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Click here or scroll down to respond to this candidateCandidate's Name , CPBStreet Address EMAIL AVAILABLE 202-597-8636 PROFESSIONAL AFFILIATIONS and CERTIFICATIONSAmerican Academy of Professional Coders (AAPC), Member in good standing Certified Professional Coder, CPC Certified Professional Biller, CPBEDUCATIONAAPC Certificate of Completion, CPB Online Medical Billing Course Certificate of Completion, Physician Office Medical Coding CPC Preparation course HIPPA Awareness for Business Associates Certificate of CompletionJohn Hopkins University Certificate of Completion Psychology First Aid-Online Course University Hyperion, Bucharest, Romania Degree in Psychology and SociologyMusic School of Popular Art Bucharest, Romania Associate Degree Canto ClassicRELEVANT SKILLS and TRAININGCPT ICD-9/10-CM HCPCSMedical Terminology Anatomy PhysiologyCoding Guidelines HIPAA Policies ModifiersCoding Payment Policies NCD and LCD Edits NCCI Edits Fluent in Romanian Basic German Basic FrenchAdministrative Support Data Assessment & Reporting Customer Service Payment Processing Revenue Cycle Cross-Functional Collaboration Health Information Management Administrative Support Team Coordination PROFESSIONAL EXPERIENCEAppeals Associate Provider Coding Team, Blue Cross Blue Shields of North Carolina, August 2022- Present Responsible for the analysis, research and completion of standard appeals and grievances within the company. Initiate claim adjustments on individual cases when necessary and follow and track until completion. Audit and oversight of entities where delegation of member and provider appeals exists. Demonstrates high degree of appropriate knowledge of all areas of the Coding Guidelines and Coding Policies. Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Accounts. Medical Billing Specialist, Advanced Care Partners, March 2022- June 2022 Manage billing process, including collecting and entering claim information, posting insurance and patient payments, submitting claims, and appealing any denials or disputes Perform timely follow-up with government, commercial, and third-party payors to resolve unpaid claims Temp Non-Clinical Support Staff (Office & Healthcare Administration), Northside Hospital, August 2021 March 2022 Identifies problems through critical thinking abilities, proposing corrective action plans, and making efficient decisions for the most productive workplace Oversees daily administrative duties such as staff recruitment, processing employment paperwork, answering multi- line phone system, and performing front desk operations Participate in meeting and educational events.Director, FUNGLISH KIDS, International Online Program, 2020 - 2021 Implemented an international online program for kindergarten aged children during school closings to deliver English lessons online in a fun and interactive ways Effectively communicated ongoing teaching barriers with the principal of each school and evaluated solutions to improve teaching standardsProject Manager & Teacher Coordinator Afterschool Gifted Program for Children Baroody Camp Inc, 2019 2020 Designed a learning-oriented curriculum for each course to meet educational rules and standards requirements Encouraged growth and development through brand promotion and recognition for school program |
