houskeeping/cleaning
Resume:
Gina Munion
**** **** ******** ****** #**** Phone: 480-***-****
Chandler, AZ 85224 ********@*****.***
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CORE COMPENTENCIES
Excellent record in bringing critical projects in on schedule and within budget.
Proficient in strategic flexibility to accurately and efficiently bring increased revenue to organizations by acquiring first time billing procedures using electronic billing software and secondary billing sources. Extensive knowledge in Explanation of Benefits and Coordination of Benefits.
Strong background in Patient Services consisting of outstanding written and verbal communication, account resolutions.
Outstanding leadership with proven ability to introduce and train others on new medical software such as Electronic Medical Records (EMR) practices. Possess knowledge and Certification with completion of HIPAA compliance.
Lead employees on implementing EMR by way of Scanning all patient charts during a second shift
Summary of Qualifications
Twenty years processing and utilizing billing procedures for Medicare, AHCCCS, Commercial claims
Twenty years knowledge and utilize ICD9 and CPT Coding and Billing procedures
Twenty years accurately billing and collections for Physicians, Hospitals, Outpatient, Urgent care
Consistently earned increased responsibilities and leadership.
Experienced meeting facilitator and educator.
Held position on Quality Assurance Team with Pacificare
Computer Skills: Microsoft Office Suite, Medical Terminology, EMR Electronic Medical Records
Professional Experience
06/2010 to Present - MIMS/Valley Anesthesiology Consultants, LTD.
Account Representative/Insurance Specialist
Medicare/AHCCCS, commercial biller for electronic and paper claims.
Follow up on unpaid claims, and manage self pay accounts to zero balance by establishing hardship and payment arrangements.
Identify problems with clearinghouse electronic billing errors and correct rejection errors on claim by accurately identifying error message codes. Take appropriate action to resolve clearinghouse and software billing problems.
Posting insurance payments accurately to make certain payments and reimbursement is accurate. Appeal payment if necessary and ensure appropriate adjustments are taken on each patient account.
Team liaison in answering billing questions for coworkers and with patient billing calls.
Strong leadership skills and motivation to ensure more time efficient strategies are being used to lower Accounts Receivables.
Meet with insurance representatives to reduce AR balances and troubleshoot problems to accounts.
Develop letters to appeal claim denials to insurance companies.
03/2010 – 05/2010 Catholic Health West Chandler Regional (contract assignment) Accountemps
Medicare/Secondary Biller, Administrative Assistant
Medicare /Secondary Biller and all Urgentcare and Hospital through Meditech consisting of 500 thousand or more in charges per day
Liaison between Medicare, AHCCCS, Commercial Payers as well as Physicians and Patients
Submit hard copy HCFA and or UB to secondary insurance companies with primary EOB as a courtesy to patients who do not have Medicare as a primary insurance or Medicare crossover
Assist in printing reports for Supervisors to track and correct errors made during Electronic Claims Submissions
Obtain prior authorization for Hospital and outpatient services rendered per Contract
View and download electronic remits
02/2009 – 03/2010 Sonora Quest Laboratories/Mckesson (contract assignment) Primestaff
Biller/Verification of Benefits Specialist/Reimbursement Specialist
Building patient Demographics consisting of not limited to Insurance verifications, researching and implementing Laboratory codes using ICD9 and CPT guidelines,
Liaison between the patient and Hospice providers for proper billing procedures according to insurance policy
Utilize proper billing procedures to Medicare and AHCCCS
Paper claims HCFA /UB submission
Process Patient Assistance for Boniva drug program with McKesson Pharmaceuticals
Inbound patient billing calls
03/2008 – 09/2008 Next care Urgent care Clinics (contract assignment) Ajilon Staffing
Account Representative/Biller
Posting Payments received from various insurance BCBS, Commercial and Self pay
Collections commercial, Medicare and self pay utilizing Aging report with accounts within 60-90 days
Billing secondary hard claims with primary EOBs attached
Posting charges
Determine insurance eligibility utilizing Online EMDEON and Payer websites
07/2003 – 08/2007 Banner Heart Hospital/Tri-city Cardiology Consultants
Biller/Registrar I/Authorizations Referral Coordinator
Patient Check in Check out obtaining copayments via Nexgen software
Posting office charges via Operative Report
Posting payments
Collections on commercial payers, Medicare, and AHCCCS
Obtaining Office and Hospital Referrals and Authorizations
Inbound calls from patients to resolve billing questions
Lead employees on implementing EMR by way of Scanning all patient charts during a second shift
Education
B.S. in Healthcare Administration/Management UOPX, present
Nursing Program prerequisites CGCC, Chandler, AZ 2009
Certified Nursing Assistant certification EVIT, Mesa, AZ 2008
Medical Terminology for Healthcare Workers Certification RSCC, Tempe AZ 2005
E/M CPT and ICD9, Hospital and Physician Billing and Coding Certification GCC, Phoenix AZ 2004
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