Tracy Ellis

• Researched complex billing issues involving multiple providers or services rendered over a period of time.
• Created and processed claims to third-party payers using specific coding guidelines.
• Updated patient accounts with information obtained from internal departments or external sources.
• Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
• Assessed billing statements for correct diagnostic codes and identified problems with coding.
• Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
• Coordinated communications between patients, billing personnel and insurance carriers.
• Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
• Collaborated closely with other departments to resolve claims issues.
• Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
• Processed and submitted claims to insurance companies electronically or by paper.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Worked closely with other departments such as clinical staff, administrative staff, and finance department personnel to resolve any issues related to billing.
• Identified potential coding issues that could lead to denials or underpayments and addressed these issues promptly.
• Reviewed claims for coding accuracy.
• Kept abreast of updates and changes in coding guidelines and reporting requirements.
• Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
• Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
• Monitored and analyzed coding error trends to improve coding accuracy.
• Submitted claims electronically to insurance companies in accordance with regulations.
• Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
• Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
• Coordinated with billing department to clarify billing issues related to coding.
• Performed data entry into electronic health record system for all relevant patient information including diagnoses, procedures performed, medications prescribed .
• Provided support and guidance to colleagues to maintain a collaborative work environment.

I manage the process of submitting and tracking medical insurance claims to ensure healthcare providers receive proper payment for services rendered to patients, which involves verifying insurance coverage, accurately coding medical procedures, communicating with insurance companies, and following up on unpaid claims to maximize reimbursement.

• Maintained detailed records of all billing activities including denials, adjustments, and payments received.
• Researched complex billing issues involving multiple providers or services rendered over a period of time.
• Kept abreast of updates and changes in coding guidelines and reporting requirements.
• Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
• Interpreted medical terminology and pharmacological information to translate information into coding system.
• Monitored and analyzed coding error trends to improve coding accuracy.
• Submitted claims electronically to insurance companies in accordance with regulations.
• Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
• Researched denied claims to determine the cause of denial and corrected errors as needed.
• Analyzed trends in denials in order to recommend process improvements which would reduce the number of denials received.
• Resolved coding discrepancies and denials to maximize reimbursement.