Dominique Galloway
Austell,GA
Summary
Dedicated and detail-oriented Medical Billing and Coding Specialist with over 15 years of experience in accurately processing patient data, managing insurance claims, and ensuring compliance with healthcare regulations. Proficient in using various medical coding systems, including ICD-10, CPT, and HCPCS. Proven track record of reducing claim denials and increasing reimbursement rates. Strong analytical skills, attention to detail, and commitment to maintaining patient confidentiality and data integrity. Adept at collaborating with healthcare providers and insurance companies to resolve billing discrepancies and streamline revenue cycle operations.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Senior Account Receivable Specialist/Certified Medical Coder
Piedmont Urgent Care By WellStreet
05.2018 - Current
- Manage front-to-end billing and collections processes for urgent care centers throughout Georgia, utilizing extensive knowledge of Medicare, Medicaid, and third-party billing while following all government and state regulations
- Follow all company policies and procedures to deliver quality work.
- Review chart records for the complete and correct assignment of CPT, ICD, Modifiers and HCPCS codes, updating codes as necessary, following strict coding guidelines for urgent care encounters and government and state regulations
- Verify proper coding, sequencing of diagnosis, and accuracy of CPT codes
- Seek clarification from the physicians for coding interpretations prior to abstracting records when needed
- Track payer coding denial trends and identify patterns that signal a need for changes in billing processes, reporting these findings to management with the goals of increasing revenue and minimizing denial days
- Train new employees in system use and daily workflow processes, creating consistency in practices, culture and procedures across the team
- Maintain and exceed quality accuracy rate of 98% while meeting production goals
- Observe confidentiality and safeguard all patient related information daily
Accounts Receivable Specialist
Premier Anesthesia
01.2014 - 01.2018
- Executed collections activities for anesthesia services rendered by five facilities and three surgery centers located in multiple states
- Identified and researched billing variances, tracking and resolving overpayments and underpayments
- Reviewed and corrected claim rejections via clearinghouse software, resubmitting updated claims for satisfactory resolution and optimal reimbursement
Accounts Receivable Specialist
Pediatric Services Of America
08.2011 - 02.2015
- Performed timely follow-up with government, commercial, and third-party payers to resolve unpaid claims for three assigned locations providing pediatric home health
- Coordinated with payment posting team to validate and post outstanding accounts receivable
- Prepared and processed patient and payer refunds for management approval
Accounts Receivable Billing Specialist
Anesthesia Healthcare Partners
08.2009 - 08.2011
- Responded to claim rejections by filing claim reconsiderations per payer billing guidelines
- Resolved payor denials and submitted appeals, updating coding when required, reducing improper and underpayment
- Assisted clinic staff and patients with questions regarding accounts receivable and account balances
Education
Skillful Coding Techniques Prep Academy
Sanford Brown Institute
Skills
- EMR and EHR Data Management Systems
- Complex Problem-Solving
- Medical Terminology
- Medical billing and Coding
- Coding Guidelines
- Charge Entry
- Customer Experience
- CPT & Code Modifiers
- ICD-10 CM Requirements
- UB-04 Form & HCFA 1500 Form
- NCCI Edits & HIPPA Policies
- Microsoft Office Suite
- Compliance
- Quality Assurance
Certification
Certificated Professional Medical Auditor
Certified Professional Coder
Medical Billing and Coding
Timeline
Senior Account Receivable Specialist/Certified Medical Coder
Piedmont Urgent Care By WellStreet
05.2018 - Current
Accounts Receivable Specialist
Premier Anesthesia
01.2014 - 01.2018
Accounts Receivable Specialist
Pediatric Services Of America
08.2011 - 02.2015
Accounts Receivable Billing Specialist
Anesthesia Healthcare Partners
08.2009 - 08.2011
Skillful Coding Techniques Prep Academy
Sanford Brown Institute
Certificated Professional Medical Auditor
Certified Professional Coder
Medical Billing and Coding
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