Shawna Neely
Front Royal,VA
Summary
Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software. Organized medical biller boasts several-year career performing difficult multitasking and claims-processing tasks. Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers and clients to handle invoicing within high-traffic office environment. Skilled Medical Billing Specialist with background in accurate coding, claims processing and managing patient accounts. Showcased proficiency in medical software systems, healthcare regulations, and insurance policies. Proven ability to streamline billing procedures leading to increased productivity and improved revenue cycle management. Known for strong problem-solving skills and commitment to maintaining confidentiality in handling sensitive patient information.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Coding and Billing Specialist
Jd Matthews Associates
Winchester, VA
06.2007 - Current
- Processed medical claims using advanced coding software for accuracy.
- Reviewed patient records to ensure proper documentation and coding compliance.
- Communicated with healthcare providers to resolve billing discrepancies efficiently.
- Maintained up-to-date knowledge of coding regulations and insurance policies.
- Collaborated with the finance team to streamline billing workflows and processes.
- Provided customer service support via phone or email regarding account balances or other inquiries related to billing issues.
- Researched denied claims to determine the cause of denial and corrected errors as needed.
- Assigned appropriate codes using ICD-10-CM for diagnosis, CPT for procedures, HCPCS for supplies and modifiers as required by payers.
- Submitted claims electronically to insurance companies in accordance with regulations.
- Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
- Performed data entry into electronic health record system for all relevant patient information including diagnoses, procedures performed, medications prescribed .
- Monitored regulatory updates from Medicare and Medicaid programs as well as private insurers.
- Maintained detailed accounts receivable aging reports on a daily basis to ensure timely payments from patients and insurance companies.
- Generated reports from software systems to track claim status and denials.
- Provided administrative support including filing documents, preparing correspondence .
- Updated patient demographics information within practice management system.
- Participated in meetings with physicians and other healthcare providers regarding coding compliance standards.
- Adhered to HIPAA regulations when handling confidential patient information.
- Facilitated payment arrangements with patients and guarantors who were unable to make full payment at time of service.
- Analyzed trends in denials in order to recommend process improvements which would reduce the number of denials received.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained high accuracy rate on daily production of completed reviews.
- Coordinated with billing department to clarify billing issues related to coding.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
- Analyzed patient charts and records to extract relevant coding information.
- Maintained positive working relationship with fellow staff and management.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Participated in professional development activities that enhanced knowledge base in the field of medical billing and coding.
- Ensured compliance with all state and federal regulations related to medical billing procedures.
- Maintained up-to-date knowledge of coding systems such as ICD 10 and CPT codes used in medical billing processes.
- Conducted audits on claims submitted by medical billing staff, ensuring compliance with all applicable laws and regulations.
Education
Some College (No Degree) - Medical Billing And Coding
Lord Fairfax Community College
MiddletownSkills
- Medical coding
- Claim processing
- Billing compliance
- Accounts receivable management
- Problem solving
- Attention to detail
- Data analysis
- Analytical and critical thinking
- ICD-10-CM coding
- CPT coding
- Insurance verification
- Claim status tracking
- Billing workflows
- Time management
- Patient communication
- Process improvement
- Collections management
- Reimbursements
- Account reconciliation
- ICD-10
- Submission of medical claims
- Claims review
- Critical thinking
- Account management
- Insurance collections
- Insurance claims processing
- Claim review
- CPT code modifiers
- Insurance billing
- HIPAA compliance certification
Certification
certified medical coder
Timeline
Medical Coding and Billing Specialist
Jd Matthews Associates
06.2007 - Current
Some College (No Degree) - Medical Billing And Coding
Lord Fairfax Community College
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