MARJORIE STMARC
Melbourne,United States
Summary
Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder knowledgeable in AMA and the CMS coding rules.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Medical Coder Specialist Ill-40 Hrs a Week
Bleu Med Consultants
Fort Lauderdale, FL
01.2020 - Current
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Assisted in the development of coding guidelines and policies.
- Maintained up-to-date knowledge of coding changes, updates, and new rules.
- Performed audits on coded claims to ensure that all required data elements are included for accurate payment processing.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Prepared reports summarizing coding trends or areas where additional training is needed.
- Collaborated with other departments such as billing, clinical documentation improvement, quality assurance to ensure accurate coding practices are being followed.
- Identified opportunities for process improvements related to medical coding operations processes and procedures.
- Validated accuracy of diagnosis codes as well as modifiers used on claims before final submission to payer and insurance companies.
- Ensured timely resolution of denials due to incorrect code assignments or missing information in the claim form.
Practice Manager
Pelvic Rehabilitation Medicine-40 hrs a week
Coconut Grove, FL
05.2019 - 12.2020
- Maintain and organize all administrative functions in the front office, oversee a variety of managerial and administrative duties, coordinate all staff activity, and maximize patient flow, accordingly
- Verify all patient's insurance, referrals, and authorizations daily Assign the patient plan to the patient's account Running a daily report to balance the daily payments communicating patients' arrival promptly, managing administrative records
- Responsible for hiring, and terminating Staff
- Maintains liaison with administrators, physicians, and outside organizations Trains and cross-trains new and existing employees
- Provides administrative and clinical supervision to ensure the effective implementation of patient services
- Authorizes and monitors vacation requests, changes in work or lunch schedules, arranging for coverage as necessary, and approved weekly employee timesheets
- Responsible for ordering office supplies.
- Developed and implemented new patient registration processes to streamline workflow.
- Maintained financial records, including billing and accounts receivable and payable.
- Coordinated staff recruitment, training, and scheduling activities.
- Monitored compliance with HIPAA regulations concerning patient privacy rights.
- Provided leadership and guidance to the medical team in order to meet goals and objectives.
- Performed administrative tasks such as creating budgets and forecasts, preparing invoices and contracts, ordering supplies and equipment.
Billing Supervisor
Southern Winds Hospital-40 hrs a week
Hialeah, FL
10.2017 - 05.2019
- Verify Patient Eligibility revenue cycle, third-party payers, Medicare, Medicaid and private, and other 3rd Paty payers strong knowledge of billing coding and collection Federal payer regulations
- Working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes
- Knowledge of business management and basic accounting principles to direct the billing and coding office
- Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers
- Developed and implemented billing procedures to ensure accurate invoicing and payment collection.
- Monitored accounts receivable aging reports to identify overdue payments, researched discrepancies, and took corrective action.
- Ensured timely processing of customer payments by setting up payment plans and negotiating settlements as needed.
- Assisted in the preparation of annual budgeting process for billing department operations.
- Conducted weekly meetings with staff to discuss performance metrics, goals, objectives, and other issues related to billing processes.
Medical Coder
Chen Medical Center-40 hrs a week
Miami, FL
08.2015 - 10.2017
- Experience Coding for PCP, Podiatry, Oncology, Urology, Endocrinology, cardiology optometry
- Billing and coding Analytics: Working in a high-Risk billing department, as a medical coder and biller
- Experience with ICD-9- ICD-10 and Cpt Codes, Examine the progress notes and use the ICD-10 book to classify the diagnosis codes provided by the provider or the Specialist
- Analyze claims adjudicated in error, making recommendations to Supervisor or Manager Improvements
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Maintained up-to-date knowledge of coding changes, updates, and new rules.
- Performed audits on coded claims to ensure that all required data elements are included for accurate payment processing.
- Provided support for coding queries raised by coders or staff members regarding specific cases or coding issues.
- Prepared reports summarizing coding trends or areas where additional training is needed.
BILLING COLLECTOR TEAM LEAD
Chrysalis Behavior Health Inc-40 hrs a week
Broward, FL
10.2012 - 09.2015
- Understanding of medical billing, collections, and payment posting, revenue cycle, third-party payers, Medicare, Medicaid and private, and other 3rd Paty payers strong knowledge of billing coding and collection Federal payer regulations
- Working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes
- Knowledge of business management and basic accounting principles to direct the billing and coding office
- Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers
- I possess excellent negotiation skills.
- Verified customer account information and payment history to ensure accuracy.
- Managed a high volume of outbound calls to collect past due payments.
- Maintained accurate records of customer interactions and transactions for future reference.
- Resolved billing disputes through research and communication with clients.
Education
Technical or occupational certificate - Certify professional Coder
AAPC training
01.2020
Technical or occupational certificate - Medical billing and Coding
Everest Institute
09.2010
High school diploma or equivalent -
Santa Fe High School
06.2007
Skills
- Documentation Oversight
- Performance Improvement
- Coding Error Resolution
- Clinical Documentation
- Data Entry
- Document Management
- Training and Mentoring
- Inpatient, Outpatient, ER Coding
- Qualified Pain Management Coder
- Revenue Cycle Management
- Records Management
- Medical Billing
- Medical Terminology
- Insurance Verification
- Workflow Management
- Data Verification
Day Phone
305-764-6415
References
- Manoucheca Mondesir, Southern Winds Hospital, Patient coordinator, 305-263-0752, manouchecamondesir@hotmail.com
- Evelyn Butus, 954-682-9943
- Dr. Estreicher Michael, Blue Med Consultants, CEO, 646-234-6471, Mike@bluemedconsultants.com
- Erik Camp, Blue Med Consultants, HR Director, 786[351[7233, erik@bluemedconsultants.com
- Linda Solime, Pelvic Rehabilitation Medicine, CMO, 207[752[0388
Certification
- CPC
Languages
English
Professional
French
Professional
Timeline
Medical Coder Specialist Ill-40 Hrs a Week
Bleu Med Consultants
01.2020 - Current
Practice Manager
Pelvic Rehabilitation Medicine-40 hrs a week
05.2019 - 12.2020
Billing Supervisor
Southern Winds Hospital-40 hrs a week
10.2017 - 05.2019
Medical Coder
Chen Medical Center-40 hrs a week
08.2015 - 10.2017
BILLING COLLECTOR TEAM LEAD
Chrysalis Behavior Health Inc-40 hrs a week
10.2012 - 09.2015
Technical or occupational certificate - Certify professional Coder
AAPC training
Technical or occupational certificate - Medical billing and Coding
Everest Institute
High school diploma or equivalent -
Santa Fe High School
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