Melanie Garcia
Wilmington,NC
Summary
Skilled Medical Biller and Coder with comprehensive experience in healthcare billing, coding procedures, insurance claims, and payment processing. Possesses strong knowledge of medical terminology, ICD-10 codes, HCPCS and electronic health records. Known for high accuracy rates in coding and billing operations while ensuring compliance with industry regulations. Previous roles highlighted by improved efficiency in medical record management and enhanced revenue recovery efforts. Knowledge in several EMR systems including Healthpac, CollaborateMD, eClinicalWorks, Raintree, Practicefusion, Healthfusion/Nextgen, Tebra and Kareo.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Medical Biller and Coder
Flatirons Practice Management
Boulder, CO
12.2018 - Current
- Submitted claims to insurance companies electronically or by mail.
- Verified accuracy of patient information and insurance data in billing system.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Provided customer service support to patients regarding billing inquiries.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Ensured timely filing of all claims within established guidelines.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
Pharmacy Technician
King Soopers
Denver, CO
07.2010 - 09.2018
- Prepared medications for dispensing by counting, pouring, labeling, and verifying doses.
- Performed data entry for patient profiles, billing information and prescription orders into the pharmacy software system.
- Provided customer service to patients by answering questions about medications and health-related topics.
- Assisted pharmacists in compounding sterile products according to state regulations.
Education
Certificate - Medical Billing And Coding
Front Range Community College
Westminster, CO05-2019
High School Diploma -
East High School
Cheyenne, WY05-2012
Skills
- Appeals processing
- Claim submission
- Patient account management
- Medical billing procedures
- Payment posting
- Medicare insurance regulations
- Statement analysis
- Medical coding and abstracting
- Training and mentoring
- Insurance coding (ICD-10 and CPT)
Certification
- Certified Coding Associate (CCA) from AHIMA
Timeline
Medical Biller and Coder
Flatirons Practice Management
12.2018 - Current
Pharmacy Technician
King Soopers
07.2010 - 09.2018
- Certified Coding Associate (CCA) from AHIMA
Certificate - Medical Billing And Coding
Front Range Community College
High School Diploma -
East High School
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