Data Analyst Health Care
Resume:
Linda L. Abreu
*****.***.*****@*****.***
PROFESSIONAL SUMMARY
A talented, creative, technically-savvy, results-oriented medical data analyst and accounting professional with a proven record of success in multiple industries including health care, government, non-profit, and for-profit entities.
OFFERS THE FOLLOWING EXPERTISE:
• Insurance claim processing and analysis of policy requirements and payment practices
• Financial budgeting, billing and invoicing
• Strong organizational, written and oral communication skills
• Medical Terminology and administration education
• Proficient with Microsoft Office components and various database software
• Extensive and diverse accounting experience including treasury management, credit, collections, cash application, billing, month-end accounting close, general ledger analysis and month-end financial procedures and reporting
SOFTWARE EXPERIENCE
• Databases: Microsoft Access, Microsoft FoxPro, Sybase, Paradox Accounting Software: QuickBooks, Quicken
• EMR / EHR: MEDENT, Medware, CDC’s CaST (Cancer Screening and Testing) system Operating Systems: Microsoft Windows 7, Windows XP, Windows 95
• Languages: HTML
• Publishing: Adobe InDesign, Microsoft Publisher
• Word processer / Spreadsheet: Microsoft Word, Excel, WordPerfect, Lotus 123 WORK EXPERIENCE
PrideStaff - Home Health Care Agency
February 2019 – Present
• Perform all billing functions using Availity daily
• Ensured all CPT codes and ICD10 codes are correct before submitting to TriWest
• Ensured all authorizations are active
• Performed all payroll functions bi-weekly
• Managed all receivables
DATA SUPERVISOR
State of Arizona
February 2018 - February 2019
• Timely filing to CDC regarding the Breast and Cervical Procedures and that all CPT codes were correct.
• Adhered to strict guidelines and submitted twice to CDC to ensure continued funding.
• Managed 4 people on the team.
MEDICAL RECORDS DATA ANALYST
Arizona Department of Health Services via Kelly Services, Phoenix, AZ July 2014 to February 2018
• Billing and entering date for the Breast and Cervical and Colorectal programs.
• Review charge documents for accuracy of codes based on established billing guidelines and completeness of charges/diagnoses by specialties.
• Prepares charge tickets for Data Entry staff and run hash types for completed batches making sure the total of hashed procedures matches the total indicated in billing system.
• Communicates coding changes to physicians; offices. LAB DATA ANALYST
Arizona Department of Health Services via Kelly Services, Phoenix, AZ January 2013- June 2013
• Entering charges for newborn screenings.
• Collections for unpaid accounts.
• Ensuring all CPT and diagnosis codes used were correct ACCOUNTANT
Cigna Health Insurance via Kelly Services, Phoenix, AZ June 2011 to January 2013
• Entering charges on a daily basis using a specific program.
• Performing accounting functions using Excel and Word Perfect.
• Accuracy and speed very important.
• Heavy email to departments to ensure protocol was met.
• Deadlines very important. Worked overtime as needed. CERTIFIED MEDICAL CODER
Valley of the Sun Professional Health Consultants, Youngtown, AZ February 2010 to May 2013
• Billing/Collections/Medical Coding for all super-bills.
• Posting insurance payment to accounts.
• 1st and 2nd level appeals. Followed an aging report. Patient billing. Bank Deposits.
• All electronic billing for Medicare and all insurances. Setting office up for EFT’s.
• Heavy website usage for all Medicare and other insurances to query claim and check status. Electronic billing.
• Heavy interaction with Medicare. Involved in auditing processes. Prepared financial statements. MEDICAL BILLER / COLLECTOR
CMED Billing Company, Waterford, CT
October 2007 to September 2009
• Billed and collected on podiatry and internal medicine claims.
• Appeal letters daily to insurance companies.
• Posted payments to all accounts from insurance companies including Medicare and Medicaid. Posted payments from patients.
• Wrote appeal letters when necessary.
• Handles all workers’ compensation and auto claims.
• Verified eligibility using the web and handled all patient telephone calls.
• Electronic billing and electronic submission.
• Used Sequel Med, Microsoft Word and Excel.
MEDICAL CODER
Community Eye Care Specialists
September 2005 to September 2007
• Acute care experience. Operative, Anesthesia, Emergency and Cardio experience.
• Medical Abstractor/Medical coding, billing and surgery billing, transcription.
• Obtaining referrals and authorizations. Verifying Medicare, Medicaid and other insurances including Workers’ Compensation and accident claims/Third party payers.
• Posting payments to patient accounts. Scheduling appointments. Dealing one on one with patients. Working on aging daily 90 days and older. Submitting claims electronically. Heavy data entry by entering all demographics and insurance information.
• Clinical Abstractions/medical record review. Scanning documents daily. Surgery and Anesthesia billing for UB92.
• Credentialing doctors to participate with insurances. Verifying all demographics.
• Training new employees. Interviewing potential new employees.
• Money receipts and daily deposits. Excellent knowledge of ICD9 and CPT.
• Software: Medware, Excel, Microsoft Word, QuickBooks. WORKERS COMPENSATION ANALYST
SCF Arizona (now CopperPoint Mutual Insurance Company) September 2002 to August 2005
• Use of Medical Terminology; claims management and/or health industry experience.
• Selecting correct diagnosis codes and CPT codes for Workers’ Compensation claims.
• Paid claims daily. Responsible for distinguishing between Time Loss Claims from Medical Only Claims.
• Obtaining claim information through document research to determine appropriate type of claim management processing.
• Understanding and interpreting Arizona Statutes. Coding Medical Claims with appropriate diagnosis codes.
• Medent, Microsoft Word, and Excel.
BILLER / COLLECTOR
Gentiva Health Services - Phoenix, Arizona February 1996 to December 1999
• Billing on UB92 and HCFA 1500's manually and electronically. Dealt primarily with AHCCCS accounts. Follow-up on all accounts.
• Daily posting and balancing of incoming payments to individual accounts. Issuing check requests for duplicate payments made by providers and reconciling Medicaid and insurance accounts including problem accounts.
• My efforts on past-due accounts resulted in successfully collecting $19 million.
• Software: Excel, Microsoft Word, Power Point, and the AS400 system. JUNIOR ACCOUNTANT
Honeywell IAC - Phoenix, AZ
June 1989 to January 1996
• Billing and Collection of unpaid invoices. Heavy volume of journal entries monthly.
• Balancing to the general ledger. Data entry of all payables. Posting checks daily to open accounts.
• Prepared FRAMS monthly. Balanced to the general ledger. Year end closing-inventory
• Software: WordPerfect, Harvard Graphics, Lotus, Peachtree, and Oracle EDUCATION
Master of Business Administration
Arizona State University, 1996 -1998
Bachelor of Science, Accounting
Western International University, Phoenix, AZ, May 1995 Associate of Science, Accounting
Glendale Community College, Glendale, AZ, June 1993
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