Job Search Status
Open to workDesired start date: Immediately
Open To Work
Janice E. Mallard
SOUTH RIVER
Work Preference
Overview
25
25
years of professional experience
Work History
PRACTICE ADMINISTRATOR/BILLING MANAGER – CERTIFIED NOTARY
COA
FREEHOLD
01.2021 - 01.2025
- PIP and Worker’s Compensation claims
- LOP’s
- AOB’s
- Knowledge of Arbitration process
- Pre-certifications
- Verifications
- Charge entry
- DME
- EDI
- EFT
- Payment posting
- Navinet, Availity, Pear Portal, Novitasphere
- CAQH
- PECOS
- Credentialing
- Accounts Receivable
- Front desk management
- Monitor daily appointment schedule for all Providers
BILLING ADMINISTRATOR
HIGHPOINT HEALTH CENTER
HIGHLAND PARK
01.2020 - 01.2021
- Oversee the operations of the Billing Department
- Audit daily documentation of patient notes
- Front desk management and training
- Monitor daily appointment schedule
- Credentialing
- CAQH
- PECOS
- Charge entry
- Verification
- No Fault and Worker’s compensation
- Full Knowledge and understanding of the Arbitration process
- Electronic Claim submission
- Insurance verification
- Medical Coding
- Chirotouch billing software
BILLING DIRECTOR
ALLIANCE MEDICAL SUPPLY
OLD BRIDGE
01.2018 - 01.2020
- Start-up of new DME Billing service
- Created all required forms
- Created and directed process from beginning of clean claim submission to processed payable claim
- Created patient profiles in billing system using eclipse software
- Claims entry
- Electronic claims submission
- Payment posting
- Obtained authorization via Navinet
- Trained and Directed front desk personnel for 4 office location
- Analyzed and resolved rejected claims
- Reviewed EOB’s and resolved any discrepancies
- Credentialing
- Reviewed and approved patient form packets for DME
- Patient statements
- Audit surgical claims and daily documentation
- Audit physical therapy and chiro documentation to support medical necessity
- Knowledge of worker’s comp and no fault
- Resolved difficult patient inquiries
- Assigned and monitored responsibilities to Billing Department and Front desk
- WEBPT/Kareo Billing Software
Billing Director
Advanced PMR
Red Bank
01.2015 - 01.2018
- Process and review claims PT, AC, and Chiro
- Review procedure and diagnosis codes for appropriateness
- Full DME billing
- Review and analyze accounts receivable
- Payment Posting
- ERA’s
- Full knowledge of PT, Chiro, Acupuncture billing
- PIP/WC claims processing
- Review and analyze EOB’s and resolve any discrepancies
- Electronic and paper claim submission
- Investigate rejected claims from clearinghouse and insurance Carriers and resolve
- Credentialing/CAQH
- Update Provider records via CAQH and PECOS
- Review claim processing for DME
- Authorizations
- Thorough knowledge of WEBPT/Kareo Billing software
- Thorough knowledge of WC/NF claim process
Medical Billing Specialist
SEAVIEW ORTHOPEDICS
OCEAN
01.2014 - 01.2015
- Claims follow-up on submitted claims
- Corrected denied claims in Navicure and resubmitted
- Read, interpreted, and resolved EOB’s from all insurance carriers
- Vast knowledge of worker’s comp and no fault process
- Educated Physical Therapist and staff on correct coding methodologies
- Completed transactions for patient credit card payments
- Effective written and verbal communication skills
- Scanned EOB’s into claims data and attached to claim
- Analyzed and resolved customer complaints and inquiries
- Set up patient and insurance company refunds
- Reviewed and provided medical records upon insurance carrier request
- Referred accounts to collections for bad debt
- Ensured G codes and functional codes were appropriately appended to Medicare claims
- CPT, ICD10 coding and medical terminology
- Requested Authorizations, Pre-certifications, Referrals
- Confirmed insurance benefits and explained to patient
- E-Clinical works software and daily use of payor sites – Navinet, Webpt
- Analyzed and resolved Account Receivable issues
- Created spread sheets to track common error coding trends
Billing Administrator
REPROGENETICS
LIVINGSTON
01.2012 - 01.2014
- Patient registration
- Charge entry
- Electronic claim submission
- Payment posting
- Accounts Receivable
- Patient Collections
- Eligibility
- Precertification/authorization
- Assigned CPT codes to genetic testing
- Updated billing system
- Researched and reviewed payment discrepancies
- Credentialing
- E-Clinical works
Part-time Temporary Instructor
FORTIS INSTITUTE
LAWRENCEVILLE
01.2011 - 01.2012
- Instruct the correct usage of ICD-9, CPT, and HCPC’s coding
- Prepared and adequately planned for classroom and laboratory instruction
- Exam preparation and administration
- Maintained student records and progress reports
- Utilized diverse questioning strategies to determine students comprehension of the subject matter
- Instructed on electronic claim preparation and submission
- Instructed on Insurance reimbursement and methodologies
- Tutoring
- Academic Advisor
Practice Administrator
ACTIVE JOINTS ORTHOPEDICS
Englewood
01.2009 - 01.2010
- Effectively trained and Supervised Front Desk on all functions
- Ensured all billing functions (payment posting, charge entry, timely electronic claims submission and reconciliation) were appropriately applied.
- Physician Credentialing via CAQH
- Payroll/Attendance
- Monitored and approved all purchase orders for office/medical supplies
- Basic Accounting
- Liaison between Practice and all outside Vendors/Insurance companies
- Responsible for Hiring and terminating employees
- PIP/WC claims processing
- Credentialing
- Prepared Performance appraisals
- Oversee maintenance of practice
- Implemented policies and procedures
- Cultivated relationships between Practice, Patients, and Staff
- Accountable for the overall operations of the practice through planning and directing of functions and activities related with administrative and practice activities
- Oversee patient and surgical schedule
- Contract Negotiations
- Analyzed EMR reports and account receivables
- Maintained Personal Calendar for all Doctors
- Arranged Travel Plans and maintained Itinerary for all Doctors
- Created and maintained spreadsheet of Billing error trends
- Triaged Phone calls and maintained call logs for all Doctors
- Created Practice Policy Manual
- E-Clinical works software
Coding/Billing Manager/Office Manager
Function First P.T. Physical Therapy
New York
01.2004 - 01.2008
- Knowledge of Medicare, Managed Care, No Fault, Worker’s Compensation
- ICD9/CPT/HCPCS Coding
- Analyzed monthly financial reports
- Researched and reviewed payment discrepancies
- Audited patient charts for Medicare compliance
- Prepared and submitted required paperwork for physician credentialing
- Electronic Billing (Medical Manager Billing Software)
- Established and successfully accomplished realistic goals, concurrent with practice objectives
- Knowledgeable of insurance company practices regarding reimbursement
- Recruited, trained, coached staff
- Set monthly goals for staff
- PIP/Worker’s compensation
- Precertifications
- Payment posting
- Created Policy manual
- Arranged and scheduled Yearly Promotional Booth at Jacob Javits Convention Center
- Promoted and Increased Patient Base via advertisement and cold calling
- Ordered all DME supplies
Coding/Billing Manager
Lisa A. Liberatore, M.D. P.C.
New York
01.2002 - 01.2004
- Collected over $50k in loss revenue during first week of hire
- Created effective in-home collection agency collecting over $100K from patient A/R
- Implemented additional procedures which increased revenue
- Directed and motivated staff to set and achieve monthly goals
- Surgical coding
- Demonstrated proficiency with Electronic Billing (Medical Manager Billing Software)
- Analyzed financial reports
- Reviewed patient charts for compliance
- Audited accounts for accurate billing
- Arranged patient payment plans
- Effectively communicate and interact with Physicians and staff
- Closely monitored account receivable with staff
- Extensive knowledge of medical billing practices
- Otolaryngology
Coding/Billing Manager
Alan Adler M.D. P.C.
New York
01.2000 - 01.2002
- Monitored Surgical Coding claims
- Collected over $100K on outstanding surgical A/R within first 3 months of hire
- Revised front desk operations for accuracy and quality assurance
- Set and achieved department goals
- Monitored adjustments
- Implemented policies and procedures
- Reviewed patient statements prior to mailing
- Strong leadership and problem solving skills
- Obstetrics/Gynecology
Summary
Dynamic billing professional with extensive experience at Alliance Medical Supply, excelling in electronic billing and accounts receivable management. Proven track record of increasing revenue through effective leadership and meticulous auditing practices. Adept at navigating complex insurance verification processes while fostering strong communication with staff and patients.
Education
M.H.A -
Seton Hall University
South Orange, N.J.01.2009
Skills
- ICD-10 and CPT coding
- Attention to detail
- Electronic billing
- Effective communication
- Insurance verification
- Computer proficiency
- Worker’s compensation and no-fault
- Medical terminology
- Accounts receivable management
- Analytical skills
- Credentialing processes
- Leadership abilities
- Durable medical equipment (DME)
- Management expertise
- Auditing practices
- Medicare guidelines comprehension
Personal Information
Title: MEDICAL BILLER/CODER
Timeline
PRACTICE ADMINISTRATOR/BILLING MANAGER – CERTIFIED NOTARY
COA
01.2021 - 01.2025
BILLING ADMINISTRATOR
HIGHPOINT HEALTH CENTER
01.2020 - 01.2021
BILLING DIRECTOR
ALLIANCE MEDICAL SUPPLY
01.2018 - 01.2020
Billing Director
Advanced PMR
01.2015 - 01.2018
Medical Billing Specialist
SEAVIEW ORTHOPEDICS
01.2014 - 01.2015
Billing Administrator
REPROGENETICS
01.2012 - 01.2014
Part-time Temporary Instructor
FORTIS INSTITUTE
01.2011 - 01.2012
Practice Administrator
ACTIVE JOINTS ORTHOPEDICS
01.2009 - 01.2010
Coding/Billing Manager/Office Manager
Function First P.T. Physical Therapy
01.2004 - 01.2008
Coding/Billing Manager
Lisa A. Liberatore, M.D. P.C.
01.2002 - 01.2004
Coding/Billing Manager
Alan Adler M.D. P.C.
01.2000 - 01.2002
M.H.A -
Seton Hall University