Medical Insurance

Renee Shorte

Pleasant View Gardens ** B Rutgers Road Piscataway, New Jersey 08854

Home: 732-***-**** - Cell: 908-***-****

Email: ***********@*****.***

Objective

To obtain a challenging position in a career oriented hospital or medical practice utilizing my office and computer skills, and assist in efficient productive company operations. Make use of my skills to their fullest potential with an opportunity for advancement and stability within the company.

Qualification Summary Skills

• Proficient in Medical Insurance Billing, Medical Terminology, Medical Coding, and Medical Transcription.

• Accounts receivable, Collections, and Accounts Payable

• Hardworking, motivated, energetic, dedicated, and professional individual able to serve clients in a conscientious and pleasant manner.

• Outstanding oral and written communication skills.

• Extensive knowledge of Data Entry 8000-9000 KS, inventory and telephone systems.

• Strong ability to multitask, organized, disciplined, attention to detail, and detail oriented.

• Medical software knowledge: Medisoft, Medical Manager and Office Hours, CPT-4 coding, ICD-9 coding, CM1500 forms and UB92 forms; Microsoft Office, Excel, Good figure aptitude, ACT, Medi Tech Software, Paper Vision, IDX, INDA system.

• Medical Billed and Collections for Ophthalmology, Cardiology, Orthopedic, Internal Medicine, In and Out Patient Facilities (Hospitalization) services

• Can type 65 wpm.

• Ambitious, Conscientious

Work Experience:

Contract Positions: October 2009 to November 2011

Medicor Cardiology, PA. Hillsborough, New Jersey - A/R Resolution Analyst February 2011 – November 2011

Responsibilities:

• Billing for medical (government Medicare/Medicaid) and all commercial carriers, following up on unpaid accounts or denying claims for their status, heavy data entry tasking, answering phones, filing, faxing and copying documents

• Collections (self pay accounts)

• Accounts Payable , Accounts Receivable

Children’s Specialized Hospital Mountainside, New Jersey- Third Party Analyst Accounts Reimbursement Specialist April 2010 – September 2010

• Remitted appeals, negotiated payments

• Verified Medicaid statuses using ePACES and NJ MMIS on line systems.

• Administrative office assignments, documenting clinical notes, filing and maintaining health information records.

• Verification and confirmed patient eligibility and insurance benefits, processed HCFA 1500 and UB04Other responsibilities

Spartan Detective Agency Union, New Jersey - Private Investigator Assistant October 2009 – April 2010

• Skip tracing, social security searches, corporate searches, non-military skill checks

• Tax / Lien searches, Abatements

• Completed tax searches, requested by law firms in foreclosure matters.

Accounts Receivable Reimbursement Specialist: December 2004 - February 2009 McKesson Provider Technologies Somerset, New Jersey

• Responsibilities include: oversaw accounts receivable for three (3) Orthopedic Surgeons that rendered services for UMDNJ Hospital, Hackensack University, Overlook Hospital, and Jersey City Hospital.

• Accountability included supervising three (3) employees in conjunction with overall business operations.

• Posted payments accordingly to applicable physician accounts (Accounts Payable).

• Rendered physician billing to commercial insurance carriers, workers compensation, personal injury protection (PIP Claims) and government insurance carriers i.e. Medicare, Medicaid, and NJ Blue Cross and Blue Shield

• Composed proposals, negotiated agreement contracts in regards to “High Dollar Accounts” as well as appeals and arbitration

• Rendered collection reports, kept account accounts receivable reports from rolling over into collections

• Rendered medical collections regarding accounts that were self-pay, physician, and insurance liabilities for accounts beginning from thirty (30) through one hundred eighty (180) days past due

Emergency Room Department Unit Secretary Coordinator (Per Diem):

March 1997-October 2004 Muhlenberg Regional Medical Center Plainfield, New Jersey

• Responsible for maintaining and ordered stat orders in the ER (emergency room) with specifics from Medical ICU (intensive care unit), CCU (critical care unit) ER physicians, specialist and residents on duty.

• Entailed multitask and extensive duties within the emergency room of the hospital for the emergency room staff

Dr. Phillip M. Miller, MD. / Laser Vision Correction Center of NJ /Miller Ophthalmology Assoc. LLC: 1987-1991 West Orange, New Jersey

• Multi tasked secretarial duties

• Answered patient, pharmacy, physician, hospital, and insurance calls accordingly

• Scheduled appointments (office), pre-admission tests, surgeries, post-operative visits, and confirmed scheduled appointments within 24 hours of the date

• Verified Medicare, Medicaid, HMO, PIP, Workers Compensation, and Commercial Insurance carriers for billing purposes

• Obtained pre-certification/authorizations and referrals applicable to the insurance contract and or insurance carriers

• Filed and pulled patient charts accordingly

• Billed Medicare, Medicaid, and Commercial Insurance Carriers for specific Ophthalmic tests and or surgeries i.e. Visual Fields, Laser treatments, Cataract Extractions

• Rendered Self Pay/ Collections

• Accounts payable applied/posted payments to their accurate accounts, rendered adjustments according to their insurance policy contracts, rendered write offs appropriately (no patient liability)

Education:

Union Catholic Regional High School College Preparatory High School Diploma Earned June 1986 Scotch Plains, New Jersey

Rider College / Business Management, Business Law September 1986- June 1989 Lawrenceville, New Jersey

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