Rachel Oaks
Stoystown,PA
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. Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
5
5
years of professional experience
Work History
Medical Biller and Coder
MBMS Medical Billing Services
- Balancing, Payments, Data Entry, Collecting rejected claims, follow-up with insurance companies regarding outstanding bills, collections
- Epic, Navinet, Waystar, Resolve, Excel
- ICD-9, ICD-10, Analyzing medical charts in resolve and applying the correct code
- Incoming/Outgoing calls from ONQ, Insurance agents and patients
- Work Tracker
Medical Assistant/Medical Biller and Coder
Somerset Surgical Services & Pain Management
09.2019 - 09.2020
- Call patients to confirm upcoming appointments
- Updated patients charts with medication lists, labs (flowsheet)
- Sent prescriptions to pharmacy per Physicians request
- Scheduled hospital appointments for inpatient and outpatient procedures
- Stock, and clean exam rooms with supplies
- Biohazard
- Diagnosis and procedure codes
- Billing, payments, prior authorizations
- Vital signs
- Uranalysis
- Roomed patients checked patients in and out
- Prepped exam room for procedures, assisted physician for procedures such as colonoscopys, pilonidal cysts, wound vacs, hemorrhoidectomy (Banding)
- Dressing changes
- Allscripts, Excel, Epic
- Pediatric Care
- Managed invoicing and payment processing operations.
- Verified accuracy of billing data and corrected discrepancies.
- Handled account payments and provided information regarding outstanding balances.
- Generated daily, weekly and monthly reports for billing department.
Medical Assistant
Pediatric Care Specialists
01.2017 - 03.2019
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Prior auths
- Assisted physician with in office procedures
- Answered phones
- injections, blood draws, hemoglobin, lab (step tests/ cultures, flu tests)
- Insurance eligibility
- Allscrips, navinet, excel
- Called families with upcoming appointment reminders
- EKG
- Traveled to satellite offices
- Obtained client medical history, medication information, symptoms, and allergies.
- Performed medical records management, including filing, organizing and scanning documents.
- Collected and documented patient medical information such as blood pressure and weight.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
- Prepared lab specimens for diagnostic evaluation.
- Oriented and trained new staff on proper procedures and policies.
- Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
Medical Assistant/Billing
Renal & Electrolytes
10.2015 - 01.2017
- Front and back-office setting, Paper charts
- Uranalysis, Flu injections
- Roomed patients, vitals, updated labs in paper charts
- Traveled to satellite offices with paper charts on PRN basis to work with physician and CRNP
- Billing, ICD-9
- Stocked, and cleaned exam rooms
- Called patients with lab results
- Posted payments and collections on regular basis.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prior authorizations
- Hippa
- Biohazard
- Filed and updated patient information and medical records.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
Education
Medical Assistant Specialist Billing and Coding -
Associates Degree - undefined
CPR Certified Meadow View Nursing Center Certified Nursing Assistant - undefined
Associate of Science - Medical Assisting/Medical Billing And Coding
Pittsburgh Career Institute
Pittsburgh, PA10.2015
Skills
- Phlebotomy, hematology, Anatomy
- Medical Terminology
- EKG, needle sticks, dressing changes
- Wound vacs
- Excel
- Doctor Communication
- Reviewing Renewals
- Financial Assistance
- Prescription Refills
- CPT Code Modifiers
- EMR Systems
- Resolve
- Navinet
- Allscripts, work tracker
- Epic
- Medical Billing and Collections
- ICD-10 (International Classification of Disease Systems)
- Insurance Claims Analysis
- Workers' Compensation Forms
- Medical Release of Information ROI
- Demographics Information
- Data Entry
- Past Due Account Management
- Process Forms
- Inpatient Coding
- Accounts Payable and Accounts Receivable
- Medical Claims Coding
- Pharmaceutical Codes
- Records Scanning
- Waystar
- HER codes
- ONQ
- Payments over the phone
- Prior authorizations
- Working Remotely
- Siemens Soarian Financials
- Invoice Statements
- Electronic Filing System Organization
- Paperwork Processing
- Customer Experience
- Inventory Coordination
- Hospital Inpatient and Outpatient Records
- Intuit QuickBooks
- ICD-10 Requirements
- Maintain Patient Confidentiality
- Medical Histories and Vital Statistics
- Medical Transcription
- Reminder Calls
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The way to get started is to quit talking and begin doing.
Walt Disney
Timeline
Medical Assistant/Medical Biller and Coder
Somerset Surgical Services & Pain Management
09.2019 - 09.2020
Medical Assistant
Pediatric Care Specialists
01.2017 - 03.2019
Medical Assistant/Billing
Renal & Electrolytes
10.2015 - 01.2017
Medical Biller and Coder
MBMS Medical Billing Services
Medical Assistant Specialist Billing and Coding -
Associates Degree - undefined
CPR Certified Meadow View Nursing Center Certified Nursing Assistant - undefined
Associate of Science - Medical Assisting/Medical Billing And Coding
Pittsburgh Career Institute
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