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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Avenue P, Apt. E9Brooklyn, NY Street Address -1001PHONE NUMBER AVAILABLEE-mail: EMAIL AVAILABLECAREER OBJECTIVEEDUCATION2010-20121980-1985CERTIFICATIONS20202017SKILLSEHR SoftwareComputersProfessionalSpecialEXPERIENCEDecember 2018-presentMay 2017-December 2018January 2017- April 2017December 2015-December 2016March 2003 November 20151985-2002To obtain a remote medical CODER/ BILLER position in health care institution.Bramson ORT College, New York, NYM.S. in MathematicsChernovitsky National University, UkraineMedical Coder Certificate from AAPCMedical Biller Certificate from AAPCTCM, Health Fusion, Practice Fusion, Eclipse, CureMD, DrChrono, AdvancedMD, Kareo, Meditech, Epic, WebPT, portals-NaviNet, Availity, UHC, Fidelis, Connex MC, Cigna, EmblemHealthProficient with Microsoft: Word&Excel&Access&PowerPoint&Outlook, Google applications, Quick Books, OCR, SQL, WordPress, Social communication program, Troubleshooting, Photoshop, otherMedical insurances federal and commercials, practice management, medical terminology and anatomy, NCCI, NCD/LCD, medical coding& billing guidelines, CPT, ICD, HCPCS, documentation requirements, medications and reimbursement guidelines, encoderTroubleshooting, communications, teaching, customer service, critical thinking, analyze and abstract data, problem-solving skills, time management and organizational skills.NY Arthritis Clinic PC, Brooklyn, NYMedical Biller/ Coder (Family /Internal medicine, Rheumatology, Pain management, Rehabilitation medicine, Infusion & injection treatment, MRI & US diagnostic)Review and validate patients insurance and demographic information to ensure accurate billingObtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed. Review medical documentation from physicians and other healthcare providers and defining its correspondence to official guidelines and standards. Ask additional information if needed.Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures. Analyze and interpret medical information, medical diagnoses, coding/classification systems, to ensure accuracy for reimbursement a specific payer policy and guidelines.Review and audit medical record documentation accurately to reflect healthcare coding and to substantiate appropriate service reimbursement. Conveying coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation.Prepare, review, and submit professional claims to insurance companies electronically or via paper CMS-1500 form.Prepare and submit claims to secondary payersPlace outbound calls to insurance companies, patients, doctors offices and/or facilities as needed.Answer billing and insurance questions from patients and staff.Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondence.Research unpaid claims through internal and external contacts Notate billing system each time the account is worked by placing a detailed comment on each account.Posting / collectionsSend statements to patient on a regular basisResolve outstanding accounts utilizing applications and websites as tools to retrieve claims status, medical documentation, and billing guidelines to substantiate corrected claim submissions, written appeals.Accounts receivable management; Responsible for aging of accounts (Insurance)Utilizes Microsoft Excel and Practice Management software to sort, filter, summarize and identify various accounts, insurances paymentsCompare and review superbills by system generated, to clinical documentation to ensure that all charges for procedures and services rendered have been accurately documented and captured.Create, analyze business support advanced reports by services: E&M service, pain management, infusions/ injections, CCM, PT, skin procedures, Ultrasound/MRI, lab, microsurgery.Administration and Troubleshooting support for office devices, EHR system and office software.Rio Consulting Service billing company, Brooklyn, NYMedical Biller/ collector/ credentialing (Family /Internal medicine, Pain management, Rehabilitation medicine, injections, MRI & US diagnostic, Cardiovascular, Allergy, Sleep medicine, Orthopedic, Chiropractic, hospital inpatient E&M)Review and validate patients insurance and demographic information to ensure accurate billingObtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.Prepare, review, and submit insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 formPrepare and submit claims to secondary payersPlace outbound calls to insurance companies, doctors offices and/or facilities as needed.Answer billing and insurance questions from office staff.Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondence.Research unpaid claims through internal and external contacts Notate billing system each time the account is worked by placing a detailed comment on each account.Posting / collectionsReview and work with the insurances EOB's or RA reportsContact with insurance companies on unpaid or denied claims. Resolve issue and resubmit claims.Create insurance or patient aging reports using the medical practice billingCollections insurance's payments for billing reports for provider's officesCredentialing and enrollment for new insurancesClearing house relations: enrollment for new insurances, electronic submission claims and posting ERA, setting accounts, correction claims, analyze reports.9th Street Vision Center, Brooklyn, NY.Medical biller/ collector (Ophthalmology billing)Review and validate patients insurance and demographic information to ensure accurate billingObtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed. Review medical documentation from physicians and technicians and defining its correspondence to official guidelines and standards. Ask additional information if needed.Accept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.Prepare, review, and transmit claims using billing software to government and commercial insurancesPlace outbound calls to insurance companies, patients, doctors offices and/or facilities as needed.Answer billing and insurance questions from patients and staff.Perform various insurance collection actions including insurance claim follow-up, resubmitting claims to insurance payers, file appropriate appeals and work correspondenceCollection all paymentsPosting paymentsIdentify and bill secondary or tertiary insurancesReview and management patient's accounts for balance due and working with aging reportsResearch and appeal denied claimsSet up patient payment plans and work collection accountsUpdate billing software with rate changesPrepares patient statements for charges not covered by insurance and mailed statements to patients on a regular basis.Updates cash spreadsheet, runs collection reportsAshley Billing Services Inc., Brooklyn, NYMedical Biller/collectorReview and validate patients insurance and demographic information to ensure accurate billingObtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as neededAccept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-9) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.Prepare, review, and transmit claims using billing software to government and commercial insurancesCollections and analyzing remittance reportsAccounts receivable analystMax Medical PLLC, Brooklyn, New York.Receptionist, Administrative Assistant, Medical biller (Pain management/Musculoskeletal/ Rehabilitation/Neurology and Neuromuscular/Orthopedic center)Performed daily medical secretary dutiesReview and validate patients insurance and demographic information to ensure accurate billingObtain missing information including patient demographics, authorizations/referrals, diagnosis codes, collection dates, and insurance information as needed.Performed technical support for medical office software and databaseManaged office adsPerformed administrative support for office websiteManaged office medical records and business forms documentationsProvided technical support front desk software and workstationsPrepared medical templates for office medical programsDaily duties as administrative assistant to general office managerManaged electronic medical recordsPerformed a medical balance test and created additional program for it (medical necessary);Performed a programming support for EMR programAccept modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards- (ICD-9) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and prepared electronical superbillsChernovitsky Institute of Information Technology, Medical College, UkraineProgrammer-Engineer, Teacher of Mathematics and Information TechnologyTaught undergraduate Mathematics courses and InformationTechnology courses to students with various college majorsProvided technical and software support for the learningprocessCreated educational computer programs for medicalinstitutions |
