Richard Gamble
Ormond Beach,FL
Summary
Accomplished Medical Biller and Coder at Volusia County Government, adept in HIPAA Compliance and Insurance Verification, significantly reduced claim denials. Demonstrated leadership as a Lead Pawnbroker and Team Leader, enhancing customer satisfaction and team productivity through effective problem resolution and staff management.
Overview
8
8
years of professional experience
Work History
Medical Biller and Coder
Volusia County Government
09.2023 - Current
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Provided support to administrative staff by ensuring proper handling of sensitive patient data according to HIPAA regulations.
- Collaborated with other billing professionals during team meetings to exchange best practices and strategies for overcoming common challenges in the industry.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Verified signatures and checked medical charts for accuracy and completion.
Lead Pawnbroker
Value Pawn & Jewelry
09.2019 - 09.2023
- Streamlined loan processes for faster transactions, resulting in improved customer experience.
- Implemented loss prevention measures to reduce shrinkage rates and protect company assets.
- Resolved customer complaints promptly and professionally, retaining valuable business relationships.
- Developed marketing strategies that increased store visibility and attracted new customers.
- Negotiated favorable terms with vendors for purchasing merchandise at competitive prices.
- Trained new team members on company policies, procedures, and best practices to ensure consistent performance standards.
- Achieved high sales targets consistently through effective communication skills and product knowledge mastery.
- Handled cash transactions accurately while maintaining strict adherence to financial security protocols.
- Conducted thorough research on market trends to stay current on industry standards and anticipate customer needs.
- Collaborated with law enforcement agencies to prevent fraudulent activities and recover stolen goods.
- Performed store open and close procedures as part of shift responsibilities.
- Negotiated sale prices to reach target profit margins while reaching suitable pricing for customer.
- Complied with local, state and federal laws in reviewing identification, obtaining thumbprints and verifying serial numbers against law enforcement databases.
- Handled over 100 daily payments, always giving receipts and explaining policies to maintain excellent customer satisfaction.
Team Leader
Moes Southwestern Grill
08.2016 - 03.2019
- Supervised team members to confirm compliance with set procedures and quality requirements.
- Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
- Built strong relationships with customers through positive attitude and attentive response.
- Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
- Managed conflict resolution among team members, fostering a positive and collaborative work environment.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Promoted high standard's through personal example to help each member understand expected behavior and standards.
Education
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
Hooksett, NH09.2022
Associate of Arts -
Daytona State College
Daytona Beach, FL08.2020
Skills
- HIPAA Compliance
- Payment posting
- Insurance Verification
- ICD-10 Proficiency
- Medicare and Medicaid Billing
- Customer Service
- Problem Resolution
- Multitasking and Organization
- Staff Management
- Communicating with clients
- Inbound Phone Call Management
Timeline
Medical Biller and Coder
Volusia County Government
09.2023 - Current
Lead Pawnbroker
Value Pawn & Jewelry
09.2019 - 09.2023
Team Leader
Moes Southwestern Grill
08.2016 - 03.2019
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
Associate of Arts -
Daytona State College
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