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Click here or scroll down to respond to this candidateCandidate's Name
Appeals Administrator II Austin, TXStreet Address
EMAIL AVAILABLEm PHONE NUMBER AVAILABLEInvestigated all supporting medical documentation to prove medical necessity. Spoke to physicians, insurance providers etc appealed denied claims Authorized to work in the US for any employerWork ExperienceReceptionist (Full time)Waterloo Roofing - Austin, TXMarch 2013 to PresentResponsibilitiesMake orders, order lumber, equipment etc.Customer serviceFiling, answer phone all administrative dutiesAccomplishmentsCompleted jobs in a timely mannerSkills UsedSpreadsheets PowerPoint wordAppeals Administrator IIThe Scooter StoreAugust 2012 to March 2013Position primarily focused on Medicare insurance verificationAnalyzed documentation received from physicians to determine if claims were valid and necessaryCalled physicians to ensure their patient's medical information was validComplied with the rules and regulations listed within HIPAAIn addition, dealt with Medicare reimbursements and account reopening Pathology/Histology Department AssistantSeton Medical Center - Austin, TXJune 2007 to August 2008Prepared Location reports to be distributed to the appropriate physicians. Distributed appropriate staging forms to the pathologist Prepared and mailed pathology reports to the assigned physicians. Combined working draft and histories for next day cases Accounts Receivable SpecialistEsoterix IncJanuary 2007 to March 2007Performed specialized processing of accounts receivables issues requiring advance training and technical skill. Responsibilities include research, audit and review support, CDM analysis and letters of credit and communication credit/refund correspondence.Intern Billing RepMemorial Maritime Clinic - Austin, TXOctober 2006 to January 2007Performed collections and appeals duties such as rebilling procedures in accordance with HIPAA Work with EOBs to research denials for services rendered for resubmission for payment Contacted insurance companies to verify claim status and reimbursement Rehabilitation TechnicianMemorial Maritime Clinic - Austin, TXOctober 2006 to January 2007Retrieved and maintained patient medical records daily to file updated chart notes and reports Documented detailed information pertaining to patient progress notes and reports on a daily basis Directed and supervised children with brain injuries on behavioral issues and assisted the elderly with daily issues EducationHigh school or equivalent in medical billing, coding and transcription Consulting Solutions. Net - Austin,TX 2005 to 2007Skills Microsoft office, word, excel, power point, all administrative etc. (10+ years) 10 Key Calculator Customer Service Billing Customer Service Skills Data Entry Filing Microsoft Microsoft Word Receptionist Scheduling Microsoft Office Clerical Inventory Organizational Skills Outlook CPT Coding ICD-10 Medical Coding Administrative Experience Medical Office Experience Excel Medical Billing Medical CollectionCertifications and LicensesMedical Billing and CodingPresentMedical Billing, coding and transcriptionPatentsCustomer service rep ll (#0)Additional InformationSKILLSPowerPoint Excel Microsoft Medicare Medicaid bad debt collection customer service (5 years)Technical SkillsMicrosoft Office, Passport (One Source), GHN, Mysis Clinical Financial/antrim, HCPCS coding, Medisoft,Microsoft Outlook, BCBS |
