Deetriha Stanley
Elkin,NC
Summary
Certified Professional Coder, utilizing knowledge of medical terminology, medical procedures, insurance policies and background of CPT and ICD-10 coding techniques, with the goal of maximizing reimbursement and minimizing write-offs.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Claim Denials Specialist
Hugh Chatham Health
02.2023 - Current
- Responsible for managing denied claims related to incorrect diagnosis codes, modifier issues, bundling, make corrections to CPT codes that have been deleted as well as many other denial reasons
- Stay up to date with current guidelines for specific payors
- Manage the clearing house to to make sure claims are received by the payors in a timely manner and correct rejected claims
- Review claims to make sure the appropriate documentation is noted for services given
- Submit appropriate medical records that are requested by payors
- Enter Charges for Family Practices
- Verify patient eligibility
Insurance Clerk
Dr. Robert Peterson - General Surgeon
12.2020 - 08.2021
- Verify medical insurance benefits and obtain necessary precertification/authorization
- Submit insurance claims
- Post insurance payments
- Inform patients about their copays, deductibles, and coinsurance
- Investigate denied claims
- Run monthly patient statements
- Perform clerical duties such as mailing, faxing, copying, scanning, and other required office duties
- Manage collection agency reports
- Manage monthly aging reports
- Run claim reports to ensure they are received in a timely manner
- Run daily clearing house reports to make sure claims are not held up due to rejection
Office Manager
Glass Doctor
08.2016 - 01.2018
- Organize office operations and procedures
- Manage relationships with vendors, service providers, insurance companies and agencies to ensure all items are invoiced and paid on time
- Monitor office staff responsibilities
- Purchase and maintain office supplies and service inventory
- Handle customer inquires and complaints in a professional manner
- Process payroll
- Bank deposits
- Disbursed funds from accounts to pay monthly bills
- Accounts payable and receivable
- Prepare monthly profit and loss reports
- Reconciled bank statements
- Mailed newsletters, promotional material and other information
IOV & Hospital Follow-Up Coordinator
Hamilton Cardiology
01.2013 - 06.2015
- Check-in/Check-out
- Verify insurance and referrals
- Collected co-pays
- Schedule patients for test and follow ups
- Scanned documents into patients EMR
- Assist office manager with monthly reports
- Schedule initial office visits for new patients and hospital follow up appointments
- Enter new demographic and insurance information
- Add and remove patients from the hospital census
- Collect hospital billing for physicians making rounds at multiple hospitals
- Maintain monthly reports
Registration Clerk
Hugh Chatham Memorial Hospital
01.2011 - 08.2012
- Register new and existing patients, update patient demographics and insurance in multiple service areas of the hospital
- Collect copays, deductibles, coinsurance and bad debt
- Operate switchboard
- Assist administrative director with monthly closings and reports including bad debt, write offs and credit balances
- Assist cashier with payments
- Correct billing issues
Education
Medical Billing & Coding
Surry Community College
Dobson, NC12.2022
Medical Office Administration
Surry Community College
Dobson, NCHigh School Diploma -
Surry Central High School
Dobson, NC05.2008
Skills
- Problem Solving
- Documentation Management
- Data Analysis
- Process Improvement
- Organization
- Multi-tasking
Certification
- Certified Professional Coder (CPC), AAPC 2023
Timeline
Claim Denials Specialist
Hugh Chatham Health
02.2023 - Current
Insurance Clerk
Dr. Robert Peterson - General Surgeon
12.2020 - 08.2021
Office Manager
Glass Doctor
08.2016 - 01.2018
IOV & Hospital Follow-Up Coordinator
Hamilton Cardiology
01.2013 - 06.2015
Registration Clerk
Hugh Chatham Memorial Hospital
01.2011 - 08.2012
Medical Billing & Coding
Surry Community College
Medical Office Administration
Surry Community College
High School Diploma -
Surry Central High School