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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Mill RoadEdison, NEW JERSEY Street Address
Tel: PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLESUMMARY:Precise, efficient medical billing professional with over 30 years of experience in inpatient, outpatient and physician medical billing. Specialize in filing accurate claims, adjusting rejected claims and understanding insurance contracts, appeals, and EOBs. Additional expertise in control, reimbursements, and implementing improved processes to enhance accuracy of business, billing and medical records department.QUALIFICATIONS:Medical BillingKnowledge of HMOs, PPOs, Medicare/Medicaid; Workers Compensation and No Fault InsuranceInsurance ContractsEXPERIENCE:Med-Metrix - Contact Management Specialist11/2017 to CurrentMaintained accountability and accurate records by entering adjustments and denials into medical manager system and forwarding information to management to be applied.Prepared all required claims documentation including referrals, treatments plans, and/or other required correspondence to reduce incidence of denial.Guarantee contracts, client medical records and pertinent information were priced correctly in the billing systemReview and revised insurance contracts for approval for clients.MEDNAX - Admin II, Medical Collection9/2016 to 11/01/2017Ensure claims processed accurately through review and audit functions to make sure claims received on a timely manner.Monitor aging of claims to ensure timely follow up and payment of claims.Responded to inquiries, questions and concerns from Insurance carriers and patients.Manage the follow-up on unpaid claims and Appeal any necessary claims.Prepare refunds for over payments and review accounts for under payments.Identify all billing errors and corrections as they relate to the claims.HEALTH NETWORK MANAGEMENT (company acquired by MEDNAX) - Patient Account Representative1/2014-9/2016Collect payments from patients for processing; resolve issues relating to patient accountsGenerate bills for patients including payment plan optionsExplain insurance benefits to patientsProcess Commercial, Medicaid and HMO insurancesMEDI CORP - Accounts Receivable Clerk6/2011-6/2013Processed Anesthesia and pain management claims.Provided Customer Service (assisting clients and providers with any problems)Handled any situation with insurance companies, (Underpayment, HCPCS, ICD9 Codes)Submitted appeals when necessaryEDUCATION:Kean CollegeUnion, NJ 07083Business AdministrationUnion County CollegeCranford, NJ 07016Business AdministrationSKILLS:30 years plus experience as a Medical Biller/CollectionsProficient in general office duties, including Microsoft Office (Outlook, Word, Excel and Powerpoint), Medsuite, Availity, Zirmed, Ebridge, Navinet, and Lotus NotesExperienced in the principles and methods using ICD-9, CPT-4, HCPCS and ASA Codes.REFERENCES FURNISHED UPON REQUEST |
