Medical Biller & Coder - Texas Healthcare Revenue Specialist

Jerusula Bunton

Medical Biller & Coder - North Texas Kidney Disease and Associates Red Oak, TX 75154 *************@*****.*** +1-214-***-****

Professional Summary

To continue experience in the medical field

Authorized to work in the US for any employer

Work Experience

Utilization Review Specialist

Shield Healthcare

August 2021 to March 2025

Contact doctors and Healthcare professionals in order to obtain information for order processing and documentation

Call Healthcare professionals for information related to prescription requests

Type authorization information into Core2

Answer questions from Healthcare professionals regarding documentation for patient services

Work renewal reports provided by management

Keep Core2 Pending Doc Queues, Enterprise Workflow and Salesforce incidents current

Miscellaneous projects as assigned

Review orders to determine if orders meet all requirements to be ready to ship.

Medical Biller & Coder

North Texas Kidney Disease and Associates-Lewisville, TX

October 2013 to May 2021

Billing supervisor, responsibilities include billing dialysis capitation charges for a group of 18 nephrologists using electronic system called intergy, and PMD. Billing and coding daily hospital charges using ICD-9 and ICD-10 codes, performing random audits of hospital subsequent charges confirming proper levels are being billed correctly. Entering demographic information from face sheets requested and pulled from hospital websites, verifying insurance coverage, obtaining authorizations/referrals when need.

Accounts Receivable Rep

Diversified Health Care-Richardson, TX November 2011 to February 2012

Assisting patients with balances that are due after insurance have been applied, along with billing on claims that have not been submitted to insurance. Assisting with setting patients up on a payment plan self-pay accounts, offering financial assistance for those who qualify, along with offering settlements on qualifying accounts. Withholding a call volume of 150 calls per day,

Patient Account Rep

Cymetrix-Lewisville, TX

May 2011 to November 2011

Assisting patients with balances that are pending insurance payments, balance after insurance payments, as well as self-pay accounts. Set patients up on payment arrangements that meet guidelines of the clients, offer settlements when able. Rebilling of insurance if needed. hms

Insurance Verification-Irving, TX August 2010 to March 2011

Producing online, and telephone verifications for insurance policy holders. Verifying information such as benefits, policy type, co-pay, deducible, earliest effective date without breaks in coverage, term dates if needed, type of policy. Meeting daily quota of 200 verifications per day, and at least a 95% QA

NCO Financial Systems

Financial Sys-Richardson, TX

April 2009 to July 2010

Contact patients of outstanding balances from hospital, setting up payment arrangements to bring patient out of debt, verifying insurance if available, and payments over the phone.

Collections Agent

Citi Group-Irving, TX

June 2008 to January 2009

Contacted customers and assisted with past due accounts, offered advice for maintaining good credit (Recognized for low call wrap up time & collecting $10,000 per hour.

Education

Certificate

Sanford Brown Institute-Dallas, TX

April 2009

Skills

•Organizational skills

•Communication skills

•Medical coding

•Dialysis Experience

•Medical Billing

•Medical records

•ICD-9

•EMR systems

•English

•Benefits administration

•Insurance Verification

•Classroom management

•39 WPM (Less than 1 year)

•Customer service

•Caregiving

•Medical billing

•Medical Coding

•Resident's rights

•Home & community care

•Bilingual

•CPT Coding

•ICD-10

•MediSoft (Less than 1 year)

•Classroom experience

•Home health

•Falcon (Less than 1 year)

•ADLs

•Windows

•CPT coding

•HIPAA

•Patient monitoring

•Typing

•Medical Insurance

•Medication administration

•Microsoft Office (Less than 1 year)

•Computer skills

•EMR Systems

•Billing (4 years)

•Medical terminology

•Workers' compensation law

•Medical office experience

Certifications and Licenses

CPR Certification

Driver's License

Certified Medical Assistant

Additional Information

TECHNICAL SKILLS

Intergy, MediSoft, PMD, Falcon, Microsoft Office, Spring Charts, Billing, Insurance Verification, Type: 39

WPM

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