Summary
Overview
Work History
Education
Skills
Certificates and achievements
Timeline
Generic

Robin Hamilton

Duluth,GA

Summary

Educated with 9 years of extensive experience in Medical Billing & Coding - Revenue Cycle Management with analytical skills, collections knowledge, & comprehensive training in auditing & accounts receivables.

Overview

21
21
years of professional experience

Work History

Medical Billing & Coding Specialist

Hope Fertility, LLC
Alpharetta, GA
10.2023 - Current
  • Implements ICD-10/CPT, HCPCS codes and modifiers.
  • Submits all claims within timely filing guidelines.
  • Processed corrections and adjustments per EOB, as needed, to ensure accurate payments from payers.
  • Reviewed medical records and documentation.
  • Interprets physician orders, notes, lab results, and radiology reports for appropriate code assignment.
  • Responds promptly to requests from insurance companies via portal, email & phone calls.
  • Prepared financial statements for both self-pay and insured.
  • Reconciles accounts receivables to ensure accuracy, including all denials and appeals.
  • Performed daily audits on accounts and refunds.
  • Counseled patients financially and collected funds.
  • Trained staff.

HYBRID RCM Auditor & A/R Specialist

CCRM- Colorado Center for Reproductive Medicine
Atlanta, GA
11.2018 - 09.2023
  • Audited delinquent accounts per the company's protocols.
  • Analyzed billing needs for both self-pay and insurance accounts within set deadlines.
  • Participated in special projects related to investigations, as required.
  • Assisted in preparing audit plans based on established objectives and standards.
  • Collaborated closely with other team members to develop effective audit plans.
  • Monitored changes in applicable laws and regulations that affect the organization's operations.
  • Reviewed financial statements to ensure accuracy and compliance with regulations, working closely with management.
  • Worked the entire Revenue Cycle from end to end, from submitting claims to third-level appeals.
  • Trained staff upon requests.

Front Office Billing Coordinator

Minimally Invasive Center Of Atlanta
Duluth, GA
03.2018 - 06.2018
  • Performed doctor's daily consult and procedure scheduling based on his availability via EHR system, DrChrono.
  • Scheduled patient's MRI appointments with Health Imaging Facilities and sent proper order ICD-10 and CPT codes, with insurance approvals, via electronic fax.
  • Created necessary appeal letters, completed pre-authorizations, analyzed claims for proper billing, coding, payments, and reimbursements with numerous insurance companies.
  • Followed up with patients and contacted new potential patients.
  • Greeted and checked patients in and out, ensured office was organized for efficient day-to-day order.

Medical Call Center Team Lead

Hewlett Packard Enterprise, LLC
Tucker, GA
05.2015 - 04.2016
  • Reviewed GA Medicaid eligibility, Insurance Claims, and EOBs, HIPAA, HCPCS, ICD-9, ICD-10-CM, and prior authorizations, along with other administrative duties upon request.
  • Established employees' productivity goals in meetings, assessed their skill levels, and assisted in the development of training programs needed to improve performance.
  • Scheduled team meetings and assisted with ensuring employees were proactively meeting the needs of business requirements.
  • Conducted regular coaching sessions with team members to improve customer service skills.
  • Assisted in strategies to increase customer satisfaction ratings and reduce call abandonment rates.
  • Resolved escalations in a timely manner.

National Back Office Customer Service Associate

AT&T INC.
ATLANTA, GA
04.2004 - 11.2013
  • Managed an average of one hundred inbound calls per day.
  • Monitored various third-party billing accounts to ensure proper billing.
  • Assisted sales representatives in the completion and processing of sales orders.
  • Monitored side by side and wireless listening to ensure outstanding call quality.
  • Assisted with Team Lead responsibilities, such as escalations, negotiations, and complaints.
  • Suspended and restored service, and recommended corrective services to address customers' complaints.
  • Provided product information to customers in a timely manner, while following applicable laws and compliance.

Education

Technical Collegiate Diploma - Medical Billing and Coding

Gwinnett College 2017-2018
Marietta, GA
05-2018

General Studies 2001-2002 -

Fort Valley State University
Fort Valley, GA

Skills

  • Studied medical terminology & insurance
  • Studied anatomy-1 & 2
  • Studied pathophysiology
  • EHR & EMR, Microsoft Office
  • Greenway
  • Medisoft
  • DrChrono
  • Athena Health and nAble
  • Scrubbed & audited CMS 1500 & hospital UB04 forms electronically & manually
  • Practiced implementing credentialing of physicians & patient financial services
  • Autonomy & integrity in regulating workflow and code of conduct
  • Patient data entry & itemized invoices
  • Training and supervisory of peers
  • Clinical Documentation review
  • Insurance Verification & registration
  • Ethical standards & prioritization
  • Customer service expert in fast paced environments and ability to assist clinical
  • Revenue Cycle Management end to end
  • Billing, Coding & Charging Error Resolution
  • Claims Processing and organization
  • HIPAA, Regulatory & compliance guidelines
  • Performance Improvement and multi-tasking

Certificates and achievements

  • HIPAA Certificates
  • CMS 1500 Certificate
  • CMS ICD-10 Certificate
  • World of Medicare Certificate
  • Combating Medicare Fraud, Wastes, & Abuse
  • Understanding the Values & Ethics of Interprofessional Collaboration
  • Introduction to Interprofessional Collaboration to Improve Healthcare
  • CBCS - Certification through NHA National Health Career Association (2018)

Timeline

Medical Billing & Coding Specialist

Hope Fertility, LLC
10.2023 - Current

HYBRID RCM Auditor & A/R Specialist

CCRM- Colorado Center for Reproductive Medicine
11.2018 - 09.2023

Front Office Billing Coordinator

Minimally Invasive Center Of Atlanta
03.2018 - 06.2018

Medical Call Center Team Lead

Hewlett Packard Enterprise, LLC
05.2015 - 04.2016

National Back Office Customer Service Associate

AT&T INC.
04.2004 - 11.2013

Technical Collegiate Diploma - Medical Billing and Coding

Gwinnett College 2017-2018

General Studies 2001-2002 -

Fort Valley State University

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