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Click here or scroll down to respond to this candidateCandidate's Name
Street Address NW 17th AVENUEMiami Gardens, FL Street Address
Cell Phone PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLEOBJECTIVE: To obtain a challenging position in the medical field that provides opportunity for advancement and growth.Special Skills/Qualifications:Ability to initiate the claims process and follow it through to the A/R resolution.Experienced in making collection calls to patients and third party payers in an effort to resolve unpaid APR balances.Experienced in registering patients by obtaining necessary information to initiate account origination using data entry, insurance verification, processing patient referrals, collecting co- payments and preparing medical records.Knowledge of Medicare, Medicaid, HMO, PPO, and W/C third party guidelines.Ability to code from source documents operative reports, history reports, radiology reports and pathology and Lab reports, utilizing CPT, HCPCS and ICD-10CM coding.Able to review, interpret and process EOBs by posting charges, payments and adjustments to patients accounts.Knowledge and application of medical terminology.Proficient in computer application, such as Microsoft Office (Word/Basic Excel/PowerPoint).Work History:Mount Sinai Medical Center 4/2015- PresentClaims SpecialistMaintain a working knowledge and understanding of CPT and ICD-10 codes.Utilize the company billing and collections system to identify and resolve any claims that have been unpaid, short paid and/or denied.Review EOBs and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms.Follow up with insurance companies by online portal, phone, and email.Identify billing errors and submitted corrected claims to insurance carriers.Provide timely and accurate follow up on accounts until they are resolved.Perform adjustments in the system as needed.Complete, review, and research any deficiency to ensure that any deficiency is properly addressed and resolved.Review, monitor and resolved assigned encounters and all assigned reports.MednaxBilling Specialist 6/13-12/14Analyze and interpret medical records.Enter patient information into the billing system.Review and process insurance claims.Verify accuracy of patient information and billing codes.Resolve discrepancies between insurance companies and patients.Communicate with insurance companies to ensure timely payment of claims.Maintain accurate records of all billing activities.Review common billing error such as DX code, missing NPI, missing modifiers, etc to ensure clean claims submission.EDUCATION: Diploma, American High School, Graduate of Concorde Career Institute.STRENGTHS: Works well under pressure, dependable and flexible.REFERENCES: Available upon request.CERTIFICATIONS: AAPC CRC certified |
