Profile: More than 15 years successful experience in medical billing service and
support with recognized strengths in insurance billing, provider and insured inquiries,
problem-solving and trouble-shooting, team work, and planning/implementing
proactive procedures and systems. Possess solid computer skills. Excellent working
knowledge using Epremis, Benchmark, Document Imaging/Siemens, SMS/Invision,
Microsoft Excel, Word Perfect, Microsoft Word, CT, DataTrac, MedTech, SMS, IDX.
Knowledgeable in medical terminology and coding using ICD9, CPT, and HCPCS.
Ability to train, motivate, and supervise up to 10 customer service employees.
Develop plan, conduct audits and variance analyses for reconciliation for clients.
Employment:
Temp. Unlimited, Cymetrix-Gardena, CA 10/2009-Present
Medi-cal Insurance Biller/Coder Specialist
Billing Medi-cal claims for Downey Regional Medical Center using several different
systems Epremis for electronical billing, Document Imaging/Siemens to pull up
itemized statements or face sheets or any other documents that were used at the
time of visit also to view itemized statements were or what side a procedure was
done if a modifier is needed and do some research on patients facesheet or any
other documentation might be in patients image. Benchmark is used to relate back
and forth with utilization management review department for NDC #'s needed or
charges that were not showing up in our system SMS/Incisions which is Downey's
system that generate bills to epremis for all billing claims. We also due coding based
on changes or rules and regulation guidelines. Hard copy billing also done due to
certification of injections,hydration, infusion or med supplies as per medi-cal state
guidelines. Also had to review each claim going out and make corrections due to
revenue codes and update hcpc codes due to medi-cal rules and regulations special
codes used for medi-cal billing also NDC #'s needed for all injections also individual
hcpc codes are used unless a generic self administer drug is being used then a
generic code is issued and used according to regulations.
Education:
Nova Institute of Health Technology, Whittier, CA Graduate
Medical Insurance Biller Specialist Certificate
Coder Specialist-CCS Certificate
Bell High School, Bell, CA Graduate