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Click here or scroll down to respond to this candidateCandidate's Name
Waldwick, NJ Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL EXPERIENCEENGLEWOOD ORTHOPEDIC ASSOCIATES, Englewood NJ May 2019 Present Account Representative/Medical Biller Process 35-50 accounts daily. Responsible for all billing inquiries and itemized statement requests Experienced in working with multiple billing systems; ECW, Epic, Athena Resolve denied claims as well as initiate appeals for proper reimbursement. Remains well-informed with changing coding guidelines, government regulations, and insurance specific coding rules. SUTHERLAND GLOBAL, Clifton NJ April 2017 May 2019 Account Representative/Medical Biller Improved coding accuracy 50%. Accurately reviewed all ICD-10 & ICD-9 CM inpatient and outpatient coding via Emdeon and Epremis. Corresponded with facility practice manager on daily worked accounts for missing information or inconsistent medical documentation. Remains well-informed with changing coding guidelines, government regulations, and insurance specific coding rules. Initiated authorization for all inpatient claims. LIBERTY BILLING & CONSULTING, Wayne NJ Feb. 2016 April 2017 Account Representative/Medical Biller Processes 30-35 accounts daily. Resolution of outpatient claim for full reimbursementof $55,000. Reported findings of medical coding audits. Appealed workers compensation and no-fault claims. SHORT HILLS SURGERY CENTER, Millburn NJ Oct. 2011 July 2015 Assistant HIM Manager Managed a small team in order to ensure accuracy of record-keeping. Processed, assembled, analyzed, and maintained surgical charts. Tracked all operative and pathology reports until follow up was complete. Interacted with medical staff for daily surgical procedures. BACK IN THE GAME THERAPY, Englewood Cliffs NJ Oct. 2010 Sept. 2011 Medical Billing Representative /Office Manager Oversaw and audited pain management coding. Updated and maintained patient files as well as updating demographic information. Collected and processed co-pays, deductibles, and all accounts receivable. Scheduled patient appointments and follow-ups. Responsible for the verification of insurance coverage. ROSELAND SPINAL REHABILITATION CENTER, Roseland NJ Dec. 2009-Sept. 2010 Medical Billing Representative Verified insurance coverage, processing of claims, and PIP case certifications. Completed and maintained appeal and arbitration files as well as daily patient information files. Collected and processed co-pays, deductibles, and all accounts receivable. EDUCATION/CERTIFICATIONSAnthem Institute, Parsippany NJMedical Billing & Coding Diploma, Graduated May 2010 Certifications Inpatient Prospective Payment Systems (IPPS) Certificate of Medical Necessity Form CMS-1500 Course Completions ICD-10 & ICD-9 CM CPT-4 & PIP |
