EDUCATION
Diploma Medical Billing and Coding 01/01/2016
Eagle Gate College, Murray, UT
SKILLS AND KNOWLEDGE
ICD-10-CM Anatomy Data Entry
CPT/HCPCS EPIC EHR Microsoft Office Suite
Medical Terminology Medical billing Customer Service
EMPLOYMENT HISTORY
UNIVERSITY MEDICAL BILLING 2016-PRESENT
MEDICAL BILLING ACCOUNT SPECIALIST
Assigned Medicaid claims and resolve denials.
Interpret medical records such as diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10 codes.
Provides feedback to management regarding any new patterns of payer behaviors or repetitive insurance verification, coding, or billing errors.
Analyze claim edits and charge review rejections for correct and compliant coding to ensure optimal reimbursement.
Exceeded departmental production goals by reducing work queue from initial 600 claims to a daily 50 claims in approximately 30 days.
Achieve and maintain an accuracy for claims resolution at 95% or above.
ACCOUNT RESOLUTION SPECIALIST
Researched, crafted and submitted appeals to multiple (a wide variety of) commercial and government payers for bundling code denials.
Audited patient registration for coordination of benefit accuracy to maintain one-time claim submission standards
Negotiated claim reimbursements with out-of-network and third party liability insurance companies.
Determined appropriate resolution path (not excited about the word path but couldnt think of a better one) claims for non-insurance payers including: Indian Health Services, Crime Victims, Utah State Prison, etc.
Created and led presentation members regarding common denials related to registration errors for a group of 30 co-workers. I was chosen to present this training based on my consistently high proficiency of claim resolution.
Developed and implemented a streamlined process to assist team members on appealing denials, locating digitally stored records and other billing duties.
TOWER ADVERTISING-Midvale, UT 2015-2016
MEDICAL BILLING TEAM LEADER
Held position of Team Leader for medical billing company managing account receivables for 5 DME companies located across the United States.
Lead team by providing direction to ensure timely and accurate submission of initial claims.
Provided direction and monitored workflows of team members regarding all claim assignments and ensuring timely follow-up of aging claims.
Identified operational practices and coding trends creating barriers to claim payments and collaboratively worked with team to resolve them.
Worked with management to develop and implement training on any issues identified within the team to ensure best practices were being utilized
Provided patients with exceptional customer service