MICA D’ALESANDRO
Daytona Beach,FL
Summary
In the past year I have working in billing and coding for ER visits with Ventra Health. I post payments and deal with denials as part of my experience. I want more training to be a better coder and further expand my career by working remotely, helping to solve problems be part of something more. I like to stay busy and complete as much work as I can.
Overview
19
19
years of professional experience
Work History
Medical Billing Representative
Ventra Health
Ponce Inlet, FL
09.2021 - Current
- Posted and adjusted payments from insurance companies.
- Precisely evaluated and verified benefits and eligibility.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Determined prior authorizations for medication and outpatient procedures.
- Evaluated patients' financial status and established appropriate payment plans.
- Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
- Promptly sent out and posted all medical claims.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Reviewed and resolved claim issues captured in TES/CLAIMS edits and clearing house.
- Confidently and adeptly handled claim denials and/or appeals.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
- Posted payments and collections on regular basis.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Delivered timely and accurate charge submissions.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Set up and maintained new electronic billing system.
Hospitality & Customer Service
Various Restaurants,
Baltimore, FL; Knoxville,TN;, MD
01.2004 - 08.2021
- Increased customer service ratings significantly through personable service.
- Collaborated with various team members to meet guests' requests.
- Tracked guest satisfaction surveys to recognize trends and create action plans for improving guest services.
- Collaborated with maintenance, housekeeping and security teams to resolve requests and issues efficiently.
- Increased revenue by implementing new ideas that resulted in full occupancy [Number] days per week.
- Responded proactively and positively to rapid change.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Delivered prompt service to prioritize customer needs.
- Met customer call guidelines for service levels, handle time and productivity.
- Educated customers about billing, payment processing and support policies and procedures.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
- Maintained up-to-date knowledge of product and service changes.
- Trained new personnel regarding company operations, policies and services.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
- Sought ways to improve processes and services provided.
Education
MEDICAL CODING
CPC-A
AAPC08.2021
Bachelor’s - Sociology: Environmental Issues with Globalization
University of Tennessee
2011
Skills
- CPT/ICD-10-CM - 1 year
- Mac and PC - 10 years
- Problem Solver
- Resourseful
- Attention to detail
- Customer Service - 10 years
- Organized
Timeline
Medical Billing Representative
Ventra Health
09.2021 - Current
Hospitality & Customer Service
Various Restaurants,
01.2004 - 08.2021
MEDICAL CODING
CPC-A
Bachelor’s - Sociology: Environmental Issues with Globalization
University of Tennessee
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