Tina Edmonds
Cape Girardeau,MO
Summary
Smart Medical Biller/Coder/Receptionist/ Cashier/ Medical Records Supervisor successful at resolving disputes and billing inquiries. Brings organized, professional presentation skills, adherence to strict data confidentiality and HIPAA requirements. Detail-oriented approach, cultivated over more than 20 years, toward performing intricate billing procedures with undeniable level of detail.
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
27
27
years of professional experience
Work History
Insurance/Medical Biller and Coder/Medical Records Supervisor
Cape Physicians Associates
Cape Girardeau, MO
12.1998 - 12.2008
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Managed multi-line phone system, directing calls to appropriate departments efficiently.
- Scheduled appointments and maintained calendar for staff, optimizing time management.
- Processed incoming and outgoing mail, ensuring timely distribution of communications.
- Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
- Assisted in retrieval and organization of medical documents for timely access by healthcare providers.
- Trained new staff on proper record management procedures and data entry protocols.
- Collaborated with healthcare providers to resolve discrepancies in patient billing records.
- Maintained up-to-date knowledge of coding standards, including ICD-10 and CPT guidelines.
Professional Medical Billing Specialist
Saint Francis Healthcare System
Cape Girardeau, MO
12.2008 - Current
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Posted charges, payments and adjustments.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Posted and adjusted payments from insurance companies.
- Completed appeals and filed and submitted claims.
- Submitted refund requests for claims paid in error.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Entered procedure codes, diagnosis codes and patient information into Med 3000 and Epic ,Mosaic.
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
- Determined prior authorizations for medication and outpatient procedures.
- Meticulously tracked and resolved underpayments.
- Scanning and copying records ,record release ,and auditing.
Receptionist/ Medical Records Clerk/Manager
11.1998 - 12.2008
- Coordinated communications between patients, billing personnel and insurance carriers.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Oversaw day-to-day operations of billing department, including medical coding, charge entry, claims.
- Organized information for past-due accounts and transferred to collection agency.
- Handled billing, waivers and claims for private and commercial clients.
- Used software system to manage provider schedules and keep calendar organized practice.
- Kept operations in full compliance with state, federal and TJC requirements.
- Medical Records Filing and Scanning, Copying,Medical Records Releases,Kept up on the laws of sending records also
Education
High School Diploma -
Cape Central
Cape Girardeau05-1988
Skills
- Bill payment
- Files and records management
- Completing FMLA Forms and Disability Forms for Patients
- Accounts payable
- Claim review
- Commercial claims expertise
- Database systems
- Information inputting
- Account follow-up
- Account management
- Professional Medical claims expertise
- Insurance claims
- Training and development
- Billing codes
- Medical coding understanding
- Insurance collections
- Reimbursements
- Data entry
- Data security procedures
- Complaint resolution
- Customer assistance
- Cash register operation
- Conflict management
Work Preference
Work Type
Full TimeLocation Preference
RemoteSalary Range
$45000/yr - $200000/yrTimeline
Professional Medical Billing Specialist
Saint Francis Healthcare System
12.2008 - Current
Insurance/Medical Biller and Coder/Medical Records Supervisor
Cape Physicians Associates
12.1998 - 12.2008
Receptionist/ Medical Records Clerk/Manager
11.1998 - 12.2008
High School Diploma -
Cape Central