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1Barbara DonaldsonStreet Address  Magnolia Ridge DriveBaton Rouge, LA Street Address
Cell: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLESkilled professional with administrative experience in a medical setting. Knowledgeable of medical terminology, medical billing, medical Coding (ICD-10 & CPT Coding) and payroll. Strong administrative skills Types 50 words per minute Detail Oriented Team Player and Self-Motivated EmployeeWork Experience:Coordinator Front End  TJMaxx (2000  to present part time) Dallas and Houston, TX, New Orleans and Denham Springs Responsibilities: Customer service customers with issues (complaints, returns, adjustments, etc), assist cashier, open and close registers, make announcements and assist with any departmental requirements. Financial Review II - Kelsey-Seybold Clinics (June 2014 to February 2024) Houston, TXResponsibilities: Customer service patients after medical services are provided, explain how their insurance(s) policy paid and the patients responsibility, follow-up on bad debts with collection agencies, called and talk with patients concerning unpaid balances and advise to payment arrangements, open and close cashiers at the begin and end of work day, report on surveys daily, and end of month close out for 1st floor encounter files. Patient Account Representative  Cymetrix (October 2008 to May 2014) Lewisville, TXResponsibilities: Process medical claims that includes contacting patients by telephone or by mail to complete medical claims confirm claim status with insurance companies and manage denials for appeals. Patient Relation Rep - Sarasota Memorial HealthCare System (February 2007 to October 2008) Sarasota, FLResponsibilities: Accurately entered patients' demographics into database, obtained correct prescription for services rendered, filed insurance claims, verified eligibility, managed denials, posted payments, maintained database and created reports. Also, scanned patient data into electronic medical records, communicated with patients, physicians and insurance companies to obtain necessary information and correct CPT/ICD9 codes using modifiers as needed. Accessioner / Data/Order Entry Operator - Labcorp (August 1995 to March 2008) New Orleans, LA- Baton Rouge, LA - Dallas, TX - Sarasota, FL Responsibilities: Processed specimens for storage and transportation (Cyto, Histo, Micro and Chem), split specimen, converted orders into test codes, performed medical billing, tracked and provided reporting of specimens. 2SKILLS: Medical Terminology Typing (50 - 55wpm) Medical Billing Medical Coding (ICD-9 & CPT Coding) Payroll Insurance Verification (Medicare, Medicaid, Private) Patient Registration (Admission, Transfer, Discharge) Account Payable/Receivable Data Entry (Alpha/Numerical) Human Resources (Credentialing, Policies & Procedures) Meeting Preparation Minutes Preparation PC Proficient (Word, Excel, Publisher, Outlook, Internet, Access, Email, PowerPoint) General Office Procedures (Phone, Fax, Copier, etc.) Education Associates Degree or 2 years Claims Payment Analyst experience in lieu of education. Experience with Microsoft products (word and excel.) Experience 3 years of Facility Claims Adjudication experience in a HMO,PPO, or TPA environment. 5 years experience as Claims Payment Analyst and demonstrated ability to process complex professional and facility claimsSpecial Skills Demonstrated understanding of DRG pricing methods, Outpatient Prospective Payment System Mechanics, Outliers and Case Rate Payment Mechanics Knowledge of CMS rules and regulations. Skillful in medical terminology, CPT and ICD9 Coding and billing. Demonstrate strong working knowledge of Payor Contracts, Utilization Review procedures (specific to authorizations) Able to interpret and apply contracts, fee schedules and reimbursement methods. Ability to understand and/or interpret regulatory guidelines (i.e. TDI, CMS, HIPAA, etc.) Strong knowledge of Claims Services and Claim Review ProcessesOther Self-directed and able to absorb new material quickly