Medical Billing, Analysis
Resume:
Detroit, MI. ***** Phone 313-***-**** / cell 313-***-****
E-mail mstewart1957@ymail,com
Marva Joanne Stewart
Objective To obtain a position that will let me further explore my potentials as a qualified Medical Billing / Coding Professional in order to help other business obtain their goals.
Education 2003-2006 Central Michigan University Troy, MI
Masters of Art in Education
1999-2000 Siena Heights University Adrian, MI
Bachelors of Arts Degree
1991-1998 Wayne County Community College Det., MI
Associates of Arts Degree
April 2008 Wayne County Community College Det., MI.
Certification in Grant Writing
Work experience 2/21/77-7/09 Blue Cross Blue Shield of MI Det., MI.
3/09-10/09 Kaplan Career Institute Instructor Det, MI.
Kaplan Career Institute Instructor
• Provided instruction to students on Medical Coding, Medical Insurance, Basic English, anatomy, power point presentations and all other inclusive curriculums.
Medical Biller/Coding Specialist Federal Employee Program (FEP)
Blue Cross Blue Shield of Michigan 02/1977-07/2009
• Provided medical billing and coding corrections to erroneously submitted claims by the physician’s office. Corrected the claims and resubmitted them on behalf of the physician office, for payment to the physician. Made sure that the physician was contacted and given the accurate information by making sure his services will not be rejected when submitting any future claims.
• Provided detailed information to the policy holder when ever billing concerns arise. Acted as a liaison between the policy holder and the insurance carrier.
• Billing Specialist for Medicare, Professional, Facility and Dental claims. All claim types.
• Wrote documentation on billing guidelines also provided steps to be taken when coding certain types of professional, facility and dental claims.
• Highly versed in manually coding procedures that needed further review when submitted by the physician office with a non-other classified (N.O.C.) code or an individual consideration (I.C.) code.
• Highly versed with using the usual customary and reasonable reimbursement system (UCR).
• Recently certified by the Michigan Medical Billing Association in processing current Medicare Consultations billing for 2010.(MMBA)
• Knowledgeable of what procedures are covered under Medicare Part B claims, which services that need approval when billing Medicaid claims, and .workers’ compensation benefits.
• Specialized in processing all lines of business for FEP Specific which includes; processing and coding Professional CMS1500 claim form, coding Facility UB92/ UB04 claim forms, coding Dental, Medicare and COB claim forms.
• Extensive knowledge in reading insurance payment vouchers.
• Extensive knowledge with using the ICD-9-CM codes manually and on line.
• Extensive knowledge with coding using CPT codes.
• Documented medical coding and billing information to use as job aids.
• Extensive knowledge with billing office visits, surgeries, radiology, laboratory, DME supplies, outpatient services, mental health, physical therapy, dialysis treatment, etc...
• Analyzed and processed high level claims via NASCO and LOCAL systems in specified timeframes.
• Advised insurance companies of correct medical billing guidelines and policies.
• Knowledgeable in providing the accurate modifiers along with the CPT code as it pertains to surgeries, anesthesia, durable medical equipment, and any procedure that may need a modifier in order to receive accurate processing and payment.
• Knowledgeable of CPT code descriptions such as “partial vs. complete” billing, “single vs. multiple’ billing and, “simple vs. complex” billing.
• Knowledgeable of the HIPAA privacy guidelines.
• Knowledge of billing National Provider Identifier (NPI) numbers.
• Extensive knowledge of using the National Uniform Billing Committee (UB-04) manual and Blue Cross Blue Shield of Michigan Maximum Payment manual.
• Extensive knowledge with billing Blue Cross Blue Shield of Michigan (BCBSM).
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