ROSEMARY MORRIS

*** * ** ***** ***.

Pomona, CA *1767

626-***-****

adwei2@r.postjobfree.com

Summary of Qualifications

Knowledge of over 14 years of Medical Billing experience of inpatient/outpatient claims, as well as hospital and professional billing. Ability to perform routine office duties under general supervision. Able to multitask in a priority and fast-paced environment. Producing and maintaining various files and records. Conduct meeting with Physicians, Attorneys, and authorized representatives. Familiar with Microsoft Word, Excel, Outlook, PowerPoint, etc. Highly adaptable to any client EMR/EHR system and have worked utilizing multiple different payer portals. Able to type over 40 wpm, 10 touch key, familiar with ICD-9 and ICD-10 coding and excellent verbal and written communication skills.

Professional Work Experience

California Business Bureau – Monrovia, CA

Medical Biller / November 2014 – Present

-Worked in different hospitals throughout California, Nevada, Arizona, and other out-of-state facilities.

-Knowledge of billing UB-04 and CMS-1500 forms, professional and facility claims.

-Updating insurance profiles to reflect correct primary, secondary, third-party insurances to ensure proper processing and payment.

-Analyzing and auditing accounts for accuracy and proper follow-up and to ensure submission of any missing information.

-Following up on unpaid claims within the standard billing cycle time frame, review EOBs, and adjusting balances with proper justification and payment, to properly bill patient responsibility.

-Contacting insurance companies regarding discrepancies/disputes of payment, if necessary.

-Contacting member for information, TPL form, COB info/updates, etc.

-Answering all inbound and outbound patient calls and insurance telephone inquiries pertaining to assigned accounts, verifying patient eligibility, patient demographics (if needed), etc.

-Review active contracts to price inpatient and outpatient accounts, as well as professional claims.

-Confirm pricing methodologies to submit pricing disputes, reconsiderations/appeals, medical necessity appeals, retro authorizations, etc.

-Adjust balances accordingly after thorough review and payment exhaustion, timely filing, bundling, etc.

-Contacting patients to collect patient responsibility amounts and patient copayments.

-Submitting corrected claims and replacement claims with proper coding edits, insurance COB updates, removed and late charges, etc.

-Scanning incoming correspondence in proper secure system.

-Familiar with posting payments and adjustments on multiple patient accounts.

-Scanning incoming and outgoing mailed medical records for necessary payment and appeal/reconsideration submissions.

-Daily review of incoming claim denials, correspondence, rebill accounts, payments, etc.

-Adaptable to multiple client systems and assignments: Meditech, EPIC, Next Gen, Office Ally, etc.

-Identifying and organizing account for pending refund and recoupment requests for payment posting and cash departments.

San Dimas Pain Management Medical Center – Arcadia, CA

Medical Assistant / June 2009 – November 2014

-Familiar with front and back office – Ambulatory Surgical Center

-Coordinate all patient and physician schedules

-Patient care coordination and assistance

-Insurance verification and authorizations

-CPT and ICD-9 coding

-Filing and organizing patient files and data.

-Drafting prescriptions

-Dispensing medications

-Conducting vital sign checks

-Administering patient vaccines

-Proper handling of specimen samples

-Assisting with patient care and recovery

-Knowledge of proper sterilization techniques

-Maintaining supplies and reordering/stocking as deemed necessary

-Monitoring patient vital signs

-Heavy calendar management of patient appointments.

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Education

North-West College - West Covina, CA

Medical Assistant – December 2008

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