Summary
Overview
Work History
Education
Skills
Timeline
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Migrely Mendez

Hollywood,FL

Summary

Accurate performs all aspects of medical billing, including coding, charge entry, transmission, correction, and resubmission. Brings 8 years of experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials.

Overview

7
7
years of professional experience

Work History

Medical Coding & Data Entry

Ruben D. Felhandler, DPM, PA
Hialeah, FL
10.2021 - Current
  • Resolved discrepancies between paper records and electronic databases.
  • Assisted physicians in understanding the requirements for accurate documentation of diagnoses and procedures.
  • Reviewed physician documentation to ensure accurate coding of diagnoses and procedures.
  • Verify outdated data and make any necessary changes to records.
  • Utilized specialized software applications related to the job role.
  • Processed incoming patient information into electronic health record system.

Medical Coding and Billing Specialist

South Florida State Hospital
Pembroke Pines, FL
09.2018 - Current
  • Reprises medical claims(CMS1500) submitted by outside provider based on the Medicaid fee schedule
  • Review Medicare denials and processes invoice for payment if needed work closely with services provider and resolves issues timely
  • Maintains and updates monthly spreadsheets of inpatient and outpatient medical claims and ambulance accruals for internal and external audit purposes
  • Maintains and update the Medicare days report for the annual Medicare cost reports
  • Researched denied claims to determine the cause of denial and corrected errors as needed.
  • Provided customer service support via phone or email regarding account balances or other inquiries related to billing issues.
  • Resolves all billing issues with payer or services provider Determine if a secondary insurance should be added to the patient account ensuring the appropriate payer is selected for Primary insurance
  • Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information
  • Enter the patient insurance information into patient accounting system ensuring the selection is the appropriate payer and associated financial class.
  • Reviewed physician orders, laboratory results, diagnostic images, clinical statements and other health care provider services for completeness and accuracy.

Billing and Coding

Pathology Specialist
Orlando, FL
11.2016 - 09.2018
  • Reading and analyzing patient records
  • Determining the correct codes for patient records
  • Maintaining patient confidentiality and information security
  • Keeping track of patient data over multiple visits
  • Send billing to insurances
  • Appeal to insurances.
  • Assigned appropriate codes using ICD-10-CM for diagnosis, CPT for procedures, HCPCS for supplies and modifiers as required by payers.
  • Submitted claims electronically to insurance companies in accordance with regulations.
  • Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
  • Performed data entry into electronic health record system for all relevant patient information including diagnoses, procedures performed, medications prescribed .

Education

Medical Billing and Coding Specialist -

Florida Technical College
06.2017

High school diploma or GED -

Skills

  • Microsoft office systems data entry
  • Billing answer
  • Leadership
  • Adaptability
  • Medical Billing & Coding
  • Microsoft Windows
  • CPT coding
  • ICD-10
  • Medical records
  • Medical office experience
  • Anatomy knowledge
  • Insurance verification
  • EMR Systems
  • Medical Terminology (4 years)
  • HIPAA
  • Insurance verification (3 years)
  • Next generation sequencing (1 year)
  • Customer service
  • Medical terminology
  • Communication skills

Timeline

Medical Coding & Data Entry

Ruben D. Felhandler, DPM, PA
10.2021 - Current

Medical Coding and Billing Specialist

South Florida State Hospital
09.2018 - Current

Billing and Coding

Pathology Specialist
11.2016 - 09.2018

Medical Billing and Coding Specialist -

Florida Technical College

High school diploma or GED -

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Migrely Mendez