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Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL PROFILECustomer service-oriented professional with 18+ years of combined medical records and healthcare industry experience. Able to provide timely and accurate data to ensure reimbursement for patient services and communicate effectively with co-workers, patients, and staff. Follows policies, procedures, and guidelines to ensure quality. Maintains patient privacy and confidentiality.Academic Honors: Ultimate Medical Academy Deans List; Wayne Community College Honor Roll.Healthcare Industry Software: eClinicalWorks Cloud-Based EMR; ZirMed RCM, Centricity Cloud-Based EMR, NextGen Cloud-Based EHR.Certifications: American Heart Association BLS, CPR, and AED.Work experience includes Medical Billing and Coding experience.Accustomed to handling sensitive confidential information.Team player who performs at high levels of productivity in fast-paced environments without missing a deadline.Demonstrates independent work initiative, sound judgment, and attention to detail.Microsoft Office Applications / MS Excel, MS Word; Typing Speed: 48 WPM.KEY QUALIFICATIONSElectronic Health Records (EHR) Electronic Medical Records (EMR) Release of InformationFront Office Operations Medical Office Procedures Scheduling Insurance Verification Insurance Claim ProcessingCMS 1500 CMS 1450 (UB-04) Managed Care (HMO, PPO, and POS) Workers Compensation Medical BillingAccounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs Medical TerminologyAnatomy and Physiology HIPAA Compliance Medical Coding (ICD-10-CM HCPCS CPT)Revenue Cycle Management Posting Payments Government (Medicare and Medicaid) 3rd Party PayersEDUCATIONUltimate Medical Academy Associate of Science Degree Medical Billing and Coding, 2020Wayne Community College Office Systems Technology / Medical Program, 1998RELEVANT PROFESSIONAL EXPERIENCELincare Summerville, SC 02/2023 08/2023Patient Account CoordinatorAccept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.Perform appropriate follow-up for missing data elements such as CPT, HCPCS, ICD-9 codes and modifiers.Provide quality customer service, maintain confidentiality, problem solving, and accuracy while complying with all HIPAA regulations.Exifin INC. Charleston, SC 06/2022- 10/2022Payment Posting SpecialistProcess and reconcile incoming payments accurately, ensure all transactions are recorded in the companys financial system.Maintain and update customer payment information, including bank account details and contact information, to ensure smooth transaction processes.Initiate and manage electronic transfers, including ACH and wire transfers, ensuring timely and secure movement of funds.Collaborate with the sales and customer service departments to resolve billing issues and improve the payment experience for customers.Palmetto Digestive Disease West Ashley, SC 11/2021 -05/2022Billing SpecialistPrepare and submit invoices through electronic or non-electronic means to ensure processing and payment.Issue and post bills, receipts, and invoices.Resolve issues related to payments by clients such as rejection or deduction analysis.Manage the status of accounts and balances and identifying inconsistencies.The Mary Jenkins Center North Charleston, SC 01/2020 10/2021Medical Insurance BillerVerify insurance coverage, process claims, and enter codes into patient records.Utilize medical terminology and follow HIPAA guidelines.Post claims, charges, and payments, follow up on claims, and file documents.Palmetto Primary Care Physicians Summerville, SC 07/2009 08/2018Revenue PosterPosted insurance payments to accounts, received payment posting lists, and compared method received from carrier.Worked on special reports and projects and posted third party insurance payments and denials.Maintained confidentiality, posted patient payments, and utilized eClinicalWorks EMR software.Completed work within authorized time limits to assure compliance and performed other duties as required.Palmetto Internal Medicine Summerville, SC 05/2006 06/2010Insurance Biller / Medical Records ClerkPrepared, coded, and submitted claims to insurance companies, and handled and sorted mail.Posted hospital charges, filed denials, and appeals, called insurance companies to follow up on claims, and verified patient demographics and insurance information.Helped patients with billing questions, handled medical records requests, and faxed and filed pertinent information.Processed x-rays, checked patients in and out, answered phones, and scheduled appointments.Smart Document Solutions Summerville, SC 02/2002 12/2005Release of Information SpecialistScanned and transmitted medical records for assigned facilities.Handled medical record requests for attorneys, insurance companies, and patients.Solved patient relation issues and ensured confidentiality of information.Per-Se Technologies, Inc. North Charleston, SC 01/2000 06/2000Medical CoderCoded Emergency Room reports for different hospitals and determined the proper CPT and ICD-9 codes.Trained for and passed MCC final examination and became Per-Se Certified Coder.Ensured work was completed in a timely manner with a high level of accuracy.Palmetto Internal Medicine Summerville, SC 05/1999 01/2000File Clerk / Medical Records CustodianFiled, faxed, and handled all medical record requests and scheduled appointments.Sorted, opened, and passed out mail, and helped in the front office when needed.Checked patients in and out for appointments.VOLUNTEER EXPERIENCESociety for the Prevention of Cruelty to Animals (SPCA) Summerville, SC 06/2010 12/2019Kitten Foster Parent / VolunteerCared for sick kittens to get them ready for permanent homes and helped stray cats in the neighborhood.Trapped cats for spay or neuter surgery and released them. |
