Medical Billing Revenue Cycle
Resume:
Vicki Mack
Philadelphia, PA. 19154
*******@*****.***
Qualifications
A highly skilled, knowledgeable, and proficient Senior Biller bringing extensive, experience working in medical billing, collections, and customer care capacity throughout hospital and independent medical billing environments. Key qualifications: Knowledgeable in ICD-9 and ICD-10 CM, HCPCS coding and Medical terminology. Recognized for proven ability to efficiently process claims for Government, State and private carriers, Workmens Compensation and No Fault. Keenly analyse and resolves discrepancies. Extensive experience going through appropriate channels to facilitate medical claims review and appeal processes.
Experience
HGS EBOS, LLC Princeton NJ (Senior Team Leader)
02/03/14-Present
● Supervising the day to day functions of the medical billing team, which consist of training other team members, monitoring tasks as well as contributing ideas to improve practices and increase revenue.
● Provide leadership and motivation by addressing clear expectations, communicating specific performance feedback to Revenue Cycle Manager and client expectations.
● Attend meetings with Revenue Cycle Manager and client personnel to appropriately meet work volume demands.
● Prepare and submit reports to management upon request. Senior Biller
● Reduce and resolve large patient accounts (multiples, over $20k, etc.).
● Recognized for appealing denied and underpaid accounts which resulted in the appeals being overturned and reimbursement received.
● Consistently meets productivity and quality goals. Medi-Corp, Cranford NJ, 03/13-05/13
Senior Biller/Temp Position
● Follow up with insurance companies to obtain the status on claims that were not paid within the guidelines of contract agreement.
● Ensured all work is performed in accordance with targets.
● Written off accounts with balances that have exhausted all efforts, exceeded filing/appeal limits.
● Worked effectively within the team dynamic.
● Monitored claim payments from various insurance carriers and aging accounts receivable.
East Orange General Hospital, East Orange NJ, 07/03-11/12 Medical Biller/Collections
● Billed Medicaid and Commercial insurance’s to assure payment based on contracted rates inpatient drg and outpatient charges.
● Escalate collection issues to field finance managers and business as needed.
● Reviewed collections and follow ups, skip tracing and TRW reports.
● Setting up payment plans for self-pay accounts
● Billed Behavioural Health claims, PIP claims & Workmen’s Compensation claims.
Trinitas Hospital, Elizabeth NJ, 02/01-03/03
Medical Biller
● Contacted insurance companies to obtain status of submitted claims
● Made client contacts as per collection (e.g. comfort calls, emails, follow-ups)
● Submitted medicals records to insurance companies upon request
● Prepared account reviews for doctor’s assessment before sending to collections.
● Analysed problems in assigned areas and resolved conflicts. Education:
Ho Ho Kus Rets, Nutley, 04/29/13-05/29/14
Medical Billing and Coding
Certificate: NCICS
Course includes:
● Anatomy and Physiology
● Medical Terminology
● ICD-9 CM
● CPT
● Physician Billing
● Hospital Billing
Drake School of Business: Medical Office Technology Co Medical Office Technology
Certificate: Medical Office Technology
Courses Include:
● Medical Terminology
● Medical Office Management
● Windows 98-00
● Phlebotomy
● EKG
● Clinical 1 & 11
EXTERNSHIP: Trinitas Hospital, Elizabeth NJ, 01/07/01- 02/12/01 Billing commercial and state insurances for primary and secondary inpatient and outpatient claims
Personal Skills: Knowledge of medical software AS400, Gaffey, Meditech, CirCus, Medi Soft and Vanguard. Microsoft Office, Excel, and Windows, Invision, ePremise, Cerner, SSI.
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