Carleen Neer

(Lawrenceville, GA)

Background Summary

To obtain the position in a company where I can excel and further enhance my ability to succeed in the workplace.

Summary of Skills:

HEDIS

Medical Administration

‘Medical Billing

EMR

HIPPA

Eligibility

Insurance

ICD-9/ICD-10

NCQA

CAQH

Familiarity with instruction, evaluation, and academic counseling

Excellent management and communication skills

Ability to judge instructors’ competence

Education

Medical Billing Specialist Certification-U.S. Career Institute 2014

Associates Degree/Business Administration-Hudson Valley College Troy, NY 2007

Associates Degree/Early hood Child Development – Hudson Valley College 2005

Certification/Resources & CH Development-CDA 2004

Morris Central High School 1998

Work Experience

AdvantEdge Healthcare Warren, NJ Feb 2021 - Nov 2021

Billing Specialist Janel Bouden- 1-678-***-**** (professional References)

Export charts to different insurance companies, deal with confidential information dealing with patient’s insurance, bill insurances/claim status and eligibility check

Send out and handle appeals/ claims, work with insurance companies, meet with insurance companies for office matters, work with an all-electronic office EMR systems,

Family & Children Services of the Capital Region Albany, NY May 2016-Jan 2021

Billing Specialist (professional references)

Export charts to different insurance companies, deal with confidential information dealing with patient’s insurance.

Documented findings in applicable HEDIS databases and on prescribed cloud-based platforms.

Bill insurances/claim status and eligibility check, send out and handle appeals/ claims, answer phones, AR reports, work with insurance companies

Meet with insurance companies for office matters, work with an all-electronic office EMR systems

Handle any computer issues that can be handled in house, CAQH, Use, CPT coding, ICD-9/ICD-10 coding

Fill out insurance forms, help set up a new EHR system, Credentialing details (get providers paneled with new insurance companies and maintain credentials, handle all daily deposits for five different sites.

Reviewing patient files, documenting diagnoses and treatments, and assign codes to the data that align with HEDIS domains of care.

Dr. Padma Sripada/Columbia Internal Medicine Castleton-On-Hudson, NY Jul 2010 - Apr 2016

Medical Billing Specialist /Medical Assistant (professional References)

Prep patients for the doctor- take vitals, weights, perform EKG’s, Spirometry test, pulse oximeter readings, prepare and order vaccines, urine dips, prep charts, prep pap’s

Sterilize exam rooms, eye exams, deal with collections and confidential information dealing with patients’ insurance, bill insurances/claim status and eligibility check

Send out and handle appeals/ claims, answer phones, AR reports, work with insurance companies, meet with insurance companies for office matters

Work with an all-electronic office EMR systems.

Reviewed and abstracted paper and electronic medical records utilizing NCQA HEDIS Technical specifications to optimize Plan HEDIS scores.

Performed complete and accurate data entry of qualifying services and results into HEDIS electronic database software.

Train/supervise student Medical Assistants, post payments

Work with electronic EMR systems, handle any computer issues that can be handled in house.

Assisted in the facility become a NCQA credited site, CAQH, PCMH, Medicare Meaningful Use, CPT coding, ICD-9/ICD-10 coding, HEDIS/ GAP reports, prep and export claims, fill out insurance forms

Fill in for all the receptionist’s duties when she is absent-calling patients with results, answering faxes and messages, check in/out patients, take and document payments, maintain office email, prep for staff meetings, set up incentive programs: HIXNY, NCQA, ect…, handle computer/IT issues

Reviewed and integrated medical information from diverse sources including the health plans internal data base, medical records, and immunization registries, from provider offices in order to abstract specific clinical data for the HEDIS Quality Metric Reporting.

Other experience

Jason Neer Construction Company Lawrenceville, GA Dec 2021 - Current

Administration Assistant (professional references)

Performed Administrative duties, organizing and implementing various clerical tasks, Scheduling and Appointment setting.

Assisted in closing procedures and closings for the company.

Faxing, imputing information onto the company website page, taking and applying payments, answering phones, plus any other office duties

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