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Click here or scroll down to respond to this candidateCandidate's Name
Lindenhurst, NY Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEWork ExperienceMedical BillerMassapequa Pain Mgmt and Rehab - Massapequa, NYSeptember 2022 to PresentMedical Billing for commercial insurance, Medicare, Medicaid physical therapy, I have a certificate in medical terminology and doing billing for forty years. Chiropractors and is n management. Working on claim denials, speaking with the insurance claims representatives on EOB's for no authorization, cpt and diagnosis codes mismatched, member policy termination before the date of service and untimelyfiling. Faxed and mailed medical note requested to support the payment of the claim. Corrected cpt codes and diagnosis codes.Since September 26, 2022 till now finding payments on the insurance websites that were not posted. One patient's insurance that were denied I got them to pay over $4,000 for all dates of service they denied. When my senior biller asked me how I did it I told her that what you're on saying me for. One co-worker retired, three people left. They hired an outside billing firm to do what the senior biller setting up claims electronically, and they may work on denials which threatens my position. Medical BillerMedical Billing Consultants - Commack, NYMay 2021 to January 2022 Reviewed, corrected and approved all primary and secondary billing, submitted hard copy and/or electronic claims to appropriate payors. Reviewed and edited any rejections stemming from electronic billing submissions and corrected and re-submitted claims, as required. Verified accuracy of patient insurance and demographic information. Generated bills to patients for services not covered by insurance. Investigated duplicate payments and took appropriate action to resolve. Initiated refund requests, where necessary, in accordance with departmental procedures. Performed follow up on all outstanding accounts assigned in accordance with established standards and proceduresCash Poster/Medical Billing/Patient Account Rep (thru Engage Partners) Catholic Health ServicesNovember 2019 to January 2021 Reviewed, corrected and approved all primary and secondary billing, submitted hard copy and/or electronic claims to appropriate payors. Reviewed and edited any rejections stemming from electronic billing submissions and corrected and re-submitted claims, as required. Verified accuracy of patient insurance and demographic information. Generated bills to patients for services not covered by insurance. Investigated duplicate payments and took appropriate action to resolve. Initiated refund requests, where necessary, in accordance with departmental procedures. Performed follow up on all outstanding accounts assigned in accordance with established standards and procedures.Medical BillerMedical Arts RadiologyJuly 2018 to April 2019 Processed accounts receivable reports on ADS billing system Recorded patient demographics, insurance information, and handled insurance screen adjustments per EOB Downloaded aged trial balance reports to clean up the AR Appealed denials for authorization, ICD9-10 codes and CPT codes Medical BillerMedysis ManagementOctober 2013 to April 2018 Constructed accounts receivable reports on EPIC and CITRIX billing software for patient demographics and account history Monitored explanation of benefits regarding denials, appeals adjustments, self-pay eligibility, authorizations, referrals, and claims online with insurance carriers Mailed/faxed denial appeals with proof of timely filing using print out of electronic submission Follow Up Specialist/ Medical BillerZwanger-Pesiri Radiology GroupAugust 2009 to October 2013 Processed accounts receivable reports on three different billing software systems including: Elegence, Fusion and RIS Used Imagine for patient demographics and account history Followed up on explanation of benefits, denials, appeals, adjustments, patient responsibility statements, deductibles, co-insurance, copayments, and denials onnot covered at time of service Checked eligibility, authorizations, referrals and claims online with username and passwords provided by Carrier Representatives Sent appeals with proof of timely filing using attached print out of NEIC electronic submission and letter of medical necessity for denials of wrong CPT &ICD 9/10 codesMedical BillerS & D RadiologyAugust 2007 to October 2009 Followed up on explanation of benefit denials, appeals, adjustments and patient statements regarding their responsibility per deductibles, co-insurances, co-payments Checked eligibility, authorizations, referrals and claims online with insurance carriers Mailed/faxed appeals with proof of timely filing using print out of electronic submission report. Medical BillerL. I. Urological AssociatesOctober 2005 to August 2007 Constructed spreadsheets to track adjustments for payroll purposes Processed the Medicare and Medicaid electronic reports/claims and sent bills to the insurance companies Printed HCFA'S to Medicaid and primary insurance carriers Follow up on explanation of benefits, sent claims to secondary carriers with the copy of explanation of benefitsFollow Up Specialist/ Medical BillerL. I. Eye Surgical CareAugust 2003 to October 2005 Followed up on explanation of benefit denials for timely filing of CPT/ICD-9 codes and marked modifiers as invalid terminating patient's coverage Mailed/ faxed appeals showing timely filing with print of NEIC electronic submission, proof of patient's coverage, letters of medical necessity for deniedICD9/ICD10 CPT CODES and modifiers Check eligibility, authorizations, referrals, and claims online with insurance carriers using passwords and usernames provided by their Claims Representatives Accounts Receivable/ Medical BillerSamaritan Respiratory Durable Medical EquipmentAugust 1995 to October 2003 Billed agencies on durable medical equipment, medical supplies Obtained and authorized follow ups every three months on wheelchairs, oxygen and hospital beds per insurance carrier case managers to see how much longer they need the equipment Followed up on claim denials by faxing and mailing necessary documents to carriers with reference numbers given Resubmitted claims and sent appeals with proof of timely filing EducationHigh school diplomaSkills Microsoft Office Suit Certified (Word/ Excel/ PowerPoint) Medicare Certified Windows Fast Track Medical Billing Software Medical Billing Software (ADS Billing system/Epic billing/Citrix billing/Elegence/ Fusion) Medical Billing Terminology (CPT/ ICD9&10 Codes) ICD-10 Medical Records EMR Systems Insurance Verification Medical Office Experience Triage HIPAA Data Entry Medical collection Medicare Communication skills Medical billing Customer service Leadership Microsoft Excel Basic math Leadership ICD coding Documentation review Computer skills ICD coding Documentation review Epic Microsoft Office CPT coding Typing Organizational skills |
