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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLEEMAIL AVAILABLEPhoenix, AZ Street Address
Provide and apply my knowledge in a meaningful position that will allow me to coordinate all of my skills and to expand and share my knowledge. As a self starter Im able to learn systems quickly and efficiently.Authorized to work in the US for any employerWork experienceMedical Biller and CoderIntegrated Orthopedics of Arizona - Scottsdale, AZDecember 2022 to April 20241.Billing Physical Therapy claims, adding appropriate modifiers2.Posting payments for Physical Therapy accounts3.Answer patients incoming calls - Clinic and Physical Therapy4.Correcting PT accounts.5.Monthly Statements6.Review Clinic accounts for proper coding, office visits, surgeries, injections, etc etc,Billing/AR Collections - Contract WorkRobles Medical Billing, LLC - Phoenix, AZSeptember 2015 to PresentCertified Professional Coder09/01/15 - PresentAM - Employment Billing/AR Collections - Contract workFull aspect of Billing and CollectionsElectronic BillingInsurance follow-upAppealsCodingPatient Billing - StatementsICD10 ProficientAnalysis skillsRun AR reportsPre-Arrival/Insurance Verification SpecialistCHS Corporate - TennesseeFebruary 2021 to March 2022Remote/Work From HomeCreate patients accountPre-Register patients (from provided hospital schedule)Enter procedure/procedures on account and code each service. Use CPT CODES.Verify patients insurance - Online or calling insurance.Confirm/Obtain benefits, calculate if any patient liability prior to service for upfront collections.If Self Pay create estimates. Offer MDSAVE and also create Good Faith Estimate (GFE) for new No Surprise bill.Call patient verify demographics and attempt to collect any patient balance due.Medical Records Sorter IIMSLA (OptumServe)Add locationJanuary 2018 to May 2018Evening employment to (Telecommute)Create an Electronic File (E-File)Retrieving an E-File from the Shared DriveCase File (C-File) Essential DocumentsCreating a C-File with AdobeCreating DividersSaving C-FileLabeling documentsFile SizingResizing a FileMilestoneNetwork Drive (O:Drive)Case File Cover PageCreating a C-File Cover PageCover page DocumentationUploading C-Files to EcapAuthorizations and Referral CoordinatorUHC Military & VeteransAdd locationMay 2016 to January 2018Evening employmentRespond to Incoming Provider and Enrollee referrals/authorizationsProvide excellent Customer Service to both Providers and Enrollees.Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.Receives Care Coordination notification cases for non-clinical assessment/intervention and provides appropriate triageProcesses out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate productsProcesses notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issuesDetermines benefit coverage issues based on employer group contractsSets up/documents/triages cases for (CCR) Clinical Coverage ReviewEnsures all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicableVerifies appropriate ICD-10 and CPT coding usageAssist with faxes and emails.Moderate work experience within own function.Some work is completed without established procedures.Basic tasks are completed without review by others.Supervision/guidance is required for higher-level tasks.Other duties as assigned by manager and/or director.Billing ManagerAdalberto C. Gonzalez, MD PC - Phoenix, AZNovember 2014 to August 2015FulltimeFull aspect of Billing and CollectionsElectronic BillingInsurance follow-upAppealsCodingOffice Manager/Patient CoordinatorRobles Aesthetic Center - Phoenix, AZJuly 2012 to November 2014Monday, Wednesday and FridayOversee day to day operationsQuotes to patient's wanting surgeryAccounts ReceivableScheduling appointmentsScheduling surgeriesLiaison between surgery centersKeep Doctors files up to dateStaff trainingCoding Plastic SurgeryInsurance billingFront Office Coordinator/Surgery SchedulerAdalberto C. Gonzlez, M.D., P.C - Phoenix, AZApril 2012 to November 2014Tuesday and ThursdayOpen/close officeAnswer incoming callsSchedule/cancel appointmentsAudit Billing company for correct billing and reimbursementCoding - Spine co-surgeon feesInsurance Follow-upCollection callsPatient Service Representative Lead - Full TimeChiricahua Community Health Centers, Inc - Bisbee, AZNovember 2010 to March 2012Open/close officeAnswer incoming callsSchedule/Cancel AppointmentsSubmit Prescription renewals to Medical Assistants, Nurses or DoctorsReconcile daily cashMake daily depositsCheck in patientsCreate billing encounters for daily appointmentsTrain new Patient Service Representative's and answer any questions they might haveCreate working schedule for PSR's with Patient Service Representative CoordinatorReview patient accounts and advise patient of outstanding balancesVerification of Insurance eligibility."Manager on duty" when Clinic Manager is absent or has scheduled time OffCollect co-pays upon registration of patientsEducationHigh School GraduateSome CollegeAccountingITSkillsTypingAuditingMedical RecordsSearch enginesMedical CollectionSee below - 10 yearsICD codingMedical collectionMicrosoft WordMultilingualCommunication skillsEMR SystemsAnatomy KnowledgeCPT CodingAccounts receivableCash handlingRevenue cycle managementMedical SchedulingOffice AdministrationGoogle Search - 10 yearsTraining & DevelopmentSpanishMedical CodingResearchCPT codingAccounts PayableReceivablesEDIMicrosoft PowerpointFirefox - 10 yearsSystems AnalysisMedical billingWindowsDocumentation reviewMedical Office ExperienceMicrosoft AccessICD CodingHospital ExperienceClinicMedical codingAnatomy knowledgePhone EtiquetteICD-9NegotiationCommunication skillsCodingeClinicalWorksAnalysis skillsICD-10Clerical experienceHIPAAEDIPatient observationMedicareSupervising experienceContract negotiationInsurance VerificationEMR systemsMedical recordsMicrosoft Office - 10 yearsData EntryHospital experienceCernerAnalysis SkillsBehavioral healthMedical TerminologyMedical terminologyClassroom experienceClerical ExperienceMicrosoft ExcelMicrosoft Outlook - 10 yearsICD-10WindowsAccountingHIPAAAccounts ReceivableMedical BillingMedical office experienceCash ApplicationPhysiology KnowledgeTriageLaboratory ExperienceTranscriptionQuickBooksLanguagesEnglish/Spanish - FluentCertifications and licensesCertified Professional CoderDecember 2014 to PresentCertified Coding SpecialistMedical Billing CertificationAssessmentsBusiness math - PROFICIENTJanuary 2020View full score reportProtecting patient privacy - PROFICIENTFebruary 2022View full score reportProtecting patient privacy - PROFICIENTJune 2022View full score reportMedical billing - PROFICIENTOctober 2022View full score reportAttention to detail - PROFICIENTOctober 2022View full score reportMedical billing - PROFICIENTNovember 2022View full score reportMedical billing - PROFICIENTOctober 2023View full score reportProtecting patient privacy - PROFICIENTOctober 2023View full score report |
