Medical Billing Manager

Ingrid S. Gorman

** ******* *****, *********, ** 410-***-**** adaqim@r.postjobfree.com

Bilingual, Medical Billing and Collections Specialist

Impeccable customer service, resourceful, dependable, with a combined understanding

of various medical specialties and care technics.

AREAS OF EXPERTISE

Medical Billing & Coding EMR Electronic /Insurance Claim Processing Medicare, Medicaid, TRICARE, Government & Third-Party Payers CMS 1500 / CM 1450- (UB-04)/Managed Care (HMO, PPO, and POS) Workers Compensation and Auto Claims Referral processing Insurance Verification Pre-authorization Appeals Credentialing Basic Accounting Principles Account Payables and Receivables Outlook, Word, MS Outlook, Excel, Access, Procentive, Zimmer, Peachtree (accounting Software), EPIC,EPR, ORMIS, SMS, GroupWise.

EXPERIENCE

Woodbourne Center a Nexus Treatment Center Baltimore, MD

(LTC 45 bed residential treatment program for adolescents) 2018-2019

Staff Accountant-AR Specialist

Prepared charges for services based on the census provided by the Admissions Coordinator

Prepared cost sheets at the time of admission and discharge

Maintained and billed services on a monthly basis

Reviewed, identified and analyzed denials for a more efficient process from the time of admission

Identified, resolved, and rebilled past due unpaid claims for reprocessing establishing the flow of income

Good Shepherd Services (LTC 100 bed residential treatment program for adolescents) Baltimore, MD

Billing Manager, Department of Finance & Bookkeeper 2015-2018

Assisted the Admissions Department. Explained, educated and assisted parents and or relatives on the completion of various documents required to secure LTC benefits.

Successfully secured single case agreements with non-participating insurance companies prior to admission. Processed census on daily basis, and created charges for the room/board, psychiatric care, and ancillary services when applied.

Organized, developed, and improved standard operating procedures (SOP) to track related paper trail

for long term care and assured timely reimbursement.

Established new SOP between established software systems to ensure efficiency and accuracy

Re-established the flow of income within 6 months to a more efficient process improving workflow and productivity

Credentialed Good Shepherd as participating provider for BC/BS

Responsible for Account Payables and related contracts for services provided

Assisted with the closing and sale of furniture, computer, maintenance, and kitchen equipment

Assisted with financial audits related to the Good Shepherd Center’s closing

Alternative Counseling Wellness Center Towson, MD

Office Administrator 2014-2016

Scheduled appointments, billed and posted payments. Reviewed denials and re-submitted for payment.

Insurance verification and requested authorization when required by the insurance carrier

Credentialed and maintained all therapists’ files up to date

Updated office policies and established new patient packet information and implementing new HIPPA

standards

Improved, trained and supervised 14 staff members in the utilization of software for better tracking of charge tickets and authorizations for optimal billing and payment return

Increased collections, implemented electronic claims with all insurance carriers, and established

electronic fund transfers

Ingrid S. Gorman

24 Arverne Court, Baltimore, MD 410-***-**** adaqim@r.postjobfree.com

Randstad -United Healthcare Global Assistance Towson, MD

Administrator Assistant 2014-2015

Managed the Bacardi account. Provided guidance and assistance to all Spanish speaking members

Processed claims, reimbursements, confirmed appointments and benefits when needed

The Back-Office Hunt Valley, MD

Medical Billing Specialist 2013-2014

Payment posting and billing for various medical specialties

Implemented electronic submission for Medical Assistance claims

Johns Hopkins Department of Plastic and Reconstructive Surgery Baltimore, MD

Medical Office Coordinator, Ariel Rad, MD, Director of Aesthetic Surgery 2009-2012

Coordinated a multi-faceted clinical practice, assisted and educated patients, schedule appointments related to treatment, surgery, pre-operative and post-operative needs

Performed tasks associated with patient coding and billing when necessary

Guided and assisted patients or family members completing medical forms and directed to appropriate resources for further information and guidance

Johns Hopkins Department of Orthopaedic Surgery Baltimore, MD

Senior Medical Office Coordinator, Frank Frassica, MD, Professor, Chairman 2007-2009

Provided administrative support maintained electronic calendars, scheduled appointments, and meetings

Coordinated a multi-faceted clinical practice, prepare charts with all necessary reports for appointments, scheduled appointments related to treatment and surgery

Guided and assisted patients or family members completing medical forms and directed to appropriate resources for further information and guidance

Orthopaedic Surgeon Glen Burnie, MD

Practice Administrator, David L. Kreisberg, MD, PA 2001-2005

Performed all administrative duties (payroll, bookkeeping, etc.). Credentialed and maintained all required license

Supervised a staff of four 4 and monitored all aspects of the practice with focus on insurance verification, pre-authorization for surgical procedures, scheduled surgeries and coding for billing accuracy.

Verified for legitimacy all auto accident and Workman’s compensation claims with the assigned case managers or attorney firms

EDUCATION

Ultimate Medical Academy Tampa, FL

Associate of Science Degree, Medical Billing

Enhanced knowledge base includes: Research and Writing Skills, Analyzing and Problem Solving, Business Communications,

Accounting for Managers, Biology, and Sociology

Medical Billing and Coding Diploma

Completed an intensive, ABHES accredited training program which included: Anatomy and Physiology, Disease Processes, Surgical Procedures, Life Cycle of an Insurance Claim, Health Care Settings, Health Care Payers, Procedure and Diagnosis Coding from Medical Records, Reimbursement Systems, Medical Practice Management Systems and Life Skills for Success

Western Connecticut State University Danbury, CT

Biology (90 Credits)

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