Annata McCalmon-Forde
Brooklyn
Summary
Detail-oriented medical billing and coding professional with experience in claims processing, insurance verification, and administrative support. Skilled in CPT, ICD-10-CM, and HCPCS Level II coding, accurate claim submission (CMS-1500 and UB-04), and denial management. Experienced in patient scheduling, front desk operations, and call center support, with a strong knowledge of EHR systems and HIPAA compliance.
Overview
8
8
years of professional experience
2
2
Certifications
Work History
No-Fault Billing Specialist - Level II
Hereford Insurance Company
New York
01.2025 - 12.2025
- Performed New York No-Fault billing in compliance with state fee schedules, CPT-4, ICD-10-CM, HCPCS Level II, and payer-specific coding guidelines.
- Reviewed medical records to ensure coding accuracy, medical necessity, and billing compliance.
- Verified and submitted claims, ensuring correct charges, modifiers, and documentation.
- Executed NF-10 denials within regulatory timelines, using appropriate denial language.
- Conducted follow-ups and collaborated with internal teams to resolve billing discrepancies.
- Researched coding and payer guideline issues to support accurate claim adjudication.
- Posted insurance bills.
- Accurately coded E/M visits and office procedures, based on provider documentation.
- Utilized knowledge of medical anatomy and terminology to review documentation, support accurate coding, and ensure compliant billing.
Billing Clerk
Ryan Health Center
Manhattan
08.2025 - 12.2024
- Processed over 200 insurance claims daily across multiple payers, with 98% accuracy.
- Verified insurance eligibility to prevent billing errors and claim rejections.
- Accurately coded E/M visits and procedures using ICD-10-CM and CPT, ensuring payer compliance.
- Submitted electronic claims, posted payments and adjustments, and reconciled reimbursement discrepancies.
- Resolved denied and rejected claims through follow-up, research, and appeals.
- Maintained HIPAA compliance, and accurate records for claims, denials, and audits.
- Applied knowledge of medical anatomy and terminology to support accurate documentation and coding.
Medical Administrative Assistant
New York City Children's Center
Brooklyn
06.2023 - 07.2024
- Scheduled and coordinated over 100 patient appointments daily across multiple providers.
- Verified insurance coverage and processed pre-authorizations for behavioral health services.
- Maintained accurate patient charts, and organized electronic and paper medical records.
- Responded to patient inquiries in person, by phone, and via email, while handling high call volumes.
- Coordinated meetings, took minutes, and managed office inventory and administrative supplies.
Medical Administrative Assistant
Columbia Doctors (NewYork-Presbyterian Hospital)
Manhattan
09.2022 - 03.2023
- Managed front-desk operations, scheduled appointments, and verified insurance.
- Assisted with billing and coding tasks, contributing to accurate claim submissions.
- Collecting co-pays and processing billing information.
- Ensured compliance with HIPAA and internal data privacy protocols.
- Managed incoming correspondence and maintained accurate recordkeeping.
- Data entry and updating records.
- Verified insurance and processed pre-authorizations.
- Greeting and assisting visitors.
Billing Clerk
Mount Sinai Hospital
Manhattan
08.2017 - 08.2022
- Collected copayments, processed insurance claims, and resolved patient billing inquiries to support timely payments, and patient satisfaction.
- Applied knowledge of medical anatomy and terminology to review documentation and ensure accurate, compliant coding.
- Accurately coded procedures using CPT and ICD-10-CM, in accordance with payer and regulatory guidelines.
- Verified insurance coverage and obtained pre-authorizations to prevent claim denials and delays.
- Generated and submitted electronic claims to commercial and government payers, and followed up on reimbursements.
- Maintained accurate patient billing records and communicated with insurers to resolve coverage and claims issues.
Education
Associate Degree - Health Information Technology
DeVry University
05-2026
Certification in Medical Billing and Coding - Health Information Technology
Swedish Institute College of Health Sciences (CCS)
New York05-2019
Skills
- Medical coding and billing (CPT, ICD-10-CM, HCPCS Level II)
- Claims processing, follow-up, and denial management
- Accurate claims submission (CMS-1500, UB-04)
- Insurance verification, eligibility, and authorizations
- HIPAA compliance and protection of PHI
- Clearinghouse systems (ePACES, Availity, Waystar, Office Ally)
- Patient scheduling, front desk, and call center operations
- Patient billing support and problem-solving
- Microsoft Word, Excel, and Outlook
- Document and EMR systems: Epic, AdvancedMD, Visuals, Metadata, eClinicalWorks, Microsoft Word, Excel, Outlook, Adobe Acrobat, and DocuSign
Personal Information
Title: Medical Administrative Professional | Billing & Coding Specialist
Accomplishments
Employee of the Month, April 2025
Certification
Medical Billing and Coding certificate (CCS) , April 2019
Timeline
Billing Clerk
Ryan Health Center
08.2025 - 12.2024
No-Fault Billing Specialist - Level II
Hereford Insurance Company
01.2025 - 12.2025
Medical Administrative Assistant
New York City Children's Center
06.2023 - 07.2024
Medical Administrative Assistant
Columbia Doctors (NewYork-Presbyterian Hospital)
09.2022 - 03.2023
Billing Clerk
Mount Sinai Hospital
08.2017 - 08.2022
Associate Degree - Health Information Technology
DeVry University
Certification in Medical Billing and Coding - Health Information Technology
Swedish Institute College of Health Sciences (CCS)