Category: ARTS

         MEDICAL BILLING SPECIALIST         Skill Highlights          Microsoft Office products such as Word, Excel, Access, and PowerPoint  Can type 60 words per minute  Experience with face-to-face customer service interaction  Experience with communications with external clients via email and conference calling  Can create and maintain detailed records of any given project or task  Some experience with mailroom machines (envelope cutters, faxes, copiers, scanners)  Experience reading medical documents (insurance forms, EOBs, procedure notes, etc.)  Strong experience with medical coding ICD-9, CPT, HCPCS II, and medical terminology  Intermediate experience with ICD-10 coding              Professional Experience     July 2014   to   December 2015     Company Name   City  ,   State     Medical Billing Specialist        Run daily report of charges ready to post for claims   Able to understand CPT, HCPCS II, ICD-9, and ICD-10 diagnosis codes   Re-code CPT codes for specialized billing (i.e., charges for Medicare patients)   Add appropriate modifiers as needed and/or requested by contacts at facility site   Submit charges in correct RVU order while following NCCI guidelines   Work with contacts at the site to ensure charges and claims are submitted cleanly via internal/external emails and weekly conference calls   Inform site contacts of any charges nearing timely filing limits   Use PrimeSUITE software for charge entry   Work with Insurance AR reps to resolve any denials/issues with submitted claims   Some knowledge of billing per insurance type (i.e. commercial, state/federal, or private insurances)   Site was a multi-specialty, multi-practice operation with roughly 25-30 providers  Charges submitted range from retail clinics to hospital procedures/surgeries.  Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology  and, pathology reports as well as clinical studies) in support of existing diagnoses.  Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.  Provided administrative support for multiple physicians.  Coded outpatient encounters at a rate of 160 per day and 120 complex specialty coding.  Accurately entered procedure codes, diagnosis codes and patient information into billing software.  Consistently ensured proper coding, sequencing of diagnoses and procedures.  Quickly responded to staff and client inquiries regarding CPT codes.  Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.  Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.  Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.  Communicated with medical transcriptionists regarding patient medical records.  Posted charges, payments and adjustments.  Performed quality control of the data entry system to verify that claims and payments were posted correctly.         January 2012   to   March 2013     Company Name   City  ,   State     Imaging Specialist I        Processed payments for medical offices, collections agencies, and utility companies Sorted and counted how much mail each client received, both live payments and correspondences Prepared live check payments for processing by ensuring information was legible Scanned checks into system and ensured quality of batches before submitting to payment processing Scanned correspondences for each client, ensuring all documents were legible Prepared and mailed out rejected payments or return mail for each client every afternoon Maintained logs with totals for client mail (incoming and outgoing) for monthly billing purposes.         September 2011   to   January 2012     Company Name   City  ,   State     Cashier        Handled customer transactions such as sales.  Responsible for handling and counting large amounts of cash.  Offered product insurance to customers when applicable.  Ask for and/or offered customer rewards card to all customers.         May 2010   to   November 2010     Company Name   City  ,   State     Cashier        Handled customer transactions such as sales and returns Answered telephones and routed calls to their correct department Responsible for handling and counting large amounts of cash Offered product insurance to customers when applicable Asked for and/or offered customer rewards card to all customers Directed customers to correct department Refilled ink cartridges for customers Called customers when their orders arrived in store Maintained cleanliness and organization of the store's front end.         April 2006   to   August 2006     Company Name   City  ,   State     Cashier        Handled customer transactions such as sales and returns Greeted customers as they entered the store Answered and handled telephone inquiries Responsible for handling large amounts of cash Responsible for counting the contents of the cash register at the end of each shift Suggested products to customers according to the contents of their orders Maintained cleanliness and organization of the store's front end Maintained cleanliness and organization of store shelves and overstock Responsible for organizing returns for floor associates so they could restock the returns according to department.          Education and Training     May 2006     Northgate High School   City  ,   State       High School Diploma                  Columbus State University   City  ,   State       Presently Attending West Georgia Technical Healthcare Information Technology Management (Associates) Computer Networking (Associates) Carrollton, Georgia                 Skills    AR, Ask, billing, cash register, Computer Networking, CPT, client, clients, customer service, diagnosis, email, faxes, filing, forms, ICD-10, ICD-9, Information Technology, ink, Insurance, notes, medical coding, medical terminology, Access, Excel, mail, Microsoft Office products, PowerPoint, Windows 98, Word, multi-tasking, organizing, payment processing, copiers, coding, quality, Quick learner, reading, retail, sales, scanners, supervision, telephone, telephones, type