Virginia Dozier
Healthcare
Morrisville,NC
Summary
Experienced Medical Billing and Coordination Professional with over 20 years in the medical field and 10 years in supervisory roles. Skilled in managing durable medical equipment processes, insurance verification, and billing, with proficiency in various EMR systems. Strong problem-solving abilities and a track record of maintaining compliance with industry standards.
Overview
26
26
years of professional experience
Work History
Durable Medical Equipment (DME) Lead Coordinator
Dressen Medical Supply
08.2012 - Current
- Oversee daily operations with CSR’s & Technicians/Insurance Biller/Obtain Prior Authorizations for Complex Rehab
- Review physician orders, medical records and any other pertinent documents for patient to qualify for Medical Equipment/Services
- Understanding and knowledge of ICD-10 codes, medical terminology
- Verify each Insurance for eligibility, network benefits, copays, deductibles and if prior authorization is required
- Coordinate with the patients, patients’ families, care takers, physicians, therapist, facilities and other entities regarding the patient needs.
- Ensure all the proper documents have been obtained with the ICD-10 codes correct in order to bill insurance properly
- Highly trained in various EMR systems.
- Knowledge of paper vs Electronic filing and know how to obtain prior authorizations.
- A clear understanding of the Medicare/Medicaid/MCO's policies and LCD requirements as it pertains to the eligibility, services and billing.
- Capable of posting payments, contractual adjustments, and working denials in a timely, accurate, and complete manner
- I complete timely submission of claims, response to denials, and re-bills of insurance claims
- Responsible for all aspects of insurance follow-ups and collections including interfacing with internal and external departments to resolve discrepancies through charge corrections, payment corrections, write-offs, refunds or other methods
- In charge of maintaining Quality Improvement (QI) by ensuring compliance with maintaining client records, policies and ensuring all ACHC requirements are met.
- Resolve client problems billing concerns and contact Insurances on denials, work individual appeals, and suggest alternatives
- Understand the ABN- Medicare Advanced Beneficiary Notices (ABN) to notify Medicare/Medicaid Beneficiaries on options of non-Coverage
- I am able to read and interpret EOB’s (Explanation of Benefits)
- Conducted thorough quality assurance checks on completed projects before delivery, ensuring client satisfaction and minimizing revisions required later on.
- Resolved conflicts within the team effectively, maintaining a positive working environment conducive to high-quality work output.
- Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping.
Nursing Recruiter
Dezeel Clinical Healthcare, Inc.
07.2008 - 07.2009
- Recruited, interviewed, hired nurses for area hospitals contracted with our company specializing in Psychiatric Hospitals
- Interviewed applicants, verified references, completed criminal background checks, and monitored drug testing for new applicants
- Ensured all medical requirements were met per hospitals guidelines
- Trained all new employees in CPR/First Aide, NCI, HIPPA and medication administration
- Communicated with hospitals on their needs daily and staffed hospitals and rest homes with RN’s, LPN’s, CNA I or II or any other specialty need
- Maintained an on-call pool of nurses for emergencies
- Responsible for all accounts payable and receivable such as invoicing hospitals for nurse’s time, completed payroll weekly through payroll portals for nurses, maintained advertising costs, supply ordering and uniform ordering and medical supplies
- Maintained advertising by placing ads for nursing needs and advertising them in areas best for positions that were open
- Worked and managed with a large advertising budget that I utilized in all hospital areas needing staff
- Staffs were tested on their skills and were taught policies and procedures of our company as well as the hospital they would be working for
- Marketed company through job fairs, open houses, and website
Assistant, Qualified Developmental Disabilities Professional, QDDP-A
Coordinated Health Services, Inc.
01.1999 - 06.2008
- Recruited interviewed and managed nursing staff of thirty
- Monitored fifteen clients under the CAP/MR/DD program
- Processed NC Medicaid applications for eligibility and completed billing for Medicaid/Medicare for services rendered
- Used medical billing coding and ICD-9 diagnosis coding
- Communicated with case managers and professionals at the area Mental Health
- Ensured services were being provided per service order for each client
- Communicated with family and staff on services and concerns
- Made monthly on-site visits and reviewed weekly notes from staff
- Reviewed and maintained accurate client charts by ensuring charts met state and company policies
- Completed payroll by reviewing timesheets and service notes bi-weekly
- Reviewed service notes on goals for each client to ensure staff following plan of care prior to sending to case manager
- Conducted regular audits on medical records and staff personal
- Member of a QA team that went to other offices to complete internal audits
- Verified employee references and conducted criminal checks
- Trained each staff in CPR/First Aide, NCI, HIPPA, Medication Administrations, Blood Borne Pathogens and skills checklist based on client needs
Education
No Degree - Human Resources Development
Louisburg College
Louisburg, NC 05.2001 -
Skills
- Insurance Billing Expertise
- EMR systems Proficiency
- ICD-10 Coding Experience
- Leadership in Healthcare Settings
- Customer Service Excellence
- Decision-making
- Multitasking and organization
- Insurance verification
- Medical terminology
- Medical billing
- Microsoft office
- Customer service management
Licensures
Certified Fitter of Therapeutic Shoes and Compression Therapy
Timeline
Durable Medical Equipment (DME) Lead Coordinator
Dressen Medical Supply
08.2012 - Current
Nursing Recruiter
Dezeel Clinical Healthcare, Inc.
07.2008 - 07.2009
No Degree - Human Resources Development
Louisburg College
05.2001 -
Assistant, Qualified Developmental Disabilities Professional, QDDP-A
Coordinated Health Services, Inc.
01.1999 - 06.2008
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