Josey Abeyta
Bellflower,CA
Summary
Dependable, detail oriented and quality focused individual with over 7 years of experience looking for a position as a Senior Risk Adjustment Coder, which will provide challenges and opportunities for growth. Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
7
7
years of professional experience
Work History
Manager Medical Coding Specialist
SBT Inc
05.2019 - Current
- Filed and updated patient information and medical records.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Liaised between patients, insurance companies, and billing office.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Collected payments and applied to patient accounts.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Managed collections claims for unpaid bills against estates of debtors.
- Precisely evaluated and verified benefits and eligibility.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Prepared billing correspondence and maintained database to organize billing information.
- Located errors and promptly refiled rejected claims.
- Evaluated patients' financial status and established appropriate payment plans.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Posted and adjusted payments from insurance companies.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Identified and resolved patient billing and payment issues.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
Manager Medical Billing and Collections
NewStart
01.2017 - 05.2019
- Supervised staff of collectors, monitoring phone calls and letters.
- Trained and mentored new employees on collection methods, documentation requirements and performance strategies.
- Established procedures for collection of past due amounts.
- Acted as a departmental resource on appeals matters.
- Created, composed and maintained appeal response templates.
- Coordinated with senior specialist to compose appeal responses.
- Modified, updated and processed existing policies.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Monitored customer accounts to identify and rectify billing issues.
- Developed and maintained billing procedures to make timely payments.
- Researched and resolved billing discrepancies to enable accurate billing.
Education
Billing And Coding Certificate
Healthcare Careers College
Los Angeles, CA2017
High School Diploma -
Paramount High School
Paramount, CA2009
Skills
- CPT, ICD-9, ICD-10, HCPCS Coding
- Keyboarding 82 wpm
- Medical Terminology
- Medical Anatomy and Physiology
- Medical Billing and Charge Entry
- Documentation Guidelines
- EDI Claims Submission
- Insurance Claims Analysis
- Accounts Payable and Accounts Receivable
- Medical Claims Coding
Timeline
Manager Medical Coding Specialist
SBT Inc
05.2019 - Current
Manager Medical Billing and Collections
NewStart
01.2017 - 05.2019
Billing And Coding Certificate
Healthcare Careers College
High School Diploma -
Paramount High School
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