Medical Billing Data Entry

CANDICE DEMARR, CLAIMS

*** **** ***** ***. * Marathon FL 33050

715-***-**** adwfpp@r.postjobfree.com

Detail-oriented and quality-focused professional who consistently produces outstanding results is seeking to build off dynamic medical education to complete a successful transition to the healthcare field.

Wisconsin State Certified Nurse Aide (CNA): #249097.

CPR, First Aid, and EAD certified.

Able to determine proper codes/modifiers for all billable services utilizing CPT-4 and ICD-9 coding publications.

Effectively apply ICD-9-CM, ICD-10 CM, CPT4, and HCPCS coding guidelines to surgical and outpatient diagnoses and procedures.

Maintain a thorough understanding of medical record practices, standards, regulations, and the American Academy of Professional Coders (AAPC) Code of Ethics.

EDUCATION SUMMARY / MEDICAL BILLING & CODING SKILLS

Ultimate Medical Academy

Medical Billing and Coding Diploma 2015

Associates Degree in Medical Billing and Coding 2016

Certificates of Completion: CMS 1500; Medicare Fraud and Abuse Prevention, Detection and Reporting; World of Medicare and Uniform Billing (UB)-04

Medical Billing Medical Coding ICD-9-CM HCPCS CPT Introduction to ICD-10-CM Medical Terminology

Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway HIPAA Compliance Tricare

Centers for Medicare and Medicaid CMS 1500 CMS 1450 (UB-04) EOBs Payment Posting Revenue Cycle

Management Scheduling Insurance Verification Insurance Billing Procedures Insurance Claim Processing

Reimbursement Methodologies Fee Schedules Outpatient / Physician Inpatient / Facility Co-Payments

Managed Care (HMO, PPO, and POS) Government Payers Third Party Payers Worker’s Compensation

Practice Management Medical Office Procedures Anatomy & Physiology Deductibles Superbill

EMPLOYMENT OVERVIEW

Spas Inc

Office

8/22 - present

Murry’s Market – Summerland Fey, FL

Casher/Deli

6/2022 – 12/2022

Island Girl Detail – Summerland Key. Fl

Cleaner

Clean and detailed boats and cars and clean homes

8/2021 – 6/2022

Outback Steak House – Key West, FL

Waitress

Took orders, delivered food, cleaned tables, handled own money

8/2021- 12/2021

Flash 4 – Black River Falls, WI

Lead Shipper

Handled all the shipments going in and out. I called the trucks for pick up. Loaded and unloaded the semi-trucks.

4/1/2020-3/2021

Optum (United Health Care) – Eau Claire, WI

Provider Date Analyst

Add provider information in the computer, handle many different states. I can do new creds, Tats States, Short Apps, special requirements for States.

7/21/17-3/2020

Harken Health (United Health Group) – Eau Claire, WI

Claims Department

I work with XC ques, unknown ques, and claim inquiry que. PT/ OT claims. Claim adjustments.

The programs I work with Macess and Facets. 2/2017 – 7/17

EOP/EOB

Work with the claims department to get documents out to the providers and members 12/2016 – 7/13

ERT (EMERGENCY RESPONSE TEAM) 09/2016

Fire drills

Response to any individual in need of help

MA (MEMBER ASSISTANT) 07/2016-01/2017

Answer phones for members

Look up claim information

Check on the billing information

Look for doctors, and hospitals in the area

Walk members through the website on how to find doctors, and pay their bill

Ho-Chunk Nation – Black River Falls, WI

CMA (CASE MANAGEMENT AIDE) 12/2014 – 10/2015

Earned multiple performance-based promotions in recognition of keen ability to support organizational objectives and bring daily efforts to successful completion.

Scheduled appointments, processed claims, and updated patient information.

Actively assisted numerous social workers, oversaw court documents, filed under the correct name, and supervised home visits between parents and children.

Answered phones, typed documentation, and completed data entry.

Certified Nurse Aide (CNA) 10/2012 – 12/2014

Supported patients throughout all activities of daily living, while overseeing meal preparation and housekeeping efforts.

Maintained accurate/detailed records of all patient care efforts, including condition, progress and issues to report, while discussing observations with senior healthcare professionals and family members.

Effectively conversed with peers and superiors regarding applicable patient care details.

CHR (COMMUNITY HEALTH REP) 06/2011 – 10/2012

Assisted with WIC program by scheduling appointments, transporting individuals to doctor visits, overseeing youth activities and manning healthcare booths.

Utilized outstanding oral, written and interpersonal communication skills to work cooperatively with personnel/teams to bring daily efforts to successful conclusion.

Pine View Care Center – Black River Falls, WI

Certified Nurse Aide (CNA) 04/2007 – 05/2011

Supported patients via customized patient-teaching tools, earning frequent commendation from superiors for maintaining the safety, respect and dignity of residents.

Coordinated with doctors and registered nurses to develop and implement innovative/successful patient-care plans, including assessments, evaluations and nursing diagnoses.

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