Summary
Overview
Work History
Education
Skills
Timeline
Generic

Dana Dorough

Nevada,TX

Summary

Highly efficient Medical Biller with coding experience in Family Medicine, Oncology , Pediatrics and Ophthalmology . Excellent multi-tasker and demonstrated team player with positive attitude. Skills in EMR and also hospital underpayment analysis.

Overview

16
16
years of professional experience

Work History

Criteria Specialist

Pam Health
Plano, TX
01.2025 - Current

Investigate under payments by either calling the insurance companies or the referring facilities. Verify information with the insurance companies regarding LTAC criteria for the referring facilities claim. Call the referring facilities and confirm that their claim meets criteria for the LTAC payment with Medicare. Send disputes to Medicare if the claim for the referring facilities do not meet LTAC criteria.

Medical Coding Specialist

Pecan Tree Pediatrics
Rockwall, TX
01.2024 - 12.2024

Scrubs multiple medical claims and add ICD codes and modifiers when needed. Posting insurance credit card payments in Office Practicum. Help out in the billing department with patient accounts. Also, verify insurance when department is needing assistance.

Customer Service Representative

Allstate Insurance
Richardson, TX
03.2023 - 11.2023
  • Answer phones and assist people with their accounts
  • Cross sale other services to add to their account
  • Call customers regarding their renewals.

Insurance Coordinator

Texas Oral and Maxillofacial Surgery
Dallas, TX
10.2022 - 01.2023
  • Call insurance companies and get updated benefit information for our patients
  • Update our computer system for each patient so the insurance information is accurate and current
  • Fill in for the Billing Coordinator when the biller is out of the office.

Medical Biller

Snyder-Hopkins Family Medicine
McKinney, TX
09.2022 - 10.2022
  • Process and balance the daily batches
  • Process medical claims using NextGen
  • Preform collections on a monthly basis
  • Post payments when needed.

Medical Biller

Dfw Retina
Richardson, TX
05.2022 - 09.2022
  • On a daily basis I use Advanced MD to bill out medical claims
  • Daily payment posting
  • I also mail out claims to insurance companies as well
  • Call patients before surgery and collect balances owed
  • Balance out all claims submitted at the end of the day
  • Send out collection letters to patients who have a past due balance.

Coding Specialist

Texas Oncology
Richardson, TX
02.2019 - 05.2022
  • Code all claims sent through the ETM
  • I work with medical claims sent by clinics and hospitals
  • Review each one to make sure everything is correct and accurate with the medical ICD Codes.

Prebiller

Emergicon, LLC
Forney, TX
07.2018 - 02.2019
  • Verify insurance by either calling insurance companies or verifying on Availity
  • Determine if insurance has a high deductible as well
  • Also check if pt has Medicare or Medicaid plans
  • Call on Workers Comp insurance and obtain all required information
  • Correct any rejections that are sent back
  • Preform work with accuracy and build speed to meet quota.

Department Lead

Edge Medical Billing and Consulting
Garland, TX
02.2016 - 07.2018
  • To preform medical data entry into Kareo
  • Along with insurance verification and medical collections
  • Handle all issues regarding verifications
  • Handle all preauthorizations and precertification when needed
  • Maintain all Data Entry and verifications in a timely manner
  • I also worked AR and sent out collection statements to patients who were past due.

Operations Specialist

PNC Bank
Richardson, TX
01.2010 - 11.2014
  • Preform data entry and ten key into computer from source documents
  • Follow guidelines for getting all files in before the deadlines
  • Accurately enter data to process claims daily.

Education

Medical Billing And Coding -

CCI Training Center
Dallas

Kaufman High School
Kaufman, TX

Skills

  • Excellent customer service skills along with:
  • Insurance billing, collections, and phone experience as well
  • Familiar with AP/AR and Programs such as: MS Word, Excel, Kareo, NextGen, ESO,
  • Centricity, Office Practicum and Advanced MD, Airos, and AVD
  • WPM 60
  • Medisoft Practice Management, HIPAA Guidelines
  • Medical Collection
  • Familiar with Worker’s Compensation
  • CPT Coding
  • Medical Records
  • Insurance Verification
  • Medical Office Experience
  • 10 Key Data Entry
  • Phone Etiquette
  • QuickBooks
  • Documentation review
  • Medical Terminology
  • Medical billing
  • Understanding the procedures and forms used for medical billing
  • Understanding privacy rules and regulations associated with patient records
  • Tendency to be reliable, dependable, and act with integrity at work

Timeline

Criteria Specialist

Pam Health
01.2025 - Current

Medical Coding Specialist

Pecan Tree Pediatrics
01.2024 - 12.2024

Customer Service Representative

Allstate Insurance
03.2023 - 11.2023

Insurance Coordinator

Texas Oral and Maxillofacial Surgery
10.2022 - 01.2023

Medical Biller

Snyder-Hopkins Family Medicine
09.2022 - 10.2022

Medical Biller

Dfw Retina
05.2022 - 09.2022

Coding Specialist

Texas Oncology
02.2019 - 05.2022

Prebiller

Emergicon, LLC
07.2018 - 02.2019

Department Lead

Edge Medical Billing and Consulting
02.2016 - 07.2018

Operations Specialist

PNC Bank
01.2010 - 11.2014

Medical Billing And Coding -

CCI Training Center

Kaufman High School
Dana Dorough