Medical Billing
Resume:
Sharon Moore
Decatur, GA *****
***************@*****.***
CONTINUED GROWTH AND EDUCATION IN THE MEDICAL A/R FIELD Authorized to work in the US for any employer
Work Experience
Front Desk Receptionist Weekends
Decatur Center for Nursing and Healing - Decatur, GA August 2023 to Present
Front Desk Administration Part-Time
Oakhurst Pediatrics - Decatur, GA
November 2020 to June 2023
Patient registration, eligibility, check-in, check-out, follow-up, scheduling, payment posting, faxing, scanning, payment collection, emails, Athena Health system. REMOTE MEDICAL REVENUE CYCLE MANAGER
Medical Billing Management Services LLC - Atlanta, GA February 2012 to March 2020
MANAGED A STAFF OF 14; RESPONSIBLE FOR THE ACCOUNTS RECEIVABLE OF 4 CLIENTS TOTALING
$15,000,000 IN CHARGES EACH MONTH, INCLUDING CREDENTIALING, DENIAL MANAGEMENT AND THIRD PARTY FOLLOW UP. ANALYZED THE TOP DENIALS FOR EACH CLIENT AND IDENTIFIED SOLUTIONS TO INCREASE CASH AND A/R DAYS. REDUCED AVERAGE DAYS IN A/R FROM 79 TO 30 IN A 3-MONTH TIME PERIOD. INCREASED NET COLLECTIONS FROM 65% TO 85%. BUILT COLLECTOR WORK FILES WORKED WITH THE CLEARINGHOUSE AND THE PAYERS TO ENSURE ALL CLAIMS WERE PROCESSED AND RECEIVED BY THE INSURANCE COMPANIES IN A TIMELY MANNER. REDUCED CLEARINGHOUSE DENIALS FROM 39%
"BOMB" RATE TO 15% IN A 6-MONTH PERIOD OF TIME. MAINTAINED A STRONG RELATIONSHIP WITH ALL CLIENTS AND PRESENTED TRENDS TO THEM ON A MONTHLY BASIS. WROTE POLICIES AND PROCEDURES FOR BILLING, COLLECTION, AND POSTING, RESPONSIBLE FOR THE CHARGE-ENTRY, PAYMENT-POSTING AND FOLLOW-UP OF ONE OF OUR LARGEST ACCOUNT WHICH HAD A MONTHLY CHARGE CAPTURE UPWARDS OF 3 MILLION DOLLARS WORKED THE DENIALS AND FOLLOWED UP WITH INSURANCES VIA TELEPHONE, DIRECT INSURANCE SITES, AVAILITY AND CMS REMOTE CONTRACT MODELER
LifePoint Health - Atlanta, GA
November 2016 to January 2017
REVIEWED, APPROVED OR DENIED HOSPITAL INSURANCE CONTRACTS, COORDINATED WITH SYSTEM ADMINISTRATORS TO LOAD EXECUTED CONTRACTS, MONITORED AND UPDATED TERMS AND RATES USING NTHRIVE, TENET BILLING SYSTEMS, WORKED WITH REVENUE TEAM PERTAINING TO OVER AND UNDERPAYMENT RESOLUTION, CONVEYED CONTRACT LANGUAGE TERMS FOR PAYOR CODE IMPLEMENTATION INTO DATABASE
SR. REIMBURSEMENT SPECIALIST
AdvancedMD - Springfield, MA
October 2012 to February 2013
SUPERVISED 12 EMPLOYEES, DUTIES INCLUDED MEDICAL BILLING AND COLLECTIONS IN A CBO FOR MULTISPECIALTY PROVIDERS AND GROUPS, FOLLOWED-UP ON DENIALS, SUPERVISION OF THE JUNIOR REIMBURSEMENT SPECIALIST, REPORTING TRENDS AND PATTERNS. APPEALS, WRITE-OFFS, SET-UP SYSTEM CODES TO CAPTURE DENIALS, PAYMENT POSTING, AND INSURANCE VERIFICATION, SKIP TRACING
MEDICAL BILLING FINANCIAL CASE MANAGER
Easter Seals - Windsor, CT
June 2011 to October 2012
COLLECTIONS, FOLLOW-UP, MONTHLY PROVIDER REPORTS, MONTHLY CLOSING OF EACH PROVIDER ACCOUNT, PROVIDER AND PATIENT SERVICES, CREDENTIALING, PROVIDER INFORMATION IMPLEMENTATION INTO DATA BASE. CONTRACT BILLING FOR THE STATE OF CONNECTICUT, COMMERCIAL,HMO, PPO, MEDICARE, MEDICAID
MEDICAL CODING MANAGER/BILLING SUPERVISOR
Community Health Services, Inc - Hartford, CT
April 2004 to July 2009
SUPERVISED AND MANAGED 27 EMPLOYEES, RESPONSIBILITIES INCLUDED: ICD-9 AND CPT, J-CODES, HCPC CODING FOR CLINIC INCLUDING PEDIATRICS, ADULT MEDICINE, WOMEN'S, HEALTH, PODIATRY, DENTAL, OPTOMETRY, MENTAL HEALTH, AND SUBSTANCE ABUSE, REVIEWED MEDICAL RECORDS FOR COMPLETENESS AND TO ABSTRACT AND CODE CLINICAL DATA, SUCH AS DISEASES, OPERATIONS, PROCEDURES, AND THERAPIES, USING STANDARD CLASSIFICATION SYSTEMS, CHART AUDITS, EDITED SYSTEM LIBRARY FOR UPDATES, DELEGATED AND ASSISTED IN WORK LOAD FOR PAYMENT APPLICATION, ACCOUNT RECONCILIATION, BALANCING, CHARGE ENTRY, SPECIAL BILLING PROJECTS, ACCOUNTS RECEIVABLE, MONITORED ACCOUNT AGING, CREATED DETAILED REPORTS, FOLLOWED-UP ON ACCOUNTS, AND COLLECTIONS,
CREATED TRAINING MANUALS FOR CODING AND PROTOCOL FOR PROVIDERS AND INTAKE STAFF TRAINING FOR CUSTOMER SERVICE, PATIENT REGISTRATION AND AUTHORIZATIONS, RESEARCHED ELECTRONIC ERRORS AND REJECTIONS REPORTS RESOLVED ISSUES AND MADE CORRECTIONS FOR ALL INSURANCE CARRIERS INCLUDING MEDICARE AND MEDICAID, GENERATED ELECTRONIC CLAIMS SUBMISSION, CLAIMS PRINTING, ELECTRONIC CLAIMS RECONCILIATION, INPUT OF INSURANCES AND PAYER ORGANIZATION ID NUMBERS TO CREATE PLAN CODE NUMBERS AND ELECTRONIC BILLING CAPABILITIES, UPDATED DIAGNOSES, PROCEDURE CODES, PRICING AND REVENUE CODES IN EHS DATABASE, ASSISTANT TO THE DIRECTOR OF REVENUE SERVICE AND CFO, CREATED SYSTEM ROLL-UP CODES, MONTH END CLOSING, MONITORED AND COMPLETED QUARTERLY FORMS FOR CREDIT BALANCE REPORTING FOR MEDICARE, WORKED WITH HEALTHPRO AND EHS BILLING SYSTEMS MEDICAL BILLING COORDINATOR
Advanced Medical Billing Associates - Farmington, CT June 1999 to April 2003
MANAGED 7 SPECIALTIES IN THE FOLLOWING AREAS: SURGERY, INFECTIOUS DISEASE, CARDIOLOGY, DIABETES AND ENDOCRINOLOGY, GERIATRICS, PULMONARY MEDICINE, DEPARTMENT OF MEDICINE, PATIENT REGISTRATION, CHARGE ENTRY, PAYMENT POSTING, ACCOUNTS RECEIVABLE, SNF BILLING, DME BILLING, FOLLOW-UP, REPORTING, ELIGIBILITY AND INSURANCE VERIFICATION, EVALUATING E/M SERVICES FOR COMPATIBILITY AND LEVEL, CORRECTIONS, BILLED AND REBILLED, PROVIDER SERVICES, IMPLEMENTED TRAINING FOR NEW RECRUITS, WORKED WITH ALL COMMERCIAL PLANS, MEDICARE AND MEDICAID, HMO'S PPO'S, INDEMNITY AND MANAGED CARE, IDX/GPMS BILLING SYSTEM MEDICAL BILLING COORDINATOR
Collins Medical Associates - Hartford, CT
February 1997 to June 1999
OPERATIONS OF REGISTRATION, BILLING, COLLECTIONS, WRITE-OFFS, DEPOSITS, BANK RECONCILIATION, ACCOUNTS RECEIVABLE AND REPORTING FOR 5 SPECIALTY PRACTICES: HEMATOLOGY/ ONCOLOGY, GERIATRIC, PULMONARY, ENDOCRINOLOGY, CARDIOLOGY, FOLLOW-UP, REFERRALS AND REBILLED ALL INSURANCE TYPES INCLUDING MEDICARE AND MEDICAID, UTILIZED THE IDX/GPMS BILLING SYSTEM
MEDICAL BILLING REPRESENTATIVE
Wheeler Clinic - Plainville, CT
January 1995 to February 1997
MEDICAID/MEDICARE AND HMO'S BILLING FOR 15 CLINICIANS AND DOCTORS, OBTAINED REFERRALS, PARTIAL HOSPITAL AND INTENSIVE OUT-PATIENT TREATMENT AUTHORIZATIONS FOR SUBSTANCE ABUSE AND MENTAL HEALTH, PAYMENT POSTING, FOLLOW-UP AND REBILLED ACCOUNTS RECEIVABLE, WRITE- OFFS, APPEALS
Billing Representative
ORTHOPEDIC ASSOCIATES OF HARTFORD - Hartford, CT
March 1993 to January 1995
BILLED MEDICARE, MEDICAID, HMO'S, LIABILITY, AND WORKER'S COMPENSATION FOR 16 PHYSICIANS INCLUDING DME BILLING, VERIFIED ELIGIBILITY, PRIVATE COLLECTIONS, ACCOUNTS RECEIVABLE, PAYMENT POSTING, FOLLOW-UP AND REBILLED IDX/GPMS BILLING SYSTEM Education
BACHELOR OF SCIENCE degree in HEALTHCARE ADMINISTRATION BAKER COLLEGE ONLINE - Flint, MI
2009 to 2013
DIPLOMA in ADMINISTRATIVE MEDICAL ASSISTANT
Fox Institute of Business-West Hartford - West Hartford, CT 1993
CERTIFICATE in NURSING ASSISTANT
CONNECTICUT BUSINESS INSTITUTE - East Hartford, CT 1991
DIPLOMA in GENERAL EQUIVALENCY DIPLOMA
STATE OF CONNECTICUT DEPARTMENT OF EDUCATION - Hartford, CT 1987
Skills
• BILLING (10+ years)
• COLLECTIONS (10+ years)
• Payment Posting (10+ years)
• IDX (8 years)
• MEDICAL BILLING (10+ years)
• QUICKBOOKS (10+ years)
• DATA ENTRY (10+ years)
• CPT (10+ years)
• MANAGEMENT (10+ years)
• REVENUE CYCLE (10+ years)
• claims
• Accounts Payable
• Receptionist
• Accounts Receivable
• Filing
• Microsoft Excel
• Medical Office Experience
• Practice Management
• Medical Terminology
• Medical Coding
• Managed Care
• ICD-9
• EMR Systems
• Medical Collection
• ICD-10
• Account Reconciliation
• Insurance Verification
• Bank Reconciliation
• Hospital Experience
• HIPAA
• Medical Records
• Cerner
• English
• Microsoft Office
• Anatomy Knowledge
• Management
• Documentation review
• CPT coding
• IVR
• Customer service
• Typing
• EDI
• Cash handling
• Front desk
• Audits (10+ years)
• Basic math
• 10 key calculator
• Phone etiquette
• Pediatrics
• Accounting
• Microsoft Outlook
• Primary care
• Patient service
• Medical scheduling
• Athenahealth (2 years)
• Medicare
• Healthcare management
• Laboratory experience
• Supervising experience
• Microsoft Word
• Employment & labor law
• Epic
• Medicaid (10+ years)
• Contracts (10+ years)
• Succession planning
• Microsoft Powerpoint
• Medical receptionist
• Continuous improvement
• Leadership
• Interviewing
• Team management
• Business management
• Behavioral health
• Ophthalmology
• Organizational skills
• Analysis skills
• HCPCS
• HCPCS
• Windows
• Microsoft Project
• Presentation skills
• Project management
• Communication skills
• Relationship management
• Revenue cycle management
• Writing skills
• Computer literacy
• Computer skills
• Time management
• Research
• Athenahealth
• Customer service
• Microsoft Office
• ICD-10
• CPT coding
• Organizational skills
• 10 key typing
• Revenue cycle management
• Medical terminology
• HIPAA
• Accounts receivable
• Documentation review
• Healthcare management
• Medical office management
• Hospital experience
• Leadership
• Interviewing
• Mentoring
• Supervising experience
• Payroll
• Cash handling
• ICD-9
• Clerical experience
• EMR systems
• Office experience
• Office management
• Administrative experience
• QuickBooks
• Clinic
• Executive administrative support
• ICD coding
• Medical billing
• Insurance verification
• Microsoft Powerpoint
• Microsoft Word
• Microsoft Excel
• Intake
• Communication skills
• Medical receptionist
• Anatomy knowledge
• Conflict management
• Pediatrics
• EDI
• Windows
• Medical office experience
• AdvancedMD
• Medical collection
• Typing
• Front desk
• Account management
• Bank reconciliation
• Continuous improvement
• Phone etiquette
• Office experience
Awards
NATIONAL DEAN'S LIST
FRESHMAN YEAR- BAKER COLLEGE
Assessments
Work style: Conscientiousness — Proficient
May 2024
Tendency to be well-organized, rule-abiding, and hard-working Full results: Proficient
Recruiting — Proficient
June 2022
Managing the candidate sourcing and selection process Full results: Proficient
Customer focus & orientation — Proficient
August 2022
Responding to customer situations with sensitivity Full results: Proficient
Working with MS Word documents — Proficient
October 2021
Knowledge of various Microsoft Word features, functions, and techniques Full results: Proficient
Principles of accounting — Proficient
October 2021
Preparing financial records according to federal policies Full results: Proficient
Medical receptionist skills — Proficient
May 2024
Managing physician schedules and maintaining accurate patient records Full results: Proficient
HR: Compensation & benefits — Proficient
October 2021
Knowledge of compensation and benefits programs
Full results: Proficient
Retail customer service — Proficient
August 2022
Responding to customer situations in a retail setting Full results: Proficient
Business math — Proficient
November 2021
Using basic math to solve problems in a business context Full results: Proficient
Administrative assistant/receptionist — Proficient October 2021
Using basic scheduling and organizational skills in an office setting Full results: Proficient
Spreadsheets with Microsoft Excel — Proficient
June 2022
Knowledge of various Microsoft Excel features, functions, and formulas Full results: Proficient
Supervisory skills: Motivating & assessing employees — Proficient October 2021
Motivating others to achieve objectives and identifying improvements or corrective actions Full results: Proficient
Office manager — Proficient
October 2021
Scheduling and budgeting
Full results: Proficient
Medical billing — Proficient
March 2024
Understanding the procedures and forms used for medical billing Full results: Proficient
Work style: Reliability — Proficient
October 2021
Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient
Protecting patient privacy — Proficient
June 2022
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Medical billing — Proficient
June 2022
Understanding the procedures and forms used for medical billing Full results: Proficient
Data entry: Attention to detail — Proficient
June 2022
Maintaining data integrity by detecting errors
Full results: Proficient
Protecting patient privacy — Proficient
October 2021
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Project timeline management — Proficient
October 2021
Prioritizing and allocating time to effectively achieve project deliverables Full results: Proficient
Medical terminology — Proficient
July 2021
Understanding and using medical terminology
Full results: Proficient
Written communication — Proficient
October 2021
Best practices for writing, including grammar, style, clarity, and brevity Full results: Proficient
Office manager — Proficient
July 2022
Scheduling and budgeting
Full results: Proficient
Customer service — Proficient
October 2020
Identifying and resolving common customer issues
Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
MANAGEMENT, PROJECT MANAGEMENT, SUPERVISION, MICROSOFT OFFICE, CENTRICITY, IDX, GPMS, RAINTREE, EMR/EHR, CERNER, nTHRIVE, KAREO, CENTRIX, CMS 1500, UB04, HIPPA COMPLIANCE, MEDHOST, EHS BILLING SYSTEM, AVAILITY, CMS INVOICING, QUICKBOOKS, CODING, MEDICAL BILLING AND COLLECTIONS, WRITE-OFFS, APPEALS, REGISTRATION, REVENUE CYCLE MANAGEMENT, DENIALS, FOLLOW-UP, PAYMENT APPLICATION, SYSTEM CONTRACT IMPLEMENTATION, REPORTING, MONTH-END CLOSING, REGISTRATION, ELIGIBILITY AUTHORIZATIONS, VERIFICATION, INPUT OF CHARGES, PAYMENT POSTING, RECONCILLIATION OF EOB'S AND RA'S
SHARON D. MOORE
EXPERT IN MEDICAL BILLING/REVENUE CYCLE
Contact this candidate