Sandra Casey

Precise, efficient medical billing & coding professional with over 25 years of experience in inpatient, outpatient, and physician medical billing & coding seeking a full-time remote position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Specializing in filing accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOBs. Additional expertise in quality control, reimbursements, and implementing improved processes to enhance accuracy of business, billing, and medical records departments.

Core Qualifications
Medical Billing CPT and HCPCS Coding, Posting and Balancing insurance Contracts, Appeals, EOBs Confidential Records Maintenance Accounts/Claims Reconciliation Quality Control Knowledge of HMOs, Medicare, and Medicaid.

Accomplishments
Gained expertise in all aspects of medical billing including filing claims, refund requests, re-filing rejected claims, completing appeals, and posting payments and accurately adjusting underpayments. Committed to staying up to date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service, and managed care plans. Improved efficiency for clients by creating an organized logging system for tracking errors in Microsoft Excel. Liaised with the business clients and medical records departments to resolve errors in high dollar accounts to ensure timely filing and accurate billing.

Professional Experience

Advocated for clients & patients by contacting insurance companies to ensure timely payments and resolve errors on rejected claims. Diligently prepared all clients required claims documentation including obtaining prior authorizations, referrals, treatment plans, or other required correspondence to reduce incidence of claim denials. Maintained accountability and accurate records by entering adjustments and denials into medical manager system. Acted as a liaison between the client's business department, billing, and medical records to resolve billing errors and apply appropriate ICD-9 and later ICD-10, CPT-4, HCPCS codes, charges, and corrected charges. As a reimbursement specialist, partnered with the business clients, billing, and third party payers to ensure accurate billing, reimbursement, and filing of denied claims. Reviewed remittance codes from EOBs/ARs, and posted charges, payments, and adjustments. Stayed current with changes in HCPCs, CPTs, DRG, and reimbursement for Medicare and Medicaid . Performed full-cycle medical billing & practice management in a fast-paced company. Promoted continued accuracy by evaluating provider fee schedule charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification, and provider signatures.

Member of : American Medical Billing Association, National Association of Health Care Professionals & American Association of Professional Coders

National Registered-Certified Medical Assistant