Medical Coding & Insurance Collections Analyst

Rajhea Bundy, CPC

******.******@*****.*** • 646-***-****

RELEVANT SKILLS and TRAINING

CPT ICD-10-CM HCPCS

Medical Terminology Anatomy Physiology

Quality control HIPAA Policies Coding Guidelines

NCCI Edits Medicare Parts A, B, C, D Modifiers

Coding Payment Policies Place of Service Compliance Medicaid Statistical analysis NCD and LCD Edits

Data Entry

Microsoft Office Suite

Accounts Receivable Collections

PROFESSIONAL EXPERIENCE

Remote Insurance Collections Analyst

Huron Consulting, September 2022 – Current

• Collaboration with hospital departments and leadership to identify denial trends and resolve efficiently with payors.

• Preparing appeals and reprocess of coding denials, denied charges, rejected claims and other issues affecting reimbursement.

• Oversee accounts by cross referencing open and aging A/R with insurance companies via phone or payor portals.

• Maintained high performance by establishing consistent records of achieving or exceeding project goals through acquired skills and experience.

• Demonstrated leadership by making improvements to work processes to help train others.

• Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future issues.

• Coordinate with billing and coding teams to ensure CMS guidelines are maintained in processing of claims.

• Analyzing accounts to determine risk and review loss reports with upper management. Remote Customer Care Team Lead

Valvoline, January 2022 – August 2022

• Improved operations by collaborating with customers and team members to find workable solutions.

• Supervised team activities to provide constructive feedback and keep peers on track.

• Mentored new members on strategies and pertinent company information to maximize performance.

• Provided superior customer service, ensuring efficient department operations.

• Process incoming and telephone calls, resolving customer issues and directing calls to appropriate destinations or supervisory personnel as needed.

Billing Coordinator I

NYU School of Medicine, November 2019 – September 2021

• Managed medical billing processes, verifying accuracy, submitting claims, and appealing incorrect payments for maximum reimbursement.

• Determine root causes for issues that impact revenue retention.

• Execute work plans to correct identified deficiencies in billing.

• Provide education related to updates and improving workflow to multiple staff levels to ensure optimization.

• Organized monthly reviews of office procedures as they relate to charge submission and recommends suggestions, ideas and solutions to improve operational processes.

• Queried providers to obtain information, documentation, and patient data to ensure compliant and complete patient documentation and medical records.

• Reviewed office procedures for efficacy, providing education and implementing operational changes at needed.

• Maintained quality accuracy rate while meeting and exceeding production goals, supporting fellow coders in the same goal.

Accounts Receivable Analyst

Eschen Prosthetic and Orthotic Labs, August 2018 – October 2019

• Increased weekly revenue over 200%

• Utilized insurance rejections and denials, analyzing trends and patterns to identify documentation compliance risks.

• Analyzed Account Receivable claims, resolving denials, incorrect coding, and improperly reimbursed claims.

• Developed payor projects to combat denial trends and denial prevention.

• Recovered over 500k in funds due to incorrect denials from various insurance companies.

• Review insurance contracts to gain thorough understanding of payment methodologies, NCCI edits and CMS guidelines.

Medical Billing Specialist

Northwell Health South Oaks Hospital - Mar 2012 Jul 2018

• Perform charge entry, payment entry and coding to ensure accurate completion of coding for all assigned physician specialties.

• Notify coding team and physicians when discrepancies are identified for correction.

• Identify cause of rejections and chooses most appropriate methods to resolve them.

• Performed billing, collections, third party reimbursements, computer data entry and retrieval.

• Conducted review of physician's coding and identify possible conflicts and notified physicians when discrepancies are identified for correction.

PROFESSIONAL AFFILIATIONS and CERTIFICATIONS

American Academy of Professional Coders (AAPC), Member in good standing

• Certified Professional Coder (CPC)

EDUCATION

Capella University

• Bachelor of Science Degree, Healthcare Administration, Health Information Management, In progress

Sanford Brown College

• Certificate, Medical Billing and Coding

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