Cynthia Howard
Health Care
Pontiac,MI
Summary
4 + Years of Healthcare experience in Medical Billing, Claims Review, QI/HEDIS, and Medical Records.
Claims review/auditing, insurance verification (government & commerical) insurance follow-ups
Strong customer service background speaking with insurances, providers, patients, 3rd parties, etc.
Call Center experience handling 100 + calls daily inbound/outbound, heavy data entry ensuring accuracy.
Proficient with EMR (EPIC, Meditec, Cerner) Microsoft Office, data entry, typing, various computer programs.
Overview
3
3
years of post-secondary education
5
5
years of professional experience
Work History
Medical Biller
Change Healthcare Corporation - Vaco
Shelby, MI
06.2020 - Current
- Complete all aspects of claims processing for assigned clients in a timely, accurate, and high-quality manner.
- 2.
- ICD-10 Coding 3.
- Claims preparation, submissions, denials, insurance filing, reconciliation, correcting claims errors and rejections.
- 4.
- Tasks apply to all claims whether primary or secondary 5.
- Updates, errors or omissions.
- Request for Medical Records to be mail to provider
Follow -Up Representative
R1 RCM Inc
Southfield, MI
07.2019 - 01.2020
- Handling inbound and outbound calls from patients who have had a medical procedure done in the hospital but do not have insurance. Working with the patient to try and get them signed up for Medicaid or another form of insurance Internet research to figure out where the patient is in the process of Medicaid, what they qualify for, etc.
BBS Billing/ROI Medical Records Specialist
MRO Corporation
Southfield, MI
11.2017 - 06.2019
- Review/audit claims/billing information ensuring proper & accurate data is entering before send for billing Determine records to be release along with UB medical records by reviewing requester information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request.
- Respond to the phone calls from medical and support personnel requesting medical records or patient identification to be read from the record.
- Log medical record requests and UB claims into MRO database.
- Scan medical records into MRO database.
- Respond to walk-in customers requesting ROI/BBS information and log information provided by customer into MRO database.
- Respond and process requests from physician offices on priority basis, fax info to requesting party Comply with site facility policies and regulations.
- At specified sites, responsible for handling and recording cash payments for requests.
- Escalate issues to manager that delay timely release of records.
Quality Improvement Coordinator
Molina Healthcare Inc
Pontiac, MI
01.2015 - 09.2017
- Works under the direction of the HEDIS Clinical Lead and other clinical personnel.
- Responsible for working independently in the office and may involve entering measure specific or testing information to a database and/or organizing and tracking records.
- Tracking of fields staff assignments and initial quality review on returned.
- Medical records to ensure the records legible and contain customer identifying and mailing members for HEDIS specific requests, maintaining an organized filing system.
- All medical records and maintained at the Client Health Care office.
- Cvd HRA from doctor input in QSHR review to make HRA is complete and sign by doctor.
- Work in Provider Engagement doing research work and work on MCIR updating immunization records.
- E N/A in Healthcare Information Technology.
Education
High School Diploma -
Pontiac Northern
Pontiac, MI 09.1985 - 06.1988
No Degree - Medical Assisting
Baker College
Flint, MINo Degree - Health Information Technology
University Of Phoenix
Tempe, AZSkills
BillingFormsICD-9Information TechnologyInsuranceKeyboardMedical BillingCodingQualityQuality AssurancePhone
Medicare and Medicaid process
Medical record security
Patient account analysis
Medical claims submission
Collection calls
Timeline
Medical Biller
Change Healthcare Corporation - Vaco
06.2020 - Current
Follow -Up Representative
R1 RCM Inc
07.2019 - 01.2020
BBS Billing/ROI Medical Records Specialist
MRO Corporation
11.2017 - 06.2019
Quality Improvement Coordinator
Molina Healthcare Inc
01.2015 - 09.2017
High School Diploma -
Pontiac Northern
09.1985 - 06.1988
No Degree - Health Information Technology
University Of Phoenix
No Degree - Medical Assisting
Baker College