Medical billing and coding
Resume:
ady7pq@r.postjobfree.com
Albany, NY
CHINIQUA HYMES RESUME 2023
MEDICAL BILLING & CUSTOMER SERVICE PROFESSIONAL
SKILLS &
ABILITIES ● ICD-10 & CPT
Coding
● HCPCS Level II
Coding
● Anatomy &
Physiology
● MS Office Suite
● Medical Terminology
● Medical Insurance
● Online & Paper Claim
Submission
● Medical Software
● Insurance
Authorizations
● Medical Billing & Reimbursement
● Claim Appeals
● HIPAA Compliant
● Administrative Support
● Electronic Health Records
● Payment Posting
● CPR
PROFESSIONAL
EXPERIENCE
BILLING INSURANCE CLERK, MENTAL HEALTH SERVICES, CEREBRAL REMOTE Jan 2022 - April 2023
• Submission of Claims to Health Insurance Payers.
• Monitoring and Following-up on the status of submitted claims.
• Executing and interpreting eligibility requests.
• Conducting outreach to clients and clinicians regarding missing or incorrect insurance information.
• Determining and billing clients their Health Insurance patient financial responsibility.
• Creating invoices for out-of-network reimbursement requests. PROVIDER SERVICE REP I, CDPHP ALBANY, NY
Oct 2018 – Oct 2021
• Provided education to providers, practitioners, facilities, adjunct/ancillary, and all other providers regarding the proper utilization of the Plan.
• Addressed and resolved service-related issues including appeals and complaints, eligibility determination and claims related issues for all product lines.
• Assisted with provider web inquiries, contract, pricing, and fee schedule determinations. MEDICAL BILLING SPECIALIST, VENGROFF WILLIAMS INC (ENZO LAB) SARASOTA, FL Oct 2016 - April 2018
• Collected and entered claim information, posted insurance, and managed patient accounts.
• Submitted claims and followed up with insurance carriers on unpaid or rejected claims.
• Entered information necessary for insurance claims such as patient, insurance ID, diagnosis, and treatment codes.
• Submitted insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
• Answered patient questions on patient responsible portions, copays, deductibles, and write-offs.
• Resolved patient complaints and explained why certain services are not covered.
• Followed up with insurance companies on unpaid or rejected claims then resolved issues.
• Prepared patient statements for charges not covered by insurance.
• Worked with patients to establish payment plans for past due accounts in accordance with provider policies.
1 CHINIQUA HYMES RESUME 2023
PROJECT MANAGER, POSIGEN ALBANY, NY
Jun 2015 – March 2016
• Reviewed customer lease documentation to verify all fields are accurately completed.
• Supported Sales Team division to facilitate proper operational flow.
• Researched and documented the permit process for the areas that the installations are located.
• Tracked outstanding documents needed to obtain a permit.
• Prepared documents to secure a permit.
• Partnered with utility contacts to obtain permits.
• Obtained permits from local government offices.
• Provided support in managing and tracking job installations.
• Supported Documents Management team in receiving, sorting, and prepping customer paperwork.
• High Volume preparation of paper documents and data entry into databases/spreadsheets for tracking of grant compliance.
• Answered phone and email requests from customers.
• Communicated with all departments to improve customer experience.
• Handled escalated customer inquiries.
• Answered questions regarding system performance, maintenance. MEDICAL RECORDS ASSOCIATE, WELLPOINT (AEROTEK) ALBANY, NY Dec 2014 - April 2015
• Responsible for handling a high volume of data entry and customer service.
• Communicated with a wide range of provider offices to update and receive patient information.
• Made sure all information was accurate and correct.
• Able to follow all company policies and procedures as well as HIPAA compliance regulations.
• Strong knowledge of healthcare terminology and medical records information.
• Maintained proper information for HEDIS records log.
• Worked side by side with abstractors and WellPoint to complete project under strict deadlines.
MEDICAL RECORDS SPECIALIST, CENTER FOR DISABILITIES SERVICES ALBANY, NY Jan 2014-Dec 2014
• Gathered patient information by collecting demographic information from a variety of sources; interacting with registration areas and physicians' offices; retrieving information from automated printer.
• Maintained record availability by processing charts into the department; using chart mark-off procedures; facilitating chart location activities.
• Retrieved medical records by following chart-out procedures; documenting reasons charts cannot be retrieved for statistical and follow-up purposes.
• Kept health care providers informed by communicating availability or unavailability of the record.
• Utilized EMR software and scanned health documents into EMR.
• Maintained patient confidence by keeping patient records information confidential.
• Enhanced medical records and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments. EDUCATION BRANFORD HALL CAREER INSTITUTE, ALBANY, NY Medical Billing and Coding (with externship), President’s List - 3.4 GPA Graduated: April 2013
2 CHINIQUA HYMES RESUME 2023
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