for contractual accuracy.

Coding/Billing Manager Envision Health/Acute Surgery Aug 2014 – Nov 2016

Managed team of 15+ members – Coding, billing, A/R, payment posting, credentialing and provider enrollment

Worked with various Leadership members incl. COO, CEO, Division Manager, Medical Directors

On Committee for growth in new hospitals, and planning

Assigned workflow for Team to meet and exceed claims performances

Maintained Timesheets, reviews, payroll issues and PTO

Coding Orthopedic, General Surgery, Trauma, E/M – inpatient and clinical. OUT OF NETWORK and In-Network

Accessed various facility portals for reviewing records for coding and medical necessity – Hcare - Meditech

Enrollment of ECF to Emdeon for 17 states

Maintained provider billing information in software.

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