Summary
Overview
Work History
Education
Skills
Certification
Timeline
CPC, CPB, CPMA
Generic

Felecia Fode

Grants Pass

Summary

Dynamic Audit Manager with a proven track record at AllCare, enhancing audit efficiency through innovative software implementation and meticulous report preparation. I excel in developing comprehensive audit plans that drive organizational success and foster effective communication.

Overview

21
21
years of professional experience
1
1
Certification

Work History

Audit Manager

AllCare
09.2023 - Current
  • Enhanced audit efficiency by streamlining processes and implementing new auditing software.
  • Delivered comprehensive audit reports that clearly communicated findings and recommendations to senior management.
  • Prepared working papers, reports and supporting documentation for audit findings.
  • Coordinated, managed and implemented auditing projects and prepared for evaluation.
  • Developed comprehensive audit plans outlining scope, goals, timelines, and resource requirements for each project.

Medical Billing Specialist

AllCare
03.2016 - Current
  • Processed medical claims using advanced billing software, ensuring compliance with regulations.
  • Reviewed patient accounts for accuracy and resolved discrepancies efficiently.
  • Communicated with insurance providers to obtain claim status and payment information.
  • Maintained detailed records of billing transactions and updates in electronic health record systems.
  • Conducted regular audits of billing processes to ensure adherence to quality standards.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Posted and adjusted payments from insurance companies.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Located errors and promptly refiled rejected claims.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
  • Collected payments and applied to patient accounts.
  • Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Delivered timely and accurate charge submissions.
  • Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.

Medical Office Manager

Bruce Perry MD
12.2010 - 03.2016
  • Managed daily operations to ensure efficient patient flow and optimal staff performance.
  • Coordinated scheduling for medical staff and maintained accurate appointment records using EHR systems.
  • Trained and mentored administrative staff on office policies, procedures, and best practices in healthcare management.
  • Oversaw billing processes to ensure compliance with insurance regulations and timely collections of payments.
  • Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and safeguarding against potential data breaches.
  • Streamlined billing processes for quicker reimbursement, improving cash flow.
  • Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.

Medical Biller and Coder

Greentree Orthopedics
02.2005 - 12.2010
  • Processed medical claims accurately, ensuring compliance with payer guidelines and regulations.
  • Reviewed patient records to verify coding accuracy and completeness prior to submission.
  • Analyzed coding trends to identify areas for training initiatives and process enhancements.
  • Developed comprehensive reports on billing activities, providing insights for strategic decision-making in revenue cycle management.
  • Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Participated in continuing education opportunities to stay current on advancements within the field of medical billing and coding, thereby elevating the overall quality of work.
  • Communicated with insurance companies to research and resolved coding discrepancies.

Education

No Degree -

Hidden Valley High School
Grants Pass, OR
06-1984

Skills

  • Financial statement review
  • Audit documentation
  • Client relationship management
  • Risk assessment
  • Audit management
  • Audit planning
  • Report preparation
  • Audit committee
  • Multitasking
  • Organizational skills
  • Active listening

Certification

CPMA - Certified Professional Auditor

CPC- Certified Professional Coder

CPB- Certified Professional Biller

Timeline

Audit Manager

AllCare
09.2023 - Current

Medical Billing Specialist

AllCare
03.2016 - Current

Medical Office Manager

Bruce Perry MD
12.2010 - 03.2016

Medical Biller and Coder

Greentree Orthopedics
02.2005 - 12.2010

No Degree -

Hidden Valley High School

CPC, CPB, CPMA

  • Certified Professional Coder (CPC®) – Demonstrates expertise in medical coding across CPT®, HCPCS, and ICD-10-CM, ensuring compliance with payer guidelines and accurate claim submission.
  • Certified Professional Biller (CPB™) – Validates proficiency in the billing process, revenue cycle management, claims processing, and payer compliance to optimize reimbursement.
  • Certified Professional Medical Auditor (CPMA®) – Establishes advanced skills in auditing medical records, identifying coding/documentation errors, ensuring compliance with regulations, and supporting risk-reduction strategies.

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