Delivery Driver Customer Service
Resume:
BRANDY MILLER-BROWN
Rapid City, SD *****
************@*****.***
I am a US citizen and am authorized to work in the US for any employer. WORK EXPERIENCE
CUSTOMER SERVICE LOGISTICS DELIVERY DRIVER
JeffBennett Transportation Erickson Ranch Road Rapid city SD 57703 October 2023 to October 2024
Full time hours per week plus overtime daily. Commission of drop payment per piece. Local deliveries around the hills area. Loading & unloading of many different products for customers. MEDICAL BILLING CLAIMS SPECIALIST
Black Hills Regional Institute 605-***-**** Supervisor: Jean O - Rapid City, SD 57701 June 2023 to August 2023
Full time per hourly wage of $21.00 per hour
Job Duties:
Coding physician encounters for practice management of optometrist encounters using ICD-10, CPT, E&M, and HCPCS codes. UB-04 & CMS1500 filing to clearing house for submission approval. Managed various doctor’s schedules of medical claims, ensuring proper claim coding with compliance of CPT and ICD-10 guidelines. To fulfill semi completed claims to payers in a timely fashion. Submit billing data to the appropriate insurance providers. Processing of professional and facility claims. Resolve denial instances. Achieve maximum reimbursement for services provided. Deploy, maintain, and report on various programs independently working on quality and quantity. Basic computer skills, such as sending emails, typing, and using spreadsheets. Interact with clients and patients. Collaborating well with others in a respectable manner. Knowledge of Medicare, Medicaid, and third-party reimbursement methodologies of local, state, and federal healthcare regulations.
I can demonstrate critical thinking skills to manage day to day basic operations, manage my own queues and the ability to seek assistance from my team with respect. MEDICAL CLAIMS PATIENT ACCOUNTS SPECIALIST AUITOR
Black Hills Surgery Hospital and Same Day Surgery Center 605-***-**** Rapid City, SD 57701 October 2022 to February 2023
Full time per hourly wage of $22.00 per hour
Job Duties:
Identify discrepancies and areas of improvement in billing and coding processes Effective communication skills. Extensive writing capabilities / efficiencies. Ability to write professional appeal letters. Ability to organize details logically and accurately. Collaborate with healthcare providers and management to implement corrective action plans. Provide training and education to coding staff to improve accuracy and compliance. Prepare detailed audit reports and present findings to senior management. Review medical records and audit for accuracy of codes (diagnoses and procedures). Maintain up-to-date knowledge of coding guidelines and reimbursement reporting requirements. Focus on continuous process improvements via conducting comprehensive audits of ED, ED-Observation, and Ambulatory Surgery accounts to ensure compliance with healthcare regulations and standards. Ability to make good judgments in demanding situations by frequent changes in duties and volume of work. Can relate to the medical necessity for hospital services to effectively communicate in writing. Ability to communicate with multiple levels in the organization (e.g., managers, physicians, clinical and technicians. Positive, can-do attitude coupled with a sense of urgency. Ability to maintain a strong relationship with various clinical and non-clinical team members to positively affect financial outcomes. Can multi-task with ease and efficiency. Self-starter with a willingness to try current ideas, work independently and be result oriented. Effective interpersonal skills, including the ability to promote teamwork. Ability to ensure an elevated level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders. Ability to use various computer applications including EPIC. Provided excellent PC operating skills (keyboard, mouse) and use of MS Office. I have a broad knowledge of health care business office practices and principles. Maintaining confidentiality of sensitive information adhering to HIPPA guidelines and rules of PHI. REMOTE WORKER ASC MEDICAL CODER AND AUDITOR
UHC-United Health Group Retrospective Audits 1-610-667-7700The Judge Group - Wayne,PA July 2021 to November 2021
Full time per hourly wage of $26.50 per hour
Job Duties:
Reviewed outpatient medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to risk adjustment. Ensure that the diagnosis codes for each chronic or major medical condition have been captured and submitted within the permitted timeframe.
Assess adequacy of documentation of claims and query outpatient provider claims to obtain proof of medical record documentation or to clarify documentation to ensure accurate and appropriate coding. Audit provider documentation ICD10 codes to ensure adherence with CMS Risk Adjustment guidelines. Participated in departmental and physician network performance improvement initiatives. Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.
ON SITE USAF BASE IN SD OUTPATIENT MEDICAL PROFEE AND FACILITY CODER AND AUDITOR Distinctive Home and HealthCare 301-***-**** ext#200 Contractor for government Bowie, MD January 2021 to June 2021
Full time per hourly wage of $24.50 per hour
Job Duties:
Applied practical knowledge of medical coding to outpatient MTF encounters using, ICD-10, CPT, E&M, and HCPCS codes demonstrating Resource-Based Relative Value Scale (RBRVS) Ambulatory Payment Classifications (APC’s) reimbursement levels. Adhering to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Monitoring ever-changing regulatory and policy requirements affection coded information for the full spectrum of services provided. Reviewing encounters and/ record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality of patients care. Extracting required information from GENESIS, AHLTA, or CHCS and entering the corrected NCCI edits into 3M encoder coding system.
Assigning codes to the encounters that qualified for the MEAT/ HCC capture of any chronic conditions by abstraction of statistical information from medical charts. Managed all ancillary and Covid clinic subspecialties to ensure proficiency with proper coding concepts and compliance of coding guidelines.
Communicating with technicians, nurses, and providers as a source of reference for coding questions via verbal and written/email communication regarding medical records documentation/education with one-on-one training when schedules permit time for support of coding proper sequences resulting from AFMS audit reviews.
Conducting evaluations of providers coding and making recommendations for change following DHA/MTF quality assurance. Identifying any conflicting, ambiguous, or incomplete significant reportable condition asking for facts based upon his or her judgment of the medical encounter by email or face to face review. Creating the coding education power points and training ed sheets that are used for coding education to ensure ethical, accurate, and complete coding for staff meetings. Performed a variety of technical complex duties involved with auditing, reviewing, and analyzing medical data & medical records contributing to IAW DHA & AFMS MCPO standards and MTF is following all regulatory bodies of agencies and coding guidelines. Performing focused audits of initial and annual coding compliance training and reporting of potential violations.
Tracking and aided with write back errors, CAPERS, or coding of clinical errors of coding cause of missed documentation transmitting to proper change of command. Promptly coding of all billable encounters to 100% accuracy rate and monitoring/coding 10% of all daily unbillable accounts to ensure records were coded properly, signed, and significant data is recorded, and corrections are made to validate the data transmittal through different government computer systems. Software used: AHLTA, CHCS, MHS GENESIS, DEERS, CIS, CCE, QAS, 3M ENCODER, EPIC ON SITE USAF BASE IN SD OUTPATIENT MEDICAL PROFEE AND FACILITY CODER AND AUDITOR Sterling Medical Corp. 513-***-**** Contractor for government Cincinnati, OH 45219 September 2019 to December 2020
Full time per hourly wage of $24.50 per hour
Job Duties:
Applied practical knowledge of medical coding to outpatient MTF encounters using ICD-10, CPT, E&M, and HCPCS codes demonstrating Resource-Based Relative Value Scale (RBRVS) Ambulatory Payment Classifications (APC’s) reimbursement levels. Adhering to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Monitoring ever-changing regulatory and policy requirements affection coded information for the full spectrum of services provided. Reviewing encounters and/ record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality of patients care. Extracting required information from GENESIS, AHLTA, or CHCS and entering the corrected NCCI edits into 3M encoder coding system.
Assigning codes to the encounters that qualified for the MEAT/ HCC capture of any chronic conditions by abstraction of statistical information from medical charts. Managed all ancillary and Covid clinic subspecialties to ensure proficiency with proper coding concepts and compliance of coding guidelines.
Communicating with technicians, nurses, and providers as a source of reference for coding questions via verbal and written/email communication regarding medical records documentation/education with one-on-one training when schedules permit time for support of coding proper sequences resulting from AFMS audit reviews.
Conducting evaluations of providers coding and making recommendations for change following DHA/MTF quality assurance. Identifying any conflicting, ambiguous, or incomplete significant reportable condition asking for facts based upon his or her judgment of the medical encounter by email or face to face review. Creating the coding education power points and training ed sheets that are used for coding education to ensure ethical, accurate, and complete coding for staff meetings. Performed a variety of technical complex duties involved with auditing, reviewing, and analyzing medical data & medical records contributing to IAW DHA & AFMS MCPO standards and MTF is following all regulatory bodies of agencies and coding guidelines. Performing focused audits of initial and annual coding compliance training and reporting of potential violations.
Tracking and aided with write back errors, CAPERS, or coding of clinical errors of coding cause of missed documentation transmitting to proper change of command. Promptly coding of all billable encounters to 100% accuracy rate and monitoring/coding 10% of all daily unbillable accounts to ensure records were coded properly, signed, and significant data is recorded, and corrections are made to validate the data transmittal through different government computer systems. Software used: AHLTA, CHCS, MHS GENESIS, DEERS, CIS, CCE, QAS, 3M ENCODER, EPIC MEDICAL BILLING CLAIMS SPECIALIST AUDITOR
Rapid City OB/GYN 605-***-**** Private Practice Clinic Supervisor: Cari Simonson - Rapid City, SD April 2017 to March 2018
Full time per hourly wage of $19.50 per hour
Job Duties:
Medical Billing & Coding/Revenue Cycle Specialist Claim Filing, NCCI edits, Claim Denials, UB-04 & CMS1500 Filings
Coding patients for practice management of OBGYN encounters using ICD-10, CPT, E&M, and HCPCS codes.
Managed submission of medical claims, ensuring proper claim coding with compliance of CPT and ICD-10 guidelines.
Communicating with internal and external customers via verbal and written communication, and performs follow-up on claims when necessary, and appeals claims when denied. Processing of claims to Medicare, Medicaid, or government-assisted programs and most of the current to date insurance carriers in the open market and workers compensation programs. I improved the use of the electronic billing/EHR medical records system with in the intra office management to upload and process fee-schedules with management for better billing practices. Willing to be accessible to other departments upon demand for inquiries regarding reimbursement. I can demonstrate critical thinking skills to manage day to day basic operations or the ability to seek assistance when needed.
Managed my own work queues and created the billing cycle claims that are created by the physicians in the office. I work steadily, efficiently and will show constant vigilance to the details of the work. I can utilize all office equipment including personal computer and application software, printer, FAX, copier, multi-line telephone system.
Knowledge of all insurance and/or government claims submittal and appeal processes. I can use appropriate reference materials when needed. I can multi-task when/if needed. Software used: e-Clinical, NextGen, Windows Excel, EPIC, Optum, Noridian, SD HHS systems. MEDICAL CLAIMS PATIENT ACCOUNTS SPECILIST
Regional Health Care and Hospital - Rapid City, SD January 2016 to March 2017
Starting wage: $12.50 per hour Phone: 605-***-**** Job Duties:
Ability to make good judgments in demanding situations. Ability to react to frequent changes in duties and volume of work. Effective communication skills. Extensive writing capabilities / efficiencies. Ability to listen empathetically. Ability to write professional appeal letters. Ability to organize details logically and accurately. Ability to construct an effective argument related to the medical necessity for hospital service. Ability to effectively communicate in writing.
Ability to communicate with multiple levels in the organization (e.g., managers, physicians, clinical and support staff)
Ability to maintain a strong relationship with various clinical and non-clinical team members to positively affect financial outcomes.
Ability to manage multiple tasks with ease and efficiency. Ability to work independently and be result oriented. Positive, can-do attitude coupled with a sense of urgency. Effective interpersonal skills, including the ability to promote teamwork. Strong problem-solving skills
Ability to ensure an important level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders. Ability to use various computer applications including EPIC. Provided excellent PC operating skills (keyboard, mouse) and use of MS Office. I have a broad knowledge of health care business office practices and principles. I have a degree in Business Management and can-do basic math skills and knowledge of general accounting principles. I strive in knowledge of business office policies and procedure. I will maintain confidentiality of sensitive information adhering to HIPPA guidelines and rules of PHI.
Software used: Legacy DOS systems, NextGen, Optum, Noridian, BCBS, Noridian, EPIC Independent Life and Health Insurance Agent
Ozark National Life Insurance Company and N.I.S. Financial Advisor's - Kansas City, MO January 1998 to December 2002
Independent Sales Agent of Life and Health Insurance Policy’s REGISTERED REPRESENTATIVE OF A BROKER/DEALER SECURIETIES AGENT Education
Bachelor's degree in business management
National American University-online campus - Rapid City, SD, Summer of 2017 to December of 2019
Associates degree in H I M and Medical Coding
Western Dakota Technical College - Rapid City, SD, US Fall of 2013 to Spring of 2016
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