Vicki Pickens
Houston,TX
Summary
To obtain a challenging position as a medical billing/coding specialist that utilizes my unique skill set and allows me the opportunity for growth in the medical field. Authorized to work in the US for any employer QUALIFICATIONS Fifteen years-combined billing, coding and customer service experience. Adept at handling sensitive business issues with discretion and professionalism. Excellent communication, organizational, and problem solving abilities. Computer/Knowledge: Medisoft software application, medical coding guidelines and techniques, ICD-9, ICD-10, CPT,HCPCS, and DRG's
Overview
23
23
years of professional experience
Work History
Reimbursement Specialist
American Surgical Professionals
Houston, TX
04.2017 - 02.2022
- Performs error analysis for disputed/denied claims for Surgical Assistants and provides recommendations for process improvements
- Assists with third party audits when necessary
- Update registration information, post denial codes and adjustments in practice management systems
- Analyze weekly denial reports to spot trends; assess opportunities to improve internal workflows
- Performs related duties as assigned.
Collection Specialist
Launch Medical Ventures, LLC
Houston, TX
09.2016 - 03.2017
- Experience with out of network medical collections, meeting filing deadlines, appeal process and negotiations process
- Monitor commercial insurance for compliance with various regulatory requirements,policies and procedures
- Investigate low allowed out of network claims
- Analyzing and researching out of state insurance programs for the claim and enrollment information to move forward account transactions
- Resubmission of corrected CMS 1500 claim for additional reimbursement
- Ability to work well under pressure and multi-task routinely.
Claims Specialist
Healix
Houston, TX
04.2008 - 09.2016
- Monitor Medicare, commercial insurance, and third party payers for compliance with various regulatory requirements, policies and procedures
- Timely submission and follow up of appeals and grievances
- Maintain complete familiarity with all major third party payers
- Ensure accuracy of all claims by performing follow up on delinquent accounts and rejected claims
- Identify and follow up on zero payment claims and recoupment
- Request patients provide Explanation of Benefits when necessary.
Medical Biller/Coder
Astro Foot Care
Houston, TX
01.2007 - 01.2008
- Performed insurance billing and filing via electronic and CMS 1500 forms
- Submitted claims to Medicare, Medicaid, Worker's Compensation, and Commercial Carriers
- Responsible tracking unpaid/denied claims and resubmission if needed
- Conducted insurance verification and online patient eligibility status using e Paces system
- Responded and communicated with patient/responsible parties concerning billing process and financial responsibilities
Warranty Clerk
Johnson Supply Company
Houston, TX
01.1998 - 01.2006
- Performed data entry and detailed record keeping
- Compiled, sorted and verified accuracy of data to be entered
- Verified clerical computations against physical count of stock made adjustments when necessary
- Provided supply carriers with company loading instructions prior to shipment delivery
- Coordinated with various supply carrier representatives to schedule loading/unloading of supplies.
Education
Certificate in Medical Billing Specialist -
Sanford Brown Institute
2007
Skills
- Account Posting
- Verbal and Written Communication
- Value Estimation
- Check Inspection and Validation
- Discrepancy Resolution
- Process Monitoring
- Dispute Negotiation
- Correspondence Preparation
- Inquiry Handling
Timeline
Reimbursement Specialist
American Surgical Professionals
04.2017 - 02.2022
Collection Specialist
Launch Medical Ventures, LLC
09.2016 - 03.2017
Claims Specialist
Healix
04.2008 - 09.2016
Medical Biller/Coder
Astro Foot Care
01.2007 - 01.2008
Warranty Clerk
Johnson Supply Company
01.1998 - 01.2006
Certificate in Medical Billing Specialist -
Sanford Brown Institute
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