Medical Manager
Resume:
Sekai Peterson, CPC-P Home phone 772-***-****
Chicago, Il 60644
Email address ********@*****.***
Areas of Expertise
Medical Terminology
ICD-9, CPT and HCPC coding
Customer Service skills
Billed Radiology, Medi-Car, Ob-Gyne,
Internal Medicine, Podiatry, ENT,
Team lead of 8+
Front-End Supervision
UB-04 and HCFA 1500 experience Training
Front-end error Reduction
Reimbursement Specialist
Professional Experience
Gateway Foundation LLC Chicago, IL 3/2011- present
Accounts Receivable Specialist, (Quality control Manager)
Coded out-patient mental and substance abuse services (ICD-9,CPT and HCPC code sets used and knowledgeable of Rev code)
Bill and Follow- up on unpaid accounts for Medicare, Medicaid and Grant funders.
Followed up on 191 days and older large dollar accounts for Commercial insurances.
Tracked newly registered accounts for (unauthorized, charge entry and billing) inaccuracies that could potentially cause revenue loss
Distribute revenue cycle reports to Executive Management Team of accounts that weren’t properly authorized or those that are at risk of being potential revenue loss.
Insurance verification for extended Partial Hospitalization and Residential stays.
Obtain retro referrals for accounts that hadn’t been authorized and at risk of exceeding timely filing limits
Submit claims electronically to Medicare
Submit claims electronically for State of Delaware Medicaid accounts
Create and distribute monthly statements to self-pay patients
Credentialed physicians to become participating providers with Medicare.
Advanced Financial Resources Temporary Agency Chicago, IL 8/2009-3/2011
Accounts Receivable Representative (Follow-up/cash poster)
Coded mental health and substance abuse outpatient and residential services (ICD-9,CPT and HCPC code sets used and knowledgeable of Rev code)
Submitted Claims to Medicare and State of Delaware Medicaid
Created and distributed monthly statements to self-pay patients
Cash posting of approximately $2-6 million revenue on a monthly basis which included check coding of vendor and client payments in order to have monies allocated to its proper general ledger account.
Aggressively followed up and collected on Blue Cross and Blue Shield, Medicare, Medicaid and Grant funded accounts.
P.C.C.T.I- Allied Health School Chicago, IL 2/2010-10/2010
Medical Billing Instructor- Fall semester
Lectured to students on medical insurance and coding, medical law and ethics, medical billing, advanced medical coding, anatomy and physiology.
Assisted students in professional development for employment in the health information management field.
Norwegian American Hospital (acute facility) Chicago, IL 7/2003-8/2009
Biller-Follow-up/ Emergency Room Charge Analyst
Coded out-patient hospital services for 40% Obstetrics, 100% Operative Reports for Minor Surgical procedures, 100% Radiology, 100% ENT and 100% Podiatry. (ICD-9,CPT and HCPC code sets used and knowledgeable of Rev code)
Aggressively followed up and collected on Managed Care Accounts.
Managed large dollar Commercial and Workers Compensation accounts.
Created and disbursed daily financial reports to Executive Management and Revenue cycle Team.
Reviewed denied and high dollar accounts for possible reimbursement by appealing the claim or analyzing the claim form for erroneous billing by staff.
Reviewed what was considered to be problem accounts for possible reimbursement by appealing the claim or analyzing the claim form for in- house billing errors.
Performed internal auditing as part of the company Revenue Cycle process for purposes of ensuring that all billable charges had been captured but accurately entered by Emergency Room Staff and not overlooked.
Credentialed on staff physicians to become participating providers with Medicare and Medicaid.
Office Team- Temporary-Chicago, IL 10/2000-7/2003
Medical Biller/Insurance Verifier
Verified insurance, benefits and obtained authorization for 60+ charts daily
Followed up on and Re-billed any unpaid claims
Fairmonte Care Center-Chicago, IL 10/1998-7/1999
Payroll/ Accounts Payable Manager
Pulled Kronos for 250 employees
Printed and distributed checks to department heads
Issued payments to Vendors
Created general ledgers
Completed applications for Medicare Residents
Screened new applicants
Software Used
Microsoft Office-Word, Excel, Info- Path, Access, Outlook
Monarch, Zip Genius, Kronos
Meditech, IDX, Medisoft, Medical Manager, CMHC, Medi-system, Avility, Nebo and PC-ACE Pro 32
Education and Training
College of Office of Technology Chicago, IL 1997 to 1998
Medical Office Administrator-graduated
Malcolm X College Chicago, IL 1996
Certified Nursing Assistant-graduated
Certifications
Certified Professional Coder- Payer AAPC (American Medical Procedural Coding) Since 2011
Certified Medical Biller and Coding- NHA (National Healthcare Association) Since 2009
References Available Upon Request
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