Carrie Friend
Woodbridge,VA
Summary
Analytical Medical Biller & Coder, and Accounts Receivable Specialist, successful at resolving claim denials and disputes. Detail-oriented professional with 7 years of experience. Knowledge of private, government and commercial insurance carriers. Ability to adapt to the ever-changing world of Medical Billing and Coding. In search of a full-time medical coding position.
Overview
29
29
years of professional experience
1
1
Certification
Work History
ACCOUNTS RECEIVABLE SPECIALIST
Avosina Healthcare Solutions
11.2021 - Current
- Independent, remote worker communicating via Ring Central, Zoom, or google meet
- Resolve discrepancies on patient accounts by verifying with the hospital or through insurance eligibility
- Submit claim reconsiderations and multi-level appeals, through provider portals, fax, mail, or phone communication
- Identify and analyze medical coding errors, make claim corrections and submit corrected claims in a timely manner
- Adhere to ICD-10, CPT, HCPCS and CMS NCCI, LCD, NCD guidelines
- Adhere strictly to HIPAA regulations when handling confidential patient information
- Track aging reports of unpaid claims and take corrective action when necessary
- Track and work monthly authorization denial reports
- Oversee client accounts maintained by offshore teams
- Create visual guides to assist offshore teams in claim resolution
- Specialities: Interventional Radiology, Urology, Critical Care
- Accomplishments: 6 months after joining the team, one of our largest accounts reached a record monthly reimbursement of over $1M, due to new process implementations and claims resolution
- Discovery of improper pre-authorization process within contracted facility, leading to an increase in revenue.
MEDICAL BILLING SPECIALIST
Physicians' Billing Service
06.2017 - 10.2021
- Manage complete billing revenue cycle for Cardiology, General Practitioners, Laparoscopic & General Surgery and Physical Therapy practices
- Verify patient coverage/eligibility for medical services
- Enter demographic and insurance information for patients
- Coordinate with physicians and their staff, to establish proper procedures
- Assist physician office staff with insurance and patient inquiries
- Review patient charges for missing or inaccurate information
- Analyze patient chart, extract and attach appropriate ICD 10 and CPT codes with HCPCS modifiers
- Utilize billing software to prepare and transmit claims
- Payment posting, deposit preparation, EFT posting and reconciliation
- Investigate unpaid claims, preparing the necessary corrective claims or multi-level appeals, resulting in claim resolution and payment
- Review and process patient statements within billing software
- Review and process collection letters, calling patients before sending them to outside collection agencies
- Resolve billing/insurance issues for patients, and work with them to settle accounts
- Scan/upload EFT, deposit journals, EOM reports, mail and other pertinent documentation to the digital office manager
- End of Month closing and physician reporting
- Adapt to updates/changes in billing software.
LEAD MASSAGE THERAPIST
Massage Envy Spa
10.2011 - 11.2014
- Supervised and trained Massage Therapists
- Assisted in maintaining shift schedules for Massage Therapists and Estheticians
- Performed professional quality massage, within my scope of practice and licensing
- Following policy and protocol; performed Swedish, Deep Tissue, and Prenatal Massage Therapy
- Designed specific sessions based on member's/guest's individual needs
- Communicated the health and wellness benefits to clients receiving massage therapy on a regular basis
- Created excellent member/guest experience through a friendly and helpful attitude
- Completed Wellness Chart documentation accurately and completely, ensuring client privacy under HIPAA
- Accomplishments: Most Requested Therapist 2014, Outstanding Membership Sales 2014.
ADMINISTRATIVE OFFICE SPECIALIST III
Northern Virginia Community College-Accounts Receivable
06.2007 - 06.2009
- Prepared daily cash/check deposits and posted in PeopleSoft AIS (accounting information system) to appropriate state revenue accounts
- Received EFT and EDI (electronic payments), posting 3rd party payments to agency accounts and posting the deposit of funds received into PeopleSoft AIS, tracking payment through Excel
- Received, researched, and processed credit card chargebacks
- Processed stop-payment and reissue of student refund checks and posted deposits
- Assisted students with financial account inquiries, and posted student financial aid awards for current aid year
- Prepared manual refund request transmittal for declined Web refunds, for submission to Business Office
- Received, tracked, and posted collection payments for delinquent student accounts
- Posted student and 3rd party tuition payments in PeopleSoft SIS (student information system)
- Communicated with staff, faculty, and students, via telephone, e-mail, and in person
- Special assignments: Filled in as the Fiscal Tech Senior for the Alexandria Business Office
- Supervised 3 full-time employees, ensuring smooth operation, following VCCS Policies and Procedures
- Assisted Parking Auxiliary office to bring collections correspondence up-to-date.
ADMINISTRATIVE OFFICE SPECIALIST III
Northern Virginia Community College-Alexandria Business Office
03.1996 - 06.2007
- Posted student and 3rd party tuition payments, by cash, check, and credit card
- Managed billing for the Dual Enrollment Program
- Communicated with students and faculty via telephone, e-mail, and in-person
- Handled more than $80,000 cash daily, during registration periods
- Placed and removed holds on student financial accounts
- Collect/reconcile/deposited Nova Card money
- Collaborated with the Registrar's Office, Academic Divisions, faculty, staff, and students to resolve payment, financial aid, and registration issues
- Managed the process for refund requests after the deadline
- Distributed the incoming mail for the Business Office, Provost's Office, Dean's Office, and Parking Auxiliary
- Special assignments: Served on the PeopleSoft SIS conversion committee
- Assisted in developing the process for the Dual Enrollment Program (current high school students enrolled in college-level courses, receiving credit for both high school and college simultaneously).
Education
Career Studies Certificate - Clinical Data Coding
Northern Virginia Community College
05.2017
Massage Therapy -
National Massage Therapy Institute
05.2011
Skills
- Account Management
- Investigative Research
- Adjustment Posting
- Claims Dispute Resolution
- Coding Proficiency
- Accounts Receivable
- Process Improvements
- Claims Processing
- Collections
- Account Reconciliation
- Knowledge: Allscripts, E-Clinical Works, Intergy, Kareo, Greenway, Waystar, Change Healthcare, Availity, Epic, Epic Billing, Codify
- ICD-10-CM, CPT, HCPCS
- Medical Terminology, Anatomy & Physiology, Pathophysiology, Pharmacology for HIM
- Provider insurance portal management
- Knowledge of commercial, private and government insurance
- Microsoft Office Suite
Affiliations
- AAPC
Certification
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balancePersonal development programs401k matchPaid time offPaid sick leaveCareer advancementCompany CultureTimeline
ACCOUNTS RECEIVABLE SPECIALIST
Avosina Healthcare Solutions
11.2021 - Current
MEDICAL BILLING SPECIALIST
Physicians' Billing Service
06.2017 - 10.2021
LEAD MASSAGE THERAPIST
Massage Envy Spa
10.2011 - 11.2014
ADMINISTRATIVE OFFICE SPECIALIST III
Northern Virginia Community College-Accounts Receivable
06.2007 - 06.2009
ADMINISTRATIVE OFFICE SPECIALIST III
Northern Virginia Community College-Alexandria Business Office
03.1996 - 06.2007
Massage Therapy -
National Massage Therapy Institute
Career Studies Certificate - Clinical Data Coding
Northern Virginia Community College
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