Data Entry Specialist
Resume:
Kimberly Treadway
*************@*****.***
OBJECTIVE
To obtain a position with an opportunity for learning and being a team player, utilizing abilities obtained through my education and experiences.
SKILLS
Aging/AR Account Follow-Up Commercial Insurance Epic Medical Billing and Coding Insurance Verification Brightree Transport Billing and Coding Authorizations Ortivus Insurance Determination Appeals HIPAA Compliance Medisoft Medical Diagnosing Medical Records Relias
Operation Diagnosis Medical/Legal Transcription PCE ICD-9/10 CM CPT Codes Bookkeeping Data Entry
Professional Billing and Coding MS Office eCW
EDUCATION
Purdue Global University, West Lafayette, IN Presently Attending Bachelors in Applied Science, Psychology
Anthem College, Phoenix, AZ
Associates in Applied Science, Medical Billing and Coding Graduated: December 2008 EXPERIENCE
Rehmann, Detroit MI 05/24 – 08/25
Billing Specialist – Mental Health Specialty
Collected data for processing claims (approved or denied) for adjudication. Tracked denied claims. Processed and tracked recoupments. Posted and reconciled payments. Reviewed medical records for duplicate statuses of claims prior to processing for determination as needed. Insight Surgical Hospital, Dearborn MI 06/22 – 03/24 AR Follow Up/Billing Specialist
Review coded claims for errors to coordinate with payer denials. Research and analyze CMS and/or Medicare guidelines and NCCI edits to support denied coded claims, UB and Professional claims, to dispute and appeal denied decisions from payers. Communicating and submitting supporting documentation necessary to prove medical necessity, including contacting hospitals for facility claims that have been denied. Review, refile, recode and appeal denied claims. Monitor and follow up on aged claims. Answer patient calls, answer questions, and take payments. Post/adjust account balances as necessary. USMM, Troy MI 07/21 – 06/22
Denial Management Specialist
Researched, verified and updated denied claims for reprocessing. Followed up with coding department to update claim for adjudication. Followed up with Medicare, Medicaid, and other insurances on claim status. Posted and worked claim denials. Called patient/family to update whatever changes were needed per their insurance carrier. Appealed claims as needed.
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