Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts, and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing, and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Experienced in ICD-10, HCPCS and CPT, proficient in HIPAA and CMS guidelines.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Office Staff
Tenafly Psychiatric Associates, LLC.
03.2023 - Current
Handled confidential patient information professionally, adhering to HIPAA regulations at all times.
Verified insurance coverage and obtained pre-authorizations.
Followed up with patients to reschedule missed appointments.
Confirmed appointments one day prior to minimize missed appointments and maximize facility utilization.
Maintained accurate patient records for proper tracking of patient history and treatment.
Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
Maintained accurate patient records using Practice Fusion EMR
Obtained payments from patients and scanned identification and insurance cards.
Checked CPT codes and billed out claims using AdvancedMD
Performed various administrative tasks by filing, copying and faxing documents.
Processed medical insurance claims and payments.
Completed administrative patient intakes with case histories, insurance information and mandated forms
Generated and submitted invoices to patients
Billing Representative
Medloop US
01.2023 - 03.2023
Reviewed and solved account and billing discrepancies.
Received incoming information and entered into database system.
Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.
Used data entry skills to accurately document and input statements.
Coordinated with intermediate parties to obtain payments and resolve issues.
Generated and submitted based upon established accounts receivable schedules and terms.
Used Healthfusion, AdvancedMD and Data iSight Softwares.
Purchaser
Mac Felder Inc
04.2016 - 03.2020
Researched suppliers based on availability, quality, selection, and price.
Monitored shipments to ensure goods were delivered on time and in good condition.
Ensured items received were items that were ordered by verifying receipts and purchase orders.
Negotiated with suppliers, vendors, and other representatives.
Maintained and reviewed computerized records of items purchased and costs associated with purchases.
Priced out materials for Estimators to provide estimating bid to contractors.
Provided submittal package to contractors for approval.
Coordinated deliveries to construction sites in a timely manner.
Education
Certified Billing And Coding Specialist - Medical Billing And Coding
Lincoln Technical Institute
Paramus, NJ
05-2023
High School Diploma -
Manhattan Center For Science & Mathematics
New York, NY
06-2000
Skills
Medical billing expertise
Comprehensive insurance verification expertise
Experience with EHR systems
Expertise in HIPAA standards
Appointment Scheduling
Payment Processing
Claims Processing
Analytical thinking
Office administration support
Preparation of invoice statements
Identifying coding errors
Customer engagement
Strong verbal and written communication
Workplace professionalism
Professional phone communication
Proficient in several languages
Detail-oriented approach
Strong task management
Leadership qualities
Multi-line Phone Systems
Certification
CBCS - Certified Billing and Coding Specialist - 5/2023
CEHRS - Certified Electronic Health Record Specialist
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Medical Office Staff
Tenafly Psychiatric Associates, LLC.
03.2023 - Current
Billing Representative
Medloop US
01.2023 - 03.2023
Purchaser
Mac Felder Inc
04.2016 - 03.2020
Certified Billing And Coding Specialist - Medical Billing And Coding
Physician Associate-Certified, Co-Owner at Professional Psychiatric Associates of RGVPhysician Associate-Certified, Co-Owner at Professional Psychiatric Associates of RGV