Remote Medical Billing/Data Entry Specialist

Melba Dawn Kermode

*** ********* ***., ******, ** 36303 ■ Phone 602-***-**** ■ Email: *********@*****.*** OBJECTIVE

To obtain work from home employment that will provide a flexible schedule while continuing to utilize and build my skills and knowledge as well as positively impact my employer, co-workers and clients/customers. STRENGTHS

• Excellent communication skills • Excellent word processing and data entry skills • Knowledge of radio transmission and clerical procedures and systems • Ability to manage and impart confidential information including HIPAA compliance • Excellent organizational skills and ability to multi-task effectively • Consistent accuracy/verification of data entry and error correction • Knowledge of medical terminology • Working knowledge of Availity, both Medicaid and private insurance portals, Dentimax, MS Office (Word/Excel/ Powerpoint/One Note/etc), Athena, ProQA, TriTech CAD/RMS(Computer Aided Dispatch/Record Management System)Health EMS, RPMS (Resource and Patient Management System) EMPLOYMENT

March 2024 - present A to Z Dental Services Remote Contract Work Dental Billing Specialist

• Completes all billing processes including claim creation, claim submission, posting/distributing EOBs, research/ resubmission of denied claims, creates and submits Prior Authorizations for procedures as required.

• Reviews all claim information for accuracy, correcting any incorrect data and locating necessary attachments

• Performs insurance eligibility checks, verifies procedures that are/are not covered benefits and copays/deductibles

• Communicates with office staff and dentists regarding claims, missing documentation, incorrect information, required updates

• Resolves unpaid claims by searching portals for EOBs, contacting insurances by phone and email, and submitting appeals as needed

September 2023 - June 2024 Southern Bone and Joint Specialists Dothan, AL Surgical Coding Assistant/Medical Biller

• Reviewed surgical notes, created claims and ensured ready to submit to insurance

• Searched for and saved all in and out-patient surgical notes as well as consultation notes.

• Updated patient information/added new patient information from multiple hospital and surgical center databases

• Prepared daily sheets for surgical coders, verified information previously entered on sheet was correct

• Posted and distributed EOBs - check payments and credit card payments, entered payment totals into Athena software for revenue cycle tracking

• Documented and tracked missing surgical notes and other documentation required for claim submission.

• Worked with Prior Authorization department to assist with creation/submission of Prior Authorization requests for private insurances and medicaid

November 2014 - July 2023 Gila River Police Department Sacaton, AZ Public Safety Telecommunications Supervisor

• Promoted to Shift Supervisor 3/2022

• Oversaw shift of 5 dispatchers, performed administrative duties including time sheet approval, employee schedules, assisted with shift coverage, updated information for locations in CAD program, assisted department manager with special projects as assigned, responsible for internal and external complaints, processed recording requests.

• Answered both 911 and admin line calls, interviewing callers to determine nature of emergency and location

• Quickly entered calls for service using CAD system to be dispatched out by radio operators

• Performed radio operator duties using CAD system and radio communications to dispatch out all Police, Fire and EMS calls as they come in via phone or radio, including tactical radio channels for priority incidents

• Conducted background checks using in house records system and NCIC/ACIC databases for multi state motor vehicle records and Warrant checks, as well as made new entries, modified existing entries and removed cleared/ cancelled/invalid entries

• Certified Training Officer - trained new hires in all aspects of telecommunication duties

• Created documentation system for local warrant entry to ensure proper verification of alerts in RMS and CAD May 2012 – October 2014 Gila River Health Care Sacaton, AZ Transportation Biller

• Received, researched to ensure accuracy and paid transportation claims from outside companies

• Prepared monthly reports reflecting number of transports, claims paid, payout amounts

• Assisted with AHCCCS billing of GRMTS claims

• Processed fuel receipts for reconciliation to monthly statement

• Fielded questions regarding patient eligibility based on procedure and location of transportation

• Served as a member of the GRHC Employee Events Committee Education:

CPR/APCO PST 1, CTO and Fire Communications/NIMS ICS-100, ICS-200 & ICS-700/Emergency Medical Dispatch certifications, Pro QA IAEMD certification, Ajo Ambulance First Responder training, National Registry First Responder Certification, 2008 (not renewed). Degree: Eastern Arizona College, Thatcher, AZ AA Liberal Studies, 1993

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