Healthcare administration medical office med. billing & coding AR
Resume:
AMANDA PRICE
**** ***** **** ****, *** Bern, NC *8560 / 252-***-**** / *************@*****.***
An experienced leader within the healthcare industry seeking to obtain a managerial or administrative position that utilizes over twenty years of hands-on patient experience, as well as office & clerical experience.
●Ability to provide managerial support in medical office operations and staffing leadership, training, hiring and development.
●Highly capable of managing all aspects of medical billing, reconciling accounts, and ensuring accuracy and completeness of data.
●Expertly manage all front-office duties, organizing and prioritizing tasks to complete simultaneous projects within deadlines.
●Possess a solid foundation in software applications, database management, and data entry, while typing 45 words per minute with 10-key skills.
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PROFESSIONAL SKILLS
HCPCS
CPT
ICD-10 CM
Medical Terminology
Superbill
Deductibles
Training/Development
Office Manager
Electronic Medical Records (EMR)
HIPAA Compliance
Tricare
Microsoft Excel
Centers for Medicare and Medicaid
CMS 1500
CMS 1450 (UB-04)
EOBs
Revenue Cycle Management
Scheduling
Insurance Verification
Insurance Billing Procedures
Insurance Claim Processing
Fee Schedules
Outpatient / Physician
Inpatient/Facility
Co-Payments
Managed Care (HMO, PPO, and POS)
Third-Party Payers
Bookkeeping
Practice Management
Medical Office Procedures
Anatomy & Physiology
Microsoft Office Suite
Accounts Receivable
Collections & Debt Management Creating & making Schedules
Customer Service/Customer Support
EDUCATION SUMMARY
Purdue University Global
Bachelor Science in Healthcare Administration (GPA 3.0-4.0) 2016-2020
●Earned High Academic Honors Recognition/ Dean’s List
●Earned High Academic Honors Recognition/ Honor Roll
Ultimate Medical Academy
Medical Billing & Coding Diploma (GPA: 4.0) April 2014- January 2015
Earned High Academic Honors Recognition / Dean’s List
●Certificates of Completion: CMS 1500; Medicare Fraud and Abuse Prevention, Detection and Reporting; World of Medicare and Uniform Billing (UB)-4.
Pamlico Community College – Grantsboro, NC
Electroneurodiagnostic Technology/ associate in applied science 2003
●Registered in Sleep Studies; Skilled in running EEGs; Trained in performing NCVs & SSEP’s.
WORK HISTORY
CVS Health Services Medicaid prior authorization rep March 31, 2025- present (REMOTE)
Make outbound calls to physician, other pharmacies, hospitals, etc. to give the outcome of medication prior authorizations.
Ensuring that different doctors receive the info needed for different prescriptions.
Working as a team with other individuals in Medicaid, commercial & specialty offices to ensure they have the info needed for different patients.
Researching a provider’s info when unable to deliver a message to the correct number so they have the proper info regarding the patient at hand.
Knowing the difference between the Medicaid, Commercial/Exchange & Specialty offices when making calls.
RHA Health Services DSP 1st& 2nd shift Supervisor June 17, 2024- January 14, 2025
Key Achievements
In charge of supervising 1st & 2nd shift employees that provide care for individuals with intellectual disabilities that are 21 years of age and under.
Overseeing the daily duties of staff to ensure that things in the unit are running correctly, and all protocols are being followed.
Maintaining that care is provided when and how it’s always needed for the individuals we support.
Helping & aiding in providing care to our clients when and where I’m needed when we are short or in emergency situations.
Creating and making the monthly schedules for my employees.
In charge of giving disciplinary actions when warranted.
Ordering and stocking supplies
Overseeing new employees and their daily training in the correct way to provide the different types of care needed for the 26 kids we care for
Every 5th weekend I’m in charge of overseeing the entire facility and all 5 units within the building working with different staff making sure that anything needed is taken care of from, providing breaks, to sending staff out with residents to dr. appointments or the hospital, reporting any maintenance work needed, helping family members there to pick up, drop off or with concerns, reporting problems or incidents to administration, etc.
PNC Bank-Remote Customer Service Representative August 15, 2022-April 26, 2023 (REMOTE)
Key Achievements
Answering daily calls from customers regarding unrecognized charges & transactions.
Helping troubleshoot and reset customer’s online access, so they can resume seeing their online activity.
Help customers file disputes towards unrecognized & unauthorized transactions (fraud & non-fraud cases).
Assisted customers calling in with various problems; transferring to other departments, placing stop payments, assisted, and providing refunds when needed.
Assisted with answering basic questions regarding protocol, account type, recent card declines, resetting card availability and access when needed.
First line of defense when suspected fraud activity on accounts.
Customer Service & Support specialist
Cherry Point Bay Nursing & Rehab Facility- Havelock, NC Business Office Manager 10/2020-12/2021
Key Achievements
●In charge of monthly billing in a long-term care facility, collecting monthly care cost payments for long term residents.
●Verify and check insurance benefits before any new admissions to the facility.
●In charge of overseeing the long-term residents' trusts account in the facility (if a resident needed any kind of money for personal reasons, any doctor bills, etc. that need to be paid out of their accounts).
●Day to day administrative office duties like updating all EMR info that has changed in the last 12 hours, making sure all personal mail in the facility, residents & faculty, gets mailed out in a timely manner.
●Ensuring that any changes made to a new or existing residents plan of care is updated and sent to the resident representative on file.
●Making sure that each account is paid up, paid on or reimbursed if a credit is left after everything has been paid.
●Conducting financial interviews when a new arrival comes in to discuss what their insurance(s) will and will not cover in a skilled nursing facility, and whether they will be responsible for any type of payment from co-insurance.
●Head of updating any changes with a resident’s “pay status,” when a resident switches from a Medicaid to Medicare A stay and from Medicare A to Medicaid, when someone is transitioned to Medicaid pending and when they must be private pay.
Coastal Sleep Lab- Myrtle Beach, SC Sleep Technologist 11/2019-02/2020
Key Achievements
●Evaluated/documented patient care needs, while prioritizing treatments and maintaining patient flow during PSG and CPAP studies
●Educated patients regarding treatments, as well as assisted patients with multiple/chronic diagnoses including COPD and asthma.
●Treated patients with strokes, head traumas, seizures, and intracranial hematomas, as well as chronic diagnoses, including COPD and asthma.
Home Life Care- New Bern, NC Office Manager 07/2019- 09/2019
Key Achievements
●Executed accurate payroll for Certified Nursing Assistants and Personal Care Aides within the surrounding counties of New Bern ensuring compliance with all state and federal laws.
●Successfully ran weekly audit reports which provided accurate payroll processing based on the company policy and governmental insurance regulations.
●Ensured all patient demographic, medical records/forms, and care plans were updated with the EMR system. Responsible for managing front office duties including scheduling creation, equipment maintenance, and inventory, address inbound calls and email communications.
●Assisted with the training and recruitment of new CNA and PCA personnel.
Premier Sleep Solutions – Tarboro, NC / Asheboro, NC Registered Sleep Technician 01/2011 – 09/2013
Key Achievements:
●Evaluated/documented patient care needs while prioritizing treatments and maintaining patient flow during PSG and CPAP studies.
●Educated patients regarding treatments, as well as assisted patients with multiple/chronic diagnoses, including COPD and asthma.
●Treated patients with strokes, head traumas, seizures, and intracranial hematomas, as well as chronic diagnoses, including COPD and asthma.
●Assisted medical personnel with oxygen therapy.
Regional Health Services – New Bern, NC/Wilmington, NC Registered Sleep Technician / EEG Technician 01/2006 – 10/2010
Key Achievements:
●Evaluated/documented patient care needs while prioritizing treatments and maintaining patient flow during PSG and CPAP studies.
●Educated patients regarding treatments, as well as assisted patients with multiple/chronic diagnoses, including COPD and asthma.
●Treated patients with strokes, head traumas, seizures, and intracranial hematomas, as well as chronic diagnoses, including COPD and asthma.
●Assisted medical personnel with oxygen therapy.
Carolina East Medical Center – New Bern, NC Registered Sleep Tech / EEG Technician 08/2005 – 07/2010
Key Achievements:
●Evaluated/documented patient care needs while prioritizing treatments and maintaining patient flow during PSG and CPAP studies.
●Educated patients regarding treatments, as well as assisted patients with multiple/chronic diagnoses, including COPD and asthma.
●Treated patients with strokes, head traumas, seizures, and intracranial hematomas, as well as chronic diagnoses, including COPD and asthma.
●Assisted medical personnel with oxygen therapy.
Nova Pain Management – New Bern, NC NCV Technician / Medical Office Assistant 09/2004 – 05/2006
Key Achievements:
●Ordered lab tests, X-rays, MRIs, Ultrasounds, and EKGs.
●Developed patient-treatment plans, including acupuncture, physical therapy, chiropractic, and medical care.
●Performed NCV tests on patients with nerve damage and disorders, accurately documenting all findings.
●Effectively cross-trained to incorporate organizational knowledge, acting as a direct front-office support specialist.
●Familiar with dealing with patients of all ages, from infant to geriatric.
●Oversaw the running of a busy front medical office, along with overseeing entering daily charges and billing, as well as balance out the drawer at the end of every day.
Certifications
Cardiopulmonary Resuscitation (CPR) American Red Cross- Carolina East Medical Center 6/18/2024-6/2026
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