Miriame Seraphin
Douglasville,GA
Summary
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
16
16
years of professional experience
Work History
MATERIAL HANDLER
KANE LOGISTICS
05.2021 - 10.2021
- Building displays, filling displays with product, building boxes and sorting candy.
BILLING SPECIALIST
THE CHIROPRACTIC CENTER LLC
01.2020 - 06.2020
- Analyze and interpret Explanation of Benefits forms to ensure insurance companies have paid for charges.
- Timely follow up on insurance claim denials or clearinghouse rejections, exceptions or exclusions.
- Recognize, claim denial trends, to create plans to obtain insurance payments, coordinate and communicate with team members and supervisor regarding changes with insurance companies, complicated and problematic patients accounts.
- Establish working relationship with billing staff to obtain the necessary information to bill chiropractic claims.
REVENUE SPECIALIST
KINDRED AT HOME
01.2019 - 12.2019
- Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing
- Assure the completion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.
- Alerts appropriate team members at the Site regarding late or missing documents required for billing.
- Ensure all internal controls and related policies/procedures are implemented and followed in accordance to the accounts receivable requirements.
- Verify patient eligibility and payer coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition.
BILLING SPECIALIST
BENEVIS
MARIETTA
05.2016 - 01.2018
- Follow up all unbilled appointments on daily basis
- Ensure that all claims are submitted within the timely filling according to payer.
- Assist in training new Billing Specialists as needed.
- Review that eligibility and benefits have been properly verified before submitting the claim for processing.
- Ensure that all charted procedures correspond to the procedures coded for billing.
COMMERCIAL VERIFICATION SPECIALIST
BENEVIS
08.2013 - 01.2016
- Gather Insurance Information
- Troubleshooting
- Responsible for updating current subscriber information. and insurance plan information. for patients
- Following up escalated communications according to protocols
- Verifying commercial insurance
- Verification of CBT
PHARMACY TECHNICIAN
PUBLIX SUPERMARKET, LAWRENCEVILLE
01.2012 - 01.2013
- Formulating, labeling, and dispensing medications
- Maintaining patient records
- Managing insurance claims
- Customer service/cashier
- Inventory
CUSTOMER SERVICE REPRESENTATIVE
PUBLIX SUPERMARKET
MARIETTA
05.2003 - 01.2012
- Accounting
- Handling Customer complaints
- Keeping inventory on special ordered items
- Responsible for completion of incident reports.
- Assign different task to my peers to complete before the end of shift.
Education
Associate of Science - Medical Billing And Coding
West Georgia Technical College
MEDICAL BILLING AND CODING CERTIFICATE - undefined
Skills
- Communication/Customer service
- Bilingual
- Data Entry
- Proficient in Word/Excel/PowerPoint
- Interpersonal skills
- Adaptability
- Teamwork
- Self-motivated
Accomplishments
Perfect attendance
10-year Employee Service Award
Pharmaceutical promotion
Timeline
MATERIAL HANDLER
KANE LOGISTICS
05.2021 - 10.2021
BILLING SPECIALIST
THE CHIROPRACTIC CENTER LLC
01.2020 - 06.2020
REVENUE SPECIALIST
KINDRED AT HOME
01.2019 - 12.2019
BILLING SPECIALIST
BENEVIS
05.2016 - 01.2018
COMMERCIAL VERIFICATION SPECIALIST
BENEVIS
08.2013 - 01.2016
PHARMACY TECHNICIAN
PUBLIX SUPERMARKET, LAWRENCEVILLE
01.2012 - 01.2013
CUSTOMER SERVICE REPRESENTATIVE
PUBLIX SUPERMARKET
05.2003 - 01.2012
Associate of Science - Medical Billing And Coding
West Georgia Technical College
MEDICAL BILLING AND CODING CERTIFICATE - undefined
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