Dean Carson
Fort Fairfield,ME
Summary
I have roughly 30 years of experience in medical coding, billing and compliance. I have overseen the coding and billing for many different specialties including GP, General Surgery, Cardiology, Pediatrics, Urology, Radiology, Pathology, Gastroenterology and Emergency Room. The last 11 years I have primarily done DME, Orthotics/Prosthetics billing/compliance. I have previously been certified by the American Academy of Professional Coders. The first certification I received from the AAPC was as a Certified Professional Coder and the second certification was as a Professional Healthcare Compliance Officer. I have extensive knowledge and experience in dealing with all Federal Payers such as Medicare, Medicaid, VA and Federal Work Comp programs as well as commercial carriers. As a Certified Healthcare Compliance Officer I have created and implemented a Compliance Plan along with Policies and Procedures programs to ensure compliance through out a medical practice. I have performed many chart audits and created check lists to document shortfalls in compliance as well as created tasks to remedy any failures in compliance. I have reviewed contracts from Payers and made suggestions to practice ownership to make sure that each contract was in the best interest of the practice. These suggestions ranged from patient accessability to billing guidelines including fee schedules.
Overview
27
27
years of professional experience
2
2
Certification
Work History
Billing Specialist
Active Mobility, LLC
Falmouth, Maine
09.2018 - Current
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Managed invoicing and payment processing operations.
- Handled account payments and provided information regarding outstanding balances.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Generated financial statements and reports detailing accounts receivable status
- Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
- Responded to customer concerns and questions on daily basis.
- Executed billing tasks and recorded information in company databases.
- Used data entry skills to accurately document and input statements.
- Developed rapport with clients and vendors to cultivate loyalty and satisfaction.
Billing Manager/Compliance Officer
Northern Prosthetics & Orthotics
Presque Isle, Maine
04.2011 - 12.2018
- Reviewed billing problems, researched issues and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Worked with customers to develop payment plans and bring accounts current.
- Trained and mentored staff on procedures, compliance requirements and collections techniques.
- Created new standard operating procedures improving billing accuracy and cash flow.
- Complied with established internal controls and policies.
- Performed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter.
- Established and enforced internal controls, workflows and policies for tracking, reconciling and reporting on accounting activities.
- Identified improvement changes regarding key processes for internal controls and accounting procedures.
- Established and checked coding procedures, monitored reports and updated internal files.
- Managed practical action plans to respond to audit discoveries and compliance violations.
- Liaised with risk management, internal audit and employee services departments to direct compliance issues to appropriate channels for investigation and resolution.
- Implemented improvement initiatives and developed compliance testing program to monitor and identify gaps in new and existing practices.
- Identified potential areas of compliance vulnerability and risk to develop and implement corrective action plans.
- Wrote and presented reports outlining findings and recommendations from compliance audits.
- Improved company policies and standards to outline ethical, safe and efficient procedures.
- Provided guidance, advice and training to improve business' understanding of related laws and regulatory requirements.
- Oversaw proper maintenance and dissemination of filing documentation as well as records and reports for review by various departments.
- Reviewed contracts for compliance and privacy-related issues.
- Reviewed company forms, marketing materials and communication procedures for compliance with applicable laws and guidelines.
- Created policies and programs to encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
- Established and cultivated productive relationships with regulatory bodies.
Billing Specialist
Medical Billing
Presque Isle, Maine
04.2006 - 04.2011
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
- Responded to customer concerns and questions on daily basis.
- Executed billing tasks and recorded information in company databases.
- Used data entry skills to accurately document and input statements.
- Managed invoicing and payment processing operations.
- Handled account payments and provided information regarding outstanding balances.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
Medical Billing Manager
Aroostook Urology
Presque Isle , Maine
1998.09 - 2002.02
- Reviewed billing problems, researched issues and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Created new standard operating procedures improving billing accuracy and cash flow.
- Performed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter.
- Complied with established internal controls and policies.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Developed strategic plans for day-to-day financial operations.
- Identified improvement changes regarding key processes for internal controls and accounting procedures.
- Established and checked coding procedures, monitored reports and updated internal files.
- Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
- Validated existing accounting management and reporting systems to assess quality and conformance, identify problems and implement corrective actions.
Billing Specialist
Medical Billing Service
Presque Isle, Maine
01.1991 - 04.1998
- Improved operations through consistent hard work and dedication.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Offered friendly and efficient service to customers, handled challenging situations with ease.
- Learned new skills and applied to daily tasks to improve efficiency and productivity.
- Maintained excellent attendance record, consistently arriving to work on time.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Prepared billing correspondence and maintained database to organize billing information.
- Trained new employees on multiple medical billing programs and data entry software.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
- Located errors and promptly refiled rejected claims.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Posted payments and collections on regular basis.
- Delivered timely and accurate charge submissions.
- Liaised between patients, insurance companies and billing office.
- Posted surgical charges for practice providers.
- Adhered to established standards to safeguard patients' health information.
Education
Associate of Applied Science - Accounting
Northern Maine Community College
Presque Isle, Me05.1991
Skills
- Creating Treatment Plans
- Check Inspection and Validation
- Statement Distribution
- Medical Billing and Collections
- Month-End Closing Procedures
- Medical Transport Billing
- Itemized Statement Preparation
- Signature Verification
- Fiscal Reporting
- Financial Documentation
- Claim Processing
- Error Revision
- Invoice Documentation Management
- Customer Contact
- Account Posting
- Records Organization and Review
- Accounts Receivable Expertise
- Billing Data Verification
- Billing Dispute Resolution
- Services Rendered Documentation
- Adding, Calculating and Billing Machines
- Billing Systems and Software
- Charge Slips
- Discrepancy Resolution
- Collection Practices
- Benefits Verifications
- Audit Procedures
- Diagnostic Codes
- Monthly Reconciliations
- Client Rapport-Building
- Invoicing Proficiency
- Effective Project Completion
- Physician Interaction
- Monetary Transactions
- Account and Ledger Reconciliations
- Correcting Submissions
- Office Supplies and Inventory
- Inputting Claims
- General Surgery
- Insurance Claim Requirements
- Legal Standards
- Breast Surgery
- Charges and Rates Documentation
- Compliance Requirements
- Discount Calculation
- Statement Billings
- Dispute Negotiation
- Patient Correspondence
- Filing Appeals
- Correspondence Writing
- Submitting Insurance Documents
- Inquiry Handling
Certification
Became a Certified Professional Coder in the year 2000. Certified by The American Academy of Professional Coders.
Became a Certified Healthcare Compliance Officer in 2018. Certified by The American Academy of Professional Coders.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
If I was half the man my father was, I'd be twice the man I am today.
Dean Carson
Timeline
Billing Specialist
Active Mobility, LLC
09.2018 - Current
Billing Manager/Compliance Officer
Northern Prosthetics & Orthotics
04.2011 - 12.2018
Billing Specialist
Medical Billing
04.2006 - 04.2011
Medical Billing Manager
Aroostook Urology
1998.09 - 2002.02
Billing Specialist
Medical Billing Service
01.1991 - 04.1998
Associate of Applied Science - Accounting
Northern Maine Community College
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