Chloe C Scott
Winston-Salem,NC
Summary
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Organized and professional boasting with 10 years of comprehensive experience in financial and medical industries Committed to maintaining 100% accuracy in job performance. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
Work History
Medical Coding and Billing Specialist
Triad Primary Care
09.2023 - Current
- Accesses various menu options to identify, review, analyze, process and complete First Party and Third-Party encounters and billing-related activities
- Applies analytical and evaluation techniques to determine if First Party co-payment bills are appropriate
- Promoted consistent accuracy of billing information by reconciling accounts monthly
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
- Reviewed patient records identified medical codes and created invoices for billing purposes
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Used software to assign procedure and diagnostic codes to patient records for billing purposes.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient and inpatient medical records.
- Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications
- Researches and analyzes data needs for reimbursement
- Analyzes medical records and identifies documentation deficiencies
- Reviews and verifies documentation supports diagnoses, procedures and treatment results
- Identifies diagnostic and procedural information
- Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines
- Identifies discrepancies, potential quality of care, and billing issues
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Handles special projects as requested
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Patient Services Coordinator
Atrium Health Wake Forest Baptist Health
03.2023 - 09.2023
- Telephoned and interviewed patients and family members to obtain pre-registration information and confirm appointments.
- Verified insurance coverage and obtained pre-authorizations.
- Used EPIC to maintain electronic patient files, successfully maintaining over [Number] patient files.
- Sent medical and surgical questionnaire forms to patients to obtain missing information.
- Communicated with primary care offices and insurance companies to obtain authorization.
- Coordinated with facilities to set up surgeries for Urology.
- Educated patients about surgeries and provided treatment plan documentation.
- Expertly managed planning, scheduling, and coordination of outpatient procedures.
- Collated pre-operative lab and imaging results to facilitate surgery planning.
- Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
- Resolved scheduling conflicts to maintain high-quality patient services.
- Assisted with medical coding and billing tasks.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Reception and Billing Team Leader
Atrium Health Wake Forest Baptist Health
03.2021 - 03.2023
- Answer questions and help other employees on procedures, policies, directives
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Supervised team members to confirm compliance with set procedures and quality requirements.
- Give training to established and new employees in accordance with established procedures and practices
- Distribute workload among employees, assure that each employee has enough work to keep busy
- Provide support to team members with creative solutions to complex challenges regarding scheduling, conflict resolution and medical care
- Pending of the status and progress of team members work, and adjust in accordance with priorities, obtaining assistance from the manager on problems that may arise
- Reviews encounter data forms for accuracy of procedure codes and diagnostics codes, required modifiers, and other encounter data
- Coordinated patient scheduling, check-in, check-out and payments for billing
- Scheduled, rescheduled and handled cancelled appointments for patients
- Assessed and forwarded procedure and service details to correct coding staff to best categorize for insurance purposes
- Completed and filed financial documentation for accounting purposes
- Participated and led employee staff meetings, reporting trends in procedures, advising leadership on resources needed and receiving information to be disseminated
- Completed clerical duties and tasks for clinic administration
- Adeptly managed multi-line phone system and pleasantly greeted all patients.
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
- Prepared variety of different written communications, reports and documents.
- Monitored and screened visitors to verify accessibility to inter-office personnel.
- Collected and distributed messages to team members and managers to support open communication and high customer service.
- Answered questions and addressed, resolved or escalated issues to management personnel to satisfy customers.
- Resolved customer problems and complaints.
Patient Service Representative
Atrium Health Wake Forest Baptist Health
05.2019 - 03.2021
- Balanced deposits and credit card payments each day.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Took copayments and compiled daily financial records.
- Used EPIC to schedule appointments.
- Assisted patients in filling out check-in and payment paperwork.
- Resolved billing inquiries and disputes in timely fashion.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Entered patient demographic and insurance data into electronic medical record system.
- Verified insurance eligibility and coverage for patients.
- Handled customer service inquiries in person, via telephone and through email.
- Built and maintained positive working relationships with patients and staff.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Provided excellent customer service to patients and medical staff.
- Trained new staff on filing, phone etiquette and other office duties.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Answered incoming calls, scheduled appointments and filed medical records.
- Followed document protocols to safeguard confidentiality of patient records.
- Delivered support to medical staff in completion of patient paperwork.
Fast Food Manager
Sonic Drive In
02.2018 - 11.2019
- Quickly identified problem situations and skillfully resolved incidents to satisfaction of involved parties.
- Reconciled cash and credit card transactions to maintain accurate records.
- Supervised food preparation stations to observe hygiene and taste quality of food served to customers.
- Effectively managed payroll and timekeeping, and paperwork for new hires and terminations.
- Carefully interviewed, selected, trained, and supervised staff.
- Met, greeted, and encouraged feedback from customers and used feedback to implement positive changes within restaurant.
- Assisted in development and implementation of new menus to offer variety and options to customers.
- Reduced health risks and safety hazards by preparing beverage products consistently while creating cleaning schedules, restocking items and sanitizing equipment to adhere to health department standards.
- Kept facility compliant with health codes, sanitation requirements and license regulations, alleviating potentially heavy fines.
- Managed staff schedules and maintained adequate coverage for all shifts.
- Handled escalated customer concerns with speed and knowledgeable support to achieve optimal satisfaction and maintain long-term loyalty.
- Motivated staff to perform at peak efficiency and quality.
- Created and implemented policies to achieve customer satisfaction and maintain food service standards.
- Promoted positive atmosphere and went above and beyond to guarantee each customer received exceptional food and service.
Provider Installation Specialist
United Healthcare
12.2015 - 05.2018
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Monitored credentials and contacted practitioners when expiration dates were nearing.
- Conversed effectively with various parties on daily basis using polished interpersonal and active listening skills
- Reviewed statistic enrollment data and prepared reports.
- Used company software to enter provider effective dates into enrollment database.
- Knowledge of Medicaid, Medicare, and Tricare
- Knowledge of Facets
Provider Verification Outreach Specialist
United Healthcare
05.2013 - 12.2015
- Followed all company policies and procedures to deliver quality work.
- Proven ability to learn quickly and adapt to new situations.
- Provided professional services and support in a dynamic work environment.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Excellent communication skills, both verbal and written.
- Participated in team projects, demonstrating an ability to work collaboratively and effectively.
- Facilitated training of new offshore customer care site in Philippines
Education
Bachelor of Arts - Communications
Salem College
Winston-salem, NC05.2019
Associate of Arts - Associates in Arts
Forsyth Technical Community College
Winston-salem, NC07.2017
Skills
- Insurance Verification
- Medical Records
- Medical Billing
- Microsoft Office skills
- International Classification of Diseases (ICD-10)
- Healthcare Common Procedure Coding System (HCPCS)
- Current Procedural Terminology (CPT)
- Medical Terminology
- Computer Skills
- Communication Skills, Attention to Detail & Organization Skills
- Active Listening, Problem-Solving Skills & Time Management
- Proactivity and Self-Motivation
- Collaboration and Teamwork
- Adaptivity and Agility
- Reporting skills
- Operational Efficiency
- Adobe Software
- Compiling Data
- Data Research and Analysis
- Medical Record Review
- Medical Office Administration
- Organizational Abilities
- Payment Posting
- Inpatient Records Coding
- Medical Terminology Expertise
- HIPAA Compliance
- Insurance Coding (ICD-9 and CPT)
- Business Administration
Languages
English
Native or Bilingual
Spanish
Limited Working
Timeline
Medical Coding and Billing Specialist
Triad Primary Care
09.2023 - Current
Patient Services Coordinator
Atrium Health Wake Forest Baptist Health
03.2023 - 09.2023
Reception and Billing Team Leader
Atrium Health Wake Forest Baptist Health
03.2021 - 03.2023
Patient Service Representative
Atrium Health Wake Forest Baptist Health
05.2019 - 03.2021
Fast Food Manager
Sonic Drive In
02.2018 - 11.2019
Provider Installation Specialist
United Healthcare
12.2015 - 05.2018
Provider Verification Outreach Specialist
United Healthcare
05.2013 - 12.2015
Bachelor of Arts - Communications
Salem College
Associate of Arts - Associates in Arts
Forsyth Technical Community College
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