Certified Billing and Coding Specialist

Debra A. Scales, CBCS

**** ***** ****** – Unit #*7

East Meadow, NY 11554

Cell #: 516-***-****

Email: ad7hd0@r.postjobfree.com

Education:

Stratford Career Institute Saint Albans, VT

Drug and Alcohol Treatment Specialist November 2021 – October 2022

Diploma

Stratford Career Institute Saint Albans, VT

Medical Billing and Coding Specialist March 2019 – May 2021

Diploma

Liberty University Lynchburg, VA 24502

AA Degree September 2011 – November 2015

Psychology - Counseling

Employment:

Apidel Technologies, LLC Plainfield, IL 60544 1/2024-8/2024

Service Center Representative (Remote/Contract)

Provided claim status and eligibility information for the provider services department.

Analyzed payer coding denials and explained the appropriate action for reconsideration.

Acted as a liaison between the insurance company and the healthcare provider.

Pulled and downloaded remittance advices for fax or email at providers’ request.

Faxed and emailed EFT/ERA forms for completion.

Contacted providers on behalf of the members experiencing billing issues.

AmeriHealth Caritas Family of Companies Philadelphia, PA 19113 05/2022-10/2023

Customer Service Representative (Remote)

Service both inbound and outbound calls to Medicaid and Medicare members and providers.

Supported members with billing inquiries, claim status, eligibility, and third-party liability.

Explained to members and participants issues and concerns regarding health coverage.

Assisted members with changing their Primary Care Physician and selecting specialists.

Documented member appeals, grievances, dissatisfaction, and complaints for review.

iTech Solutions (Remote) Farmington, CT 06032 10/2021-12/2021

Managed Care Coordinator (Contract)

Verified Coordination of Benefits (COB) for insurance coverage for Third Party Liabilities.

Artech, LLC (Remote) Morristown, NJ 07960 03/2021-08/2021

Customer Service Representative II (Contract)

Assists claimants with various issues with their Pandemic Unemployment Insurance claims.

Trained in various software systems utilized by New York State for data entry and claims processing.

Displayed empathy and compassion when assisting claimants, with loyalty, and respect during the difficult time.

Superior relations skills with the ability to communicate clearly and accurately.

BroadPath Healthcare Solutions (Remote)

Health Plan Member Services Representative (Contract) Tucson, Arizona 85715 11/2018-03/2019

Managed high volume inbound calls during enrollment period.

Assists with benefit and eligibility information, EOB, claims and billing, Primary Care Physician selections and posted payments.

Compliant with confidential and sensitive information according to HIPPA guidelines

Proficient with Microsoft Office Suite 10 and 11

Ability to deescalate challenging conversations with compassion and empathy.

The Mental Health Association of Nassau County, Inc. Hempstead, NY 11550 02/2013-07/2015

Administrative Support Associate (On-Site)

Maintained front desk in the outpatient adult day program for mental health and substance abuse clients.

Set-up transportation and appointments.

Monitored client’s attendance and daily discharge for the day.

Proficient in Microsoft Office Suite

Ability to deescalate challenging conversations with compassion and empathy.

Urban League of Westchester County, Inc. Westchester, NY 11601 10/2012-02/2013

Trainee/Paralegal (On-site)

Processed follow-up correspondence for complaints and rebuttals.

Assisted with pre-hearing conferences.

Processed and distributed daily mail.

Assisted at front reception desk as needed.

Northwell Health Systems Manhasset, NY 11030 12/2005-04/2010

Administrative Support Associate (On-Site)

Overnight ward clerk in the labor & delivery and nursery units.

Registered patients, prepared charts for admissions.

Performed administrative support for Patient Access, Case Management and Social Work units.

Maintained RN’s daily calendars for appointments and meetings.

Maintained staff’s education and certification records according to State Law.

Managed staffs’ timesheets for payroll processing.

Proficiently recorded, typed, and distributed staff meeting minutes and monthly reports.

Prepared charts and graphs using Microsoft Office Suite.

Handled phones, filing, faxing, scanning and other duties as assigned by manager.

Certifications

Certified Billing and Coding Specialist

National Health Career Association (NHA)

License Number C3B2J9Y8

November 9, 2023 – November 9, 2025

Contact this candidate