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Click here or scroll down to respond to this candidateCandidate's Name
Atlanta, GA PHONE NUMBER AVAILABLE EMAIL AVAILABLEAnalytical and detail-oriented Medical & Billing Coder with extensive experience in ICD-10 coding, payment integrity, and medical billing. Proven track record in evaluating and verifying billing information, ensuring compliance with program standards, and resolving complex claims. Adept at improving cash flow, delivering high-quality customer service, and excelling in remote work environments.SKILLSClinical KnowledgeQuality Assurance (QA)Healthcare Policy ComplianceRemote Work ProficiencyData AccuracyConflict ResolutionTimelinessCustomer Service ExcellenceTechnical Proficiency (Google Workspace, various computer programs)Medical CodingCollection ManagementInsurance VerificationHIPAA compliantMedical terminologyMedical ClaimsEOBMedical RecordsProcess automationSupervisory/Leadership Notary Public Dekalb CountyMedicare/MedicaidAccount ReceivablesAppeals/DenialsElectronic Health Records (EHR)Creative problem solvingAdaptabilityMeticulous OrganizationPROFESSIONAL EXPERIENCERevenue SpecialistSkyland Trail, Atlanta, GANov 2023 PresentReviewed and assessed over 50 claims daily with a 98% accuracy rate, utilizing specific software/tools (Aura, etc.) to ensure compliance with program standards.Enhanced claim resolution time by 30% by identifying and addressing claim underpayments and denials.Coordinated with internal and external stakeholders to ensure timely resolution and adherence to client deadlines, achieving 100% compliance.Developed detailed reports and documentation, utilizing advanced reporting tools to improve transparency and accountability.Billing ManagerGeorgetown Pediatrics, Dunwoody, GAMar 2014 Nov 2023Directed all facets of medical billing, including ICD-10 coding and charge entry, managing 100 claims daily and ensuring accuracy.Created and enforced coding and billing guidelines, decreasing errors by 25% and aligning with industry standards.Performed comprehensive reviews of medical records, addressing discrepancies with a 95% resolution rate.Supervised clinical review of complex billing cases, resolving quality issues and increasing claim approvals by 20% through targeted interventions.Billing/Front Office SupervisorABC Pediatric Group, Stone Mountain, GAOct 2007 Mar 2014Managed medical billing and claims submissions using advanced billing software, handling 75 claims daily with a focus on accuracy.Ensured correct insurance verification and processed referrals, reducing claim rejections by 15%.Reconciled patient accounts and processed EOPs, maintaining a 98% accuracy rate in billing and account management.Developed and enforced front office policies, improving overall operational efficiency by 20% through process enhancements.Front Desk Medical ReceptionistSulton Pediatrics Group, Lithonia, GAAUG 2005 SEP 2007Oversaw front desk functions, including patient registration and copay collection, supporting billing accuracy for 50 patients daily.Resolved insurance and billing issues, achieving a 95% resolution rate on first contact and ensuring prompt follow-up.Enhanced appointment scheduling and patient record maintenance, improving efficiency by 25% and supporting accurate billing.Delivered exceptional customer service, increasing patient satisfaction scores by 30% through effective communication and problem resolution.Front Desk ReceptionistSouthside Medical Center, Atlanta, GAAUG 2002 AUG 2005Facilitated patient check-in and verified insurance and copayments, managing charts for 60 patients daily and supporting billing accuracy.Coordinated physician schedules and handled patient inquiries, improving appointment accuracy by 20% and supporting timely billing.Addressed insurance and referral inquiries, managing 100+ inquiries weekly and ensuring accurate billing and coding.Maintained accurate records and supported billing functions, leading to a 15% reduction in administrative errors.Reservation Sales ManagerMarriot Frenchmans Reef & Morningstar Beach Resorts, St. Thomas, USVIOct 1996 Mar 2002Directed the Reservations department, applying revenue management strategies to boost profitability by 10%, demonstrating strong analytical and strategic skills.Coordinated with various departments to manage room blocks and group bookings, showcasing effective cross-departmental collaboration.Trained and managed a team of 10 agents, enhancing performance and customer service, skills transferable to managing billing and coding teams.Addressed complex booking issues with a 95% satisfaction rate, reflecting problem-solving abilities applicable to billing and claims resolution.EducationHigh School Diploma or Equivalent, Technical College System of Georgia - Dec 2019 |
