Connie Smith
St. Louis,MO
Summary
- A Medical Biller Professional with over 25 yrs of progressive experience in the healthcare industry performing various medical billing and coding responsibilities
- Demonstrated ability to see the “BIG PICTURE”, achieve results and meet deadlines
- Demonstrated management skills of planning, organizing, managing, controlling, and staffing while managing multiple priority projects simultaneously and efficiently, ability to adjust readily to change, make difficult decisions independently and self-motivated.
- Demonstrated ability to effectively get things performed through, with, and by people: dependable, reliable and able to maintain good interpersonal relationships.
- Able to identify problems and successfully implement solutions by thinking “Outside of the Box”.
- Strong communication skills ability to impart knowledge of procedures and techniques: ability to educate and train new and existing personnel.
Overview
2020
2020
years of professional experience
Work History
Claims Processor II & Payment Posting
Aerotek Staffing
2021 - 2024
- Processed EDI and paper claims, analyzed validity, and handled payments and denials.
Billing & Collections Coordinator 1/ Remotely & In office
Numotion
01.2017 - 01.2020
- Ensure order set up accuracy for proper reimbursement through coding
- Performed daily review of orders for clean claim billing through clearing house
- Follow-up and collections activities on accounts to reduce days sales outstanding(DSO).
- Recommend receivables for refund, adjustment, or write off
- Submitted reconsiderations or appeals as require
- Performed inquiries to payer on outstanding receivables
- Initiated resolution of billing holds with order processors
Corporate Medical Accounting Specialist for SNF
Healthcare Accounting Services
01.2015 - 01.2017
- Balanced census, Processed monthly close, Posted electronic and paper charges , payments, notes and other information to Primary, Secondary, and Tertiary insurances , coordinates billing to payers and patients and processes patient statements, works and communicates with peers, patients, and payers regarding accounts receivable collections for services rendered, verifies CPT, HCPCS, ICP-9, ICD-10 and modifiers to accurately reflect documented services, resolves problems relating to data and prepares data for electronic filing, storage and backup, work aging accounts, clearinghouse and payer denials, and submitting appeals and reconsiderations, update census daily
Claims Processor II
Aerotek Staffing
01.2015 - 01.2015
- Processed EDI and paper claims, Analyzed claims checking for validity, processed payments and denials, assed medical documents, adjudicated claims and adjustments, priced and resolved claim edits and suspended claims, managed and updated required reference materials to adjudicate while maintaining excellent written and oral communication skills for adjudication process
Coder and Payroll Specialist
Angels of Mercy Home Health
01.2011 - 01.2015
- Revised and Audited patients medical records and clinician documentation to determine proper diagnosis and procedure codes for insurance reimbursement, processed and corrected claims submitted to managed care, Medicare and Medicaid insurance, utilized specialized medical classification software assigned to procedure and codes for insurance billing, processed test runs for ICD 10 implementation, performed daily payroll department operations, maintained workflow to ensure all payroll transactions, loaded imported files received from HR, executed e-time, ADP and attendance and processing interface with payroll, tracked and processed reimbursement mileage and expense reports, responded to inquiries from employees about salaries and wages, processed overtime payments, resolved any discrepancies surrounding payroll issues, updated changes in company tax status, set up direct deposits, prepared and distributes paper checks when necessary, contacted banks and IRS of any withdrawal or tax questions and discrepancies, prepared office for any audits, kept detailed and organized payroll records, communicated daily with benefits experts and finance managers to ensure that all employee records and accounts were in line, processed W-4 for tax purposes, distributed W-2s for tax purposes, prepared year end reports
Billing Representative
Aerotek Staffing
01.2011 - 01.2011
- Processed primary and secondary claims for home infusions therapy, home respiratory therapy, and home medical equipment. Ran and evaluated aged and daily reports, performed internal audits to ensure proper ICD-9 and CPT codes. Identified prepared adjustments and write offs as appropriate. Interpreted contracts with payers to ensure proper reimbursement. Follow up on daily correspondence (denials, low pays) to appropriately work patient accounts.
Office Manager
National Medical Services
01.2009 - 01.2010
- Responsible for the operational and clinical management and business administration of the family practice, Collaborated with the Physician to provide effective and successful plans regarding operations, fiscal accountability, systems/quality improvement, human resources, staff development and strategic direction, Promoted change and processed to maintain compliance with all regulatory agencies and quality standards to facilitate efficient and cost effective medical group operations, provided solid knowledge of operations, revenue cycle, Processed payroll for a staff of 40 employees, made sure all payroll accounts balanced, entered employee info into payroll database, prepared and submitted payroll documents, adhered to all state and federal regulations for payroll processing, explained benefits and payroll process to new employees, QuickBooks, ADP, Gateway EDI, Medical Manager
Managed Care Representative
SSM Health Care
01.2007 - 01.2009
- Ensured fee-for-service high dollar claims are paid correctly in accordance with provider contracts, demonstrated in claims collections recovery and/or claims auditing. Thorough knowledge of various claims payment methodologies, with Medicaid, Medicare and Managed Care experience., responsible for analyzing claims overpayments not to exceed 1 year and determine collection recovery strategies, Maintain and reconcile department reports for outstanding payments collected, past-due overpayments, uncollectible claims, and auto-payment recoveries, posted cash and denials.
Medical Biller Manager
Naumovich Medical- St. Louis, MO
01.2003 - 01.2007
- Oversees and guides in the processing of insurance claims and appeals, performs audits for medical accounts, post charges and cash audits, corrects and re-bill claims that were submitted improperly, answers patient inquiries, process daily closes and patients statements. Assisted with streamlining workflow to increase accounts receivable while decreasing accounts payable by 30%.
Medical Biller
County Primary Healthcare-St. Louis, MO
01.2001 - 01.2003
- Responsible for processing insurance claims (PI & Workman’s Comp), pre-certs, referrals, posting charges & payments, verifying insurance coverage, processed end of the month close out, monthly billing, ICD-9 & CPT coding, auditing accounts, updated policies and procedures while reconciling front and back office cash daily.
Medical Biller
The Health Centers-St. Louis, MO
01.1999 - 01.2001
- Guided in the processing of insurance claims and appeals, performs audits for medical accounts, posts charges and cash, audits, corrects and re-bill claims that were submitted improperly, answers patient inquiries, processed daily closes and patients statements.
Education
Diploma - Medical Insurance Billing & Coding
Everest College
undefined
St. Louis Community College
St. Louis, MO07.2025
Skills
- ICD-9 , ICD-10 & CPT Coding, In-Patient, Out-Patient Coding, UB-92 Billing, 485 Billing, Oasis Creation, Modifiers, Electronic Claim submission, Claim Processing, HCFA Creation, Medical Terminology, Anatomy and Physiology, Emdeon, Gateway EDI, Medware, Medi Soft, Medical Manager, Epic, Epermis, Allscripts, HBOC, American Medical Software, EMR, Timetrak, ADP, Paychex, Quickbooks, Matrix, PCP, Kean, Waystar, Provider Portals
Disclaimer
01/01/2024 To whom it may concern: Please consider my interest of employment with your organization. The following resume will furnish you within information regarding my qualification. I have acquired a large variety of skills through a wide range of work assignments. I feel confident in being able to apply this knowledge and experience towards the needs of your organization. I would greatly appreciate an opportunity to discuss my qualifications with you at your earliest convince. Please contact me at the above address or telephone number to arrange an interview to further discuss how my capabilities could apply towards the realization of your company’s goal. Sincerely, Connie Smith Enclosure my resume
Timeline
Billing & Collections Coordinator 1/ Remotely & In office
Numotion
01.2017 - 01.2020
Corporate Medical Accounting Specialist for SNF
Healthcare Accounting Services
01.2015 - 01.2017
Claims Processor II
Aerotek Staffing
01.2015 - 01.2015
Coder and Payroll Specialist
Angels of Mercy Home Health
01.2011 - 01.2015
Billing Representative
Aerotek Staffing
01.2011 - 01.2011
Office Manager
National Medical Services
01.2009 - 01.2010
Managed Care Representative
SSM Health Care
01.2007 - 01.2009
Medical Biller Manager
Naumovich Medical- St. Louis, MO
01.2003 - 01.2007
Medical Biller
County Primary Healthcare-St. Louis, MO
01.2001 - 01.2003
Medical Biller
The Health Centers-St. Louis, MO
01.1999 - 01.2001
undefined
St. Louis Community College
Claims Processor II & Payment Posting
Aerotek Staffing
2021 - 2024
Diploma - Medical Insurance Billing & Coding
Everest College
Similar Profiles
Heath McGowenHeath McGowen
Forklift Operator at Aerotek StaffingForklift Operator at Aerotek Staffing
Iliaser MelendezIliaser Melendez
Heavy Equipment Fueller at Aerotek StaffingHeavy Equipment Fueller at Aerotek Staffing
MARCUS DOOLEYMARCUS DOOLEY
Warehouse Lead at Aerotek StaffingWarehouse Lead at Aerotek Staffing
Alayna DucharmeAlayna Ducharme
Quality Assurance Lead at Peraton, LLCQuality Assurance Lead at Peraton, LLC
Jill GuessJill Guess
Office Coordinator, Division of Cardiothoracic Surgery at Washington University School of Medicine in St. Louis, MOOffice Coordinator, Division of Cardiothoracic Surgery at Washington University School of Medicine in St. Louis, MO