As a Medical Billing and coding specialist, I was responsible for posting primary EOB's to patients accounts, researching and resolving denied claims in an effective manner, resubmitting corrected claims to commercial and Medicaid payers, identifying improper coding of CPT, HCPC, and diagnosis codes to ensure proper billing per CCI Edits. Reviewing trending denied claims to identify different discrepancies of chronology of CPT/HCPC/Diagnosis codes amongst payers to ensure accurate payment is receiving. Report to administration any trending denials or current updates for various codes/diagnosis for the current year. I was also responsible for transferring patients and insurance balances and credits from an old EMR to the new systems, along with answering all phone calls and helping all patients and staff with insurance questions/discrepancies for 3 different locations. Other responsibilities included ensuring all payments, electronic remittances, adjustments, denials, and rejections are accurately posted to patient's accounts, managing variances, verifying accuracy of patient's registration and insurance information, light balancing of daily batch deposits, assisting in training new hires on claims and insurance information.
- Medical Billing and Coding Specialist at Pediatrics
- Medical Billing Specialist at Epic Medical Solutions
- PATIENT CARE LEAD (Promoted) at Epic Medical Solutions
- PATIENT CARE COORDINATOR at Epic Medical Solutions
5 months at this Job
- Bachelor's in Health Care Administration - Health Care Administration
Certified Professional Coder
• Reviews medical records for accuracy and completeness, assigns the proper diagnostic and procedural codes necessary for billing
• Ensure all assigned CPT and ICD codes meet federal, legal and insurance regulations so payments are obtained in a timely fashion
• Communicate and educate health care providers to ensure they are up to date on all coding and insurance regulations and guidelines Medical Billing Specialist
• Review claims to ensure all eligible services are billed
• Enter all charges into computerized health information technology (HIT) system - AS400
• Ensure all electronic claims are submitted without errors and in a timely manner
• Review all payments for accuracy and credit patient accounts accordingly
• Review denials and partially paid claims and work with the involved parties to resolve the discrepancy
• Maintain physician group cash sheets and ledgers
• Opening, sorting and routing incoming mail. Preparing and sending outgoing mail.
• Perform a variety of administrative duties necessary for the job including copying, filing, faxing, scanning, emailing and customer service.
- Medical Billing and Coding Specialist at Big Valley Commercial/ MedTech Billing Services
- Unit Secretary/Patient Care Technician at MEMORIAL HOSPITAL - LOS BANOS
12 years at this Job
- 41 total earned credits - cumulative GPA 3.40 - General Education, Psychology, Medical Terminology
- High school
• Researched and communicated insurance requirements, including patient financial responsibilities and fee-for-service
• Kept accounts current by reports and analysis strategies
• Flagged return claims and dealt with insufficient payments
• Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
• Managed many accounts at once.
• Submitted claims to insurance companies.
• Review medical records to meet insurance company requirements.
• Input procedure codes, diagnostic codes, and patient information into billing software to generate up to date invoices.
• Investigated denials and collaborated with internal team members and third party representatives to identify solutions.
• Documented and filed patient data and medical records.
• Checked claims Coding for accuracy with ICD-9 standards.
• Applied HIPAA Privacy and Security Regulations while handling patient information.
• Reviewed all claims for accurateness and appropriateness.
• Researched and rectified account discrepancies.
• Collected, posted and managed patient account payments.
• Filed and submitted insurance claims.
- Medical Billing and Coding Specialist at Medical Billing and Coding
2 years, 6 months at this Job
- G.E.D - Medical Billing and Coding
Process patient super bill/encounter forms manually. Create and submit CMS-1500 claims/forms to insurances for multiple doctors. . Concentration on very detailed work, find and match medical services and their codes, follow policies, procedures and guidelines. Provide timely and accurate data to ensure reimbursement for patient services. . Medicaid, Medicare and commercial billing ICD-10, CPT working with suspended, denied rejected claims, payments, collections, accounts balancing, eligibility verification, HIPAA requirements. . Keep updated all coding and general changes, working with medical software including Total MD, Office Ally, Eclinical and Traknet.
- Medical Billing and Coding Specialist, at Online Billing
- Medical Billing and Coding Specialist at Health Care Billing Resource
- Billing Clerk, Reliable Energy at
2 years, 1 month at this Job
• Insurance Verification
• Intake Coordinator
• Submitting Insurance Claims and Patient Statements
• Scanning Insurance Claims and Denials
• Applying Insurance Payments and Insurance Denials
• Aging Reports for Therapists and Doctors I am in charge of eight Practices that I do Medical Billing.
- Medical Billing and Coding Specialist at Medical Billing Solutions, Inc.
- Billing Specialist at Preferred Pediatrics
- Billing Specialist at Medical Billing Solutions
- Officer in Charge at United States Postal Service
2 years, 5 months at this Job
- AAS - Health Information Management
Comply with all legal requirements regarding coding procedures and practices. Collaborate with billing department to ensure all bills are satisfied in a timely manner Communicate with insurance companies about coding errors and disputes Many administrative duties, including answering telephones, greeting patients, updating and filing patients’ medical records, filling out insurance forms, handling correspondence, scheduling appointments, arranging for hospital admission and laboratory services, and handling billing and book keeping.
- Medical Billing and Coding Specialist at Good Samaritan Medical Center
- Surgical Assistant at Michigan medical center
- Passenger Service Agent at Menzies Aviation
- Medical Scheduler/Receptionist at UI Health
11 months at this Job
- Bachelor of Science - Computer Information System
Submission of claims to various insurance entities using Office Ally and Dental Sleep Solutions (DS3) Medical coding out of the CPT, ICD-10, and HCPCs coding books. Training in anatomy and physiology, medical terminology, insurance claims and billing. Worked past due reports contacting multiple insurance companies.
• Work closely with multiple doctor's offices with incoming payments, document requests or general questions.
• Prepare requested documentation packets sent to the insurance companies for reconsideration or adjustment of a claim.
• Claim submission, invoicing, batching and posting payments. Preparing appeals for denied claims.
• Verify incoming EOB's are paying according to the patient's policy.
• Work closely with the insurance companies for prompt claim processing.
- Medical Billing and Coding Specialist at Gogo Billing
- Animal Health Receptionist/Office Manager at Squaw Peak Animal Hospital
- Loan Coordination Specialist/Compliance Officer at Mortgage Alliance/PERSONNIQ - Formally Foundations Financial
- Animal Health Technician at Squaw Peak Animal Hospital
4 months at this Job
- Veterinary Technician Degree - Medical Billing and Coding
Review medical procedures as documented by doctors. Translate medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities. Transmit coded patient treatment information to payers and other recipients. Coordinate insurance reimbursement of care providers. Handle patient billing. Analyze patient medical records for accuracy. Responsible for coding treatment information using Common Procedure Terminology (CPT) codes. Communicate with medical billing specialists to ensure treatment codes are properly received. Obtain patient treatment codes to use in assembling reimbursement claims. Create reimbursement claims and transfer to third-party payers. Reconcile reimbursement activities with payers. Bill patients for medical services.
- Medical Billing and Coding Specialist at Gary Weichbrodt, M.D. Private Medical Practice
- Front Desk Coordinator at Dirk Huttenbach, M.D. Private Medical Practice
3 years, 2 months at this Job
- Bachelor of Arts
Wound care medical coding/remote and in office.
● Medical Records
● Billing for lab companies. Urine testing, genetics testing and fluid testing.
● Working AR and checking patient information and NPI provider information (entry) corresponding with insurance companies to get claims paid by remittance codes and sending medical records requested.
- Medical Billing and Coding Specialist at PHOENIX HEALTHCARE SERVICES, Springhill, TN
- Various Roles at GENESIS HEALTH AND WELLNESS INC
4 months at this Job
- - Medical Billing and Coding Specialist
Review and abstract for inpatient, Outpatient Ambulatory Surgery and Emergency Room records to select appropriate codes for principal and secondary diagnoses and procedures according to Uniform Hospital Discharge Data Set guidelines.
• Determine proper codes to be used for each diagnosis and procedure.
• Sequence the diagnoses and procedures according to established criteria.
• Use coding guidelines in order to meet coding and billing requirements.
- MEDICAL BILLING AND CODING SPECIALIST at Nassau University Medical, Center
- MEDICAL BILLING SPECIALIST at Zwanger-Pesiri Radiology
3 years, 2 months at this Job
- - Medical Billing and Coding Graduate