Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

KEOSHA FLOYD

Houston,TX

Summary

Efficient billing professional 5 + years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Coding and Billing Specialist

Clinica Hispana
02.2021 - Current
  • Oversee and provide administrative support to physicians, interpreting necessary data to assign various medical codes.
  • Accurately and efficiently access hospital billing and information systems to secure and assemble all necessary physician records and coded payments.
  • Assign 100 + codes per day via medical billing & create claims per assigned insurance carrier.
  • Ensure 100% accuracy of codes and sequence in accordance with government and insurance regulations.
  • Perform insurance verification, pre certification, and pre authorization services.
  • Supervise daily billing department functions, including but not limited to medical coding, charge entry, claims, payment posting, and reimbursement management.
  • Enter diagnosis codes and patient information into billing software maintaining currency on coding, sequencing, procedures, best practices, and updates.
  • Examine and oversee patients encounter forms to verify diagnosis codes and reconcile codes against services rendered.
  • Maintain accurate records of customer payments and reconcile accounts receivables to general ledger.
  • Verify the efficiency of accounts payable payments, resulting in 92% reduction in remittance errors and check reissues.
  • Follow up and track delinquent & submitted claims/invoices assuring that all are paperwork is processed accurately with the intent to reduce unpaid & outstanding balances .
  • Review patient charts to better understand health histories, diagnoses, and treatments.
  • Assess and validate accuracy of charges including dates of service, procedures, level of care, location, patient identification, and provider signature.
  • Apply official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Guard against fraud and abuse by verifying that coded data accurately reflects services provided.
  • Process insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
  • Analyze outpatient records and interpret documentation to identify diagnoses, procedures, and accuracy of patients information in medical history.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
  • Apply active listening, interpersonal, and telephone etiquette skills when communicating with others.
  • Kept vendor files accurate and up-to-date to expedite payment processing.
  • Process patient, vendor, and supplier payments via telephone and in person with focus on accuracy and efficiency.
  • Generate accounts payable reports for management review to aid in financial and business decision making.

Patient Service Representative

Clinica Hispana
01.2018 - 02.2021
  • Advocated for patients by contacting insurance companies to ensure timely payment and resolve errors on rejected claims.
  • Diligently prepared all required claims documentation including referrals, treatment plans, and other required correspondence to reduce incident of denials.
  • Maintained accountability and accurate records by entering adjustments, rejections etc., into medical manager system and forwarded information to delegated management team to be applied.
  • Managed office logistics by scheduling appointments, maintaining files, assisting with processing and collecting medical insurance claims and payments.
  • Checked patient insurance, demographic, and health history to keep information current.
  • Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
  • Answered telephone calls to offer office information, answered questions, and directed calls to staff.
  • Delivered support to medical staff in completion of patient paperwork.
  • Facilitated communication between patients and various departments and staff.
  • Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
  • Managed patient registration process, confirming data accuracy and completeness.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.
  • Provided exceptional customer service to patients, answering questions and addressing concerns.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning glass.
  • Helped patients complete necessary medical forms and documentation.
  • Adhered to strict HIPAA guidelines to protect patient privacy.
  • Assisted with medical coding and billing tasks.
  • Managed office bookkeeping with insurance billing and patient payments.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
  • Greeted visitors and initiated triage processes for clients to streamline patient flow.
  • Registered and verified patient records before triage with most up-to-date information.
  • Conducted patient intake interviews, recording and documenting relevant information.
  • Supported office staff and operational requirements with administrative tasks.
  • Printed prescription requests and queries in compliance with practice protocol.
  • Organized and maintained patient chart filing system to promote quick data finding for staff.
  • Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
  • Notified manager of incidents and potential incidents relating to patients and staff for swift action.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.
  • Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
  • Maintained records by recording, obtaining and updating personal and financial information.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.
  • Investigated insurance claims denials and appeals.
  • Recommended service improvements to minimize recurring patient issues and complaints.
  • Helped address client complaints through timely corrective actions and appropriate referrals.

Front Office Manager

Tutors With Computers
03.2016 - 01.2018
  • Successfully managed budgets and allocated resources to maximize productivity and profitability.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
  • Managed senior-level personnel working in marketing and sales capacities.
  • Leveraged data and analytics to make informed decisions and drive business improvements.
  • Launched quality assurance practices for each phase of development
  • Managed 200 + files and records for clients and adhered to safety procedures to prevent breaches and data misuse.
  • Controlled resources and assets for department activities to comply with industry standards and government regulations.
  • Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
  • Analyzed data related to administrative costs and spending trends to prepare budgets for personnel.
  • Reconciled end-of-day reports to determine accurate billing and payment processing.
  • Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets.
  • Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
  • Set aggressive targets for employees to drive company success and strengthen motivation.
  • Supervised and guided new employees and responded quickly to questions to improve understanding of job responsibilities.
  • Streamlined and monitored quality programs to alleviate overdue compliance activities.
  • Defined clear targets and objectives and communicated to other team members.
  • Communicated corporate objectives to various divisions to meet deadlines and adhere to company budgets.
  • Prepared agendas and took notes at meetings to archive proceedings.
  • Planned, created, tested and deployed system life cycle methodology to produce high quality systems to meet and exceed customer expectations.
  • Developed detailed plans based on broad guidance and direction.
  • Coached employees through day-to-day work and complex problems.
  • Monitored customer service trends and provided insights to management team for further improvement.
  • Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
  • Assisted in organizing and overseeing assignments to drive operational excellence.
  • Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
  • Established team priorities, maintained schedules and monitored performance.
  • Developed procedures to establish accurate and organized check-in and check-out processes.
  • Identified and communicated customer needs to supply chain capacity and quality teams.
  • Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
  • Prepared reports to assist business leaders with key decision making and strategic operational planning.
  • Established performance goals for employees and provided feedback on methods for reaching those milestones.
  • Delivered performance reviews, recommending additional training or advancements.

Junior Front Office Executive

Tutors With Computers
04.2014 - 03.2016
  • Routed business correspondence, documents, and messages to correct departments and staff members.
  • Oversaw maintenance of office facilities and equipment by collaborating with and inspecting work of repair contractors.
  • Applied advanced administrative and analytical skills in overseeing day-to-day operational activities.
  • Managed and properly accounted for petty cash issued to facilitate general office activities.
  • Scheduled conference rooms, prepared agendas, and maintained calendars to prepare for meetings and events.
  • Monitored and oversaw general cleaning of office in line with company cleanliness standards.
  • Interacted with customers by phone, email, or in-person to provide information.
  • Reconciled account files and produced monthly reports.
  • Prepared mail and packages for shipment, pickup, and courier services to expedite delivery.
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
  • Screened visitors and issued badges to maintain safety and security.
  • Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
  • Responded to inquiries from callers seeking information.
  • Edited documents to improve accuracy of language, flow, and readability.
  • Assisted in preparation and processing of payroll to facilitate prompt staff payments.
  • Facilitated office productivity, coordinating personnel schedules, quality assurance and procedural improvements.
  • Supported company leaders by managing budgets, scheduling appointments and organizing itinerary.
  • Continually sought methods for improving daily operations, communications with clients, recordkeeping and data entry for increased efficiency.
  • Facilitated new hires, transfers, terminations, changes in job classifications and merit increases to main human resources files.
  • Updated reports, managed accounts, and generated reports for company database.
  • Analyzed data related to administrative costs and spending trends to prepare budgets for personnel.
  • Received inquiries from corporate customers, major vendors and trade press and delivered informed responses with minimal input from executives.
  • Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
  • Increased office participation in special events by creating newsletter with detailed calendars and other office updates.
  • Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
  • Facilitated timely delivery of special projects to meet organizational and departmental objectives.
  • Scheduled meetings, coordinated with invitees and organized logistics, technology and refreshments for executive management and customers.
  • Surpassed team goals by partnering with colleagues to implement best practices and protocols.
  • Assisted coworkers and staff members with special tasks on daily basis.
  • Established workflow processes, monitored daily productivity, and implemented modifications to improve overall performance of personnel.
  • Requested, reviewed, processed and distributed status reports from various team members to executive management according to established workflow processes.

Education

Bachelor of Science - Social Sciences

Loyola University New Orleans
New Orleans, LA
06.2014

Skills

  • CPT, ICD-10-CM and HCPCS Level II codes
  • Insurance Regulations
  • PPE Compliance
  • Medical Billing
  • Posting and Balancing
  • Insurance Contracts, Appeals, EOBs
  • Confidential Records Maintenance
  • Accounts/Claims Reconciliation
  • Quality Control
  • Extensive knowledge of HMOs, Medicare, and Medicaid

Certification

  • Front Office, Medical Billing, Coding & Administration, Florida Career College -2021

Timeline

Coding and Billing Specialist

Clinica Hispana
02.2021 - Current

Patient Service Representative

Clinica Hispana
01.2018 - 02.2021

Front Office Manager

Tutors With Computers
03.2016 - 01.2018

Junior Front Office Executive

Tutors With Computers
04.2014 - 03.2016

Bachelor of Science - Social Sciences

Loyola University New Orleans

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KEOSHA FLOYD