OCTAVIA MITCHELL
Medical Billing and Coding
Charlotte,NC
Summary
Medical Office Manager with about 5 years of experience in managing and mentoring new employees. History of positive management resulting in improved operations and employee retention. Experienced and efficient medical billing professional and Charge Capture Specialist with over 15 years of experience in reconciling insurance and patient payments and resolving account disputes. Diligent in producing clean medical records and insurance claims capturing billable activities. Well-versed in conducting audits, collaborating with departments and providers, and updating records with speed and efficiency. Experienced in ICD-10 and CPT coding processes. Highly accurate and compliant with all documentation and HIPAA requirements.
Overview
17
17
years of professional experience
Work History
Charge Capture Specialist
Optum
Charlotte, NC
05.2017 - Current
- Direct end-to-end charge capture and entry, claims submission processes, ensuring accurate and clean claims to maximize reimbursement
- Verify claims data against TES edits and correct documentation, querying providers as necessary to obtain information and submit claims with
- Assign correct ICD-10 and CPT codes according to patient conditions and medical documentation
- Audit chart documentation to support accurate coding including acting as liaison between providers and billing department
- Work closely with provider and clinical managers to ensure all charges are entered by month-end closing Resolve monthly reconciliation and analyze provider's claims with low revenue
- Assist billing department in resolving coding and billing issues, including pre-billing issues from electronic billing system and/or payers to facilitate theaccurate and timely filing of clean claims submission
- Review and process missing charges for appropriate documentation to ensure claim efficiency
Medical Biller/Referrals/Office Manager
Monique Brown MD PC
Charlotte, NC
03.2011 - Current
- Medical Billing Specialist (Remote) January 2018 - Current
- Effectively filed claims to NC Medicaid, Medicare, Tricare, and Commercial Carriers
- Payment posting, processed claims denials, and billed patients (responsible party) for the outstanding balance
- Working knowledge of ICD-9 and ICD-10, CPT and HCPCS Coding
- Processed Insurance verification and create billing reports and spreadsheets
- Referral Coordinator (Remote) May 2016 - May 2017
- Process incoming referrals via electronic fax
- Verify patient insurance by obtaining benefits and eligibility for mental health office visits
- Create charts, schedule appointments
- Coordinate appointment information with referring provider
- Medical Office Manager March 2011- April 2016
- Effectively managed and trained office staff in administrative functions
- Perform job performance reviews
- Created office policies and procedures
- Facilitated provider credentialing, license renewal, and reappointments
- Facilitated Audit reviews with Local Management Entities
- Effectively filed claims to NC Medicaid, Medicare, Tricare, and Commercial Carriers
- Payment posting, processed claims denials, and billed patients (responsible party) for theoutstanding balance
- Working knowledge of ICD-9 and ICD-10, CPT and HCPCS Coding
- Efficient in all front desk functions
- Processed Insurance verification and created billing reports and spreadsheets
- Perform QA review of medical records management and compliance
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
Coder
Gebbs Healthcare Solutions Remote
Charlotte, NC
08.2016 - 11.2016
- Perform demographic reviews daily to ensure accuracy of data
- Verify all pertinent information and matched data to expected data based on the observed data
- Worked various issuers/insurance plans client accounts during the review process
- Audited initial reviews to ensure accuracy
Billing Specialist
Medix/Ensemble Health Partners
Huntersville, NC
05.2016 - 07.2016
- Properly uses coding data to prepare and submit clean claims to insurance companies electronically or via paper
- Uses correct billing guidelines to process payer specific edits on UB-04 form
- Process rejections from 277 reports to resubmit claims
- Submit additional information including medical records to payers to aide in processing timely payment
- Coordinate with onsite hospital staff to update necessary demographic and clinical information to insure claims are processed accurately and timely
- Check insurance verification to ensure claims are processed by the correct payer
- Work through edits from SSI Scrubber
Education
Bachelor of Science - Psychology-Christian Counseling, Health Information
Liberty University
06.2014
Certified Medical Assisting: Medical Assisting - Medical Assisting
ATI Career Training Center - Miami
Miami, FL05.2001
High School Diploma -
Miami Northwestern High School
Miami, FL06.1992
Skills
- Skills Highlights:
- Medicare and Medicaid Processes
- Itemized Statement Preparation
- Chart Auditing
- Commercial and Private Insurance
- Billing Data Verification
- Account Posting and Reconciliation
- Claim Processing
- Revenue Operations
- CMS-1500 Billing Forms
- Adjustment Posting
Timeline
Charge Capture Specialist
Optum
05.2017 - Current
Coder
Gebbs Healthcare Solutions Remote
08.2016 - 11.2016
Billing Specialist
Medix/Ensemble Health Partners
05.2016 - 07.2016
Medical Biller/Referrals/Office Manager
Monique Brown MD PC
03.2011 - Current
Bachelor of Science - Psychology-Christian Counseling, Health Information
Liberty University
Certified Medical Assisting: Medical Assisting - Medical Assisting
ATI Career Training Center - Miami
High School Diploma -
Miami Northwestern High School
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