Rosemarie Matibag

· Performs specialized coding services for outpatient medical office visits. Reviews physician coding and provides updates.

· Navigates the EMR to thoroughly abstract ICD10CM diagnoses at the highest level of specificity across the Oncology & Therapeutic infusion centers.

· Assigns accurate CPT codes by adhering to the CPT hierarchy coding guidelines for injection and infusion therapy services rendered in the facility.

· Query providers and provide guidance, as appropriate, for instances where drug administration, modifier usage or documentation in the EMR is unclear, unfinished or inaccurate.

• Communicated with insurance providers to resolve denied claims and resubmitted.
• Posted and adjusted payments from insurance companies.
• Communicated effectively and extensively with other departments to resolve claims issues.
• Located errors and promptly refiled rejected claims.
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Identified and resolved patient billing and payment issues.
• Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
• Collected payments and applied to patient accounts.
• Precisely evaluated and verified benefits and eligibility.
• Reconciled accounts receivable to general ledger.

• Communicated with insurance providers to resolve denied claims and resubmitted.
• Posted and adjusted payments from insurance companies.
• Located errors and promptly refiled rejected claims.
• Identified and resolved patient billing and payment issues.
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
• Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
• Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
• Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
• Collected payments and applied to patient accounts.
• Precisely evaluated and verified benefits and eligibility.
• Filed and updated patient information and medical records.
• Verified insurance of patients to determine eligibility.
• Posted payments and collections on regular basis.
• Prepared billing statements for patients and verified correct diagnostic coding.
• Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.

• [Scholarship Name] Jose De Venecia Jr. Scholar