Objective
Competent medical billing professional with ability to manage a busy medical office and provide excellent customer service to all patients. Organized medical biller with 5+ years experience accurately and auditing/updating patient charts and billing corresponding parties
Summary of Qualification
Extensive experience with heavy scheduling
Energetic and organized
Self- starter with professional manner
Microsoft office, excel, power point
CMS-1500 Billing form
Claims appeal procedures
Familiar with Physicians Current Procedures Terminology (CPT)
Filling and data archiving
Filling/edit patient charts
HCFA common procedures coding systems HCPCS
Health insurance processing
HIPAA Compliance
Insurance eligibility verification
International classification of diseases (ICD9CM)
Medical Billing
Nexgen Medical billing software
Centricity medical billing software
Online claim submission
Patient scheduling
Patient care advocacy
Proficient with medical terminology
5+years experience in a fast past pediatric and family practice office.
Professional Accomplishment
2010 –2011 Saint Joseph Hospital Atlanta, GA
Patent Account Rep
Insurance verification, procurement of authorization for scheduled and unscheduled services i.e. referrals, pre authorization and retrospective authorization
New Patient Rep- verifies insurance benefits for all patients. Call various managed care organizations and physicians offices to obtain referrals. Documents activities in Medical Manager systems
Exiting Patient Rep- verified insurance benefits for all exiting patient. Updates system with new insurance information when obtain and verifies.
Surgery Authorization Rep- Contact insurance companies to obtain authorization for all schedule surgeries for patients haven robotic surgery.
Diagnostic Testing Rep- Contact insurance companies to obtain authorization for all tests such as CT Scans PET Scan etc for cancer patients.
Medical software , Medical manager, also Centricity
2004-2010 Dr. Merinda Herron M.D. P.C. Atlanta, GA
Medical Assistant (pediatric office)
Check in & check out, scheduling appointments, answering a mu-lit-line phones , completing a number of front office duties.
Insurance verification, referrals to out patient service and specialist, coping and recording medical record, also obtains per authorization for medication as well as medical treatment.
Phlebotomy, blood draw (pediatric and young adults) new born metabolic screen , Glucose testing, PKU testing, lead testing, drug screen, hemoglobin testing, setting up for wet preps, pap smears.
Patient care, getting vital signs , working patients up, throat cultures, ear irrigation, staples & stitches removal , breathing treatments, pick-flow testing, EKG testing, birth control administration. hearing & vision screens, also calling or faxing in new and refill prescriptions.
Immunization logging to GRITS (Georgia Immunization Registry). Which is the Georgia tracking system of immunizations where I had to keep inventory of usage to prevent waste.
Billing all private and Medicaid CMO (Amerigroup, Peach state, & Wellcare) insurances, accounts receivable, collections, reimbursements with an 80% era free return. Coding clinical notes and super bills.
Clinical superior for medical student from Graduate Medical Group, assistant students during their pediatric rotation.
2003-2004 Piedmont Medical Foundation Gwinnett, GA
Offices Float (family practice)
Lab, drug screens, EKG, PKU, pap smears, phlebotomy, urine dips, processing lab orders, drawing a number of lab test, on adults and chil...
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