Data Entry Patient Account
Resume:
Charlotte Walker
**** ******** **. *******, ** 38115 901-***-**** ady8ri@r.postjobfree.com
Education
Certificate: Medical Billing, 05/2010
Southwest Community College - Memphis, TN
Diploma: Dental Assistant, 08/2012
Concorde Career College - Memphis, TN
Diploma: Medical Secretary
Rice College - Memphis, TN
Diploma: 05/1993
H.W. Byers High School - Holly Springs, MS
Professional Summary
Knowledgeable Medical Coder specializing in hospital inpatient coding and credentialing. Talented at correcting and resubmitting claims, preparing patient charts for registration and reviewing health records to identify proper relationship between procedure and diagnosis codes. Offering 15-year background in reviewing, analyzing and managing medical record information to identify appropriate coding. Experienced knowledge of credentialing and enrollment.
Professional Achievements
Enrollment Specialist: 01/2021 to present
LifeLinc Anesthesia – Memphis, TN
Create, verify, and maintain processes for all aspects of provider enrollment for each payor and location
across several states.
Communicate with the credentialing team to receive provider information
Prepare applications, for all new providers then submit those applications to payors.
Track and follow up to obtain provider numbers.
Develop working knowledge of payor policies for multiples states.
Maintain and work reports of non-complaints providers and held A/R.
Credentialing Soecialist: 09/2019 to 01/2021
BMG-Central Business Office – Memphis, TN
Maintains current provider profiles in the BMG Credentialing database SyMed OneApp.
Maintains current provider profiles in the CAQH database.
Performs primary data source verification of new providers joining BMG.
Performs initial communication to providers requesting supporting documents required for the completion of payer enrollment.
Facility Affiliation.
Claim Specialist: 01/2019 to 01/2021
Case Management
Initiate correction on all claims with errors by the designated time.
Maintain knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
Reject or accept documentation, determine benefit due, and start the denial or payment process to resolve medical claims.
Post payments from the different payers to the appropriate patient’s account.
Denial Specialist/Patient Account Rep: 01/2018 to 12/2019
Lifelinc Anesthesia – Memphis, TN
Assured timely verification of insurance benefits prior to patient procedures or appointments.
Reviewed and corrected claim errors to facilitate smooth processing.
Created appeal and reconsideration for claims
Posted payments and processed refunds.
Patient Account Representative: 01/2015 to 01/2018
Memphis Obstetrics & Gynecological Association – Memphis, TN
Directed patients through the registration process, providing medical history and physician specific forms for
completion.
Contacted benefits providers to gather policy benefits/limitations to ensure services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.).
Explained plans for treatment and payment options.
Maintained office inventory and organized supplies, for expected efficiency needs.
Receptionist/Billing: 01/2005 to 01/2015
Desoto Adult Medicine – Southaven, MS
Organized paperwork such as charts and reports for office and patient needs.
Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
Received, recorded and filed medical payments by check, cash and credit cards.
Scheduled, rescheduled and handled cancelled appointments for patients.
Data entry.
Enrolled the provider with payers.
Checked denied claims and resubmitted for processing.
Skills
Administrative procedures: Admitting, scheduling appointments, and patient chart maintenance
Insurance Knowledge
Internal Medicine billing
CPT and HCPCS coding
Data Entry
Microsoft Office Proficient
Account Payable/Receivable
Account Management
Analytical problem-solving
Complaint Resolution
Contact this candidate