Medical Billing/ Audit And Appeals Specialist/ Accounts Recievables
Resume:
VANESSA EMBRICK
*** ********** ****** *******, ******* 30666
PH:678-***-**** adueju@r.postjobfree.com
I am an efficient, hardworking individual looking for a position with the opportunity for growth and promotion.
SKILLS
Work well as a team player or as an individual.
Problem solving and decision-making skills.
I am detail oriented and communicate effectively.
I am very persistent and resourceful.
I have strong work ethic and Dedication.
I have great organizational skills.
EXPERIENCE
APRIL 2021- NOVEMBER 2022
BILLING SPECIALIST, PRUITT HEALTH
Verified submitted claims processed through Rycan and made any corrections needed.
Submit Noa’s and Finals for billing daily through HCHB.
Verified patient information and SNF stays on palmetto site when needed.
Review HCHB ERA reports to balance billing in HCHB daily.
Processed all billing and coordination notes through workflow.
Kept contact with the branches I was responsible for regarding any issues.
Record cash amounts to the home health scorecard to track daily cash velocity.
Worked aging daily to get DSO down to under 120 days.
Completed any HIPPS, PEP, etc. adjustments needed.
Pulled and worked the unbilled report weekly.
Posted cash for Medicare, Humana, WellCare of SC, etc.
Made record of any issues with Medicare.
FEBUARY 2018 – JULY 2020
BILLING SPECIALIST, 180 medical, inc.
Verified accuracy and completeness of all documentation and patient information.
Coded products with the correct HCPC coding
Verified diagnosis codes with the correct ICD-10 coding
Entered orders into billing system.
Mailed and submitted claims to Medicare, Supplemental, and Commercial Payors.
Verified patient eligibility with their insurance electronically payors and updated as needed.
Acquired Prior Authorizations when needed per Medicare guidelines.
Requested any medical records.
Reviewed and updated aged receivables for unpaid balances.
Printed and mailed patient statements.
Processed credit card payments from patients.
Communicated with patients regarding their bills.
Completed any appeals / collections needed.
Completed any refunds needed to patients and payors.
Handled collections for my payors (Medicare, Supplemental and Commercial).
Posted money and denials received from insurance payors from paper and electronic remits to the correct accounts.
Any other billing duties as requested by supervisor.
MARCH 2013 – JANUARY 2018
AUDIT & APPEALS SPECIALIST, care medical
Handle billing calls and patient walk-ins that could range from picking up rented equipment to insurance and payment issues.
Verified order and diagnosis codes on patient accounts.
Submitted any overpayments and refunds needed to patients and Medicare.
Worked denials from aging and Medicare ERN's by appealing or resubmission.
Collected/ requested all documentation per Medicare guidelines.
Made detailed notes on all patient accounts.
Acquired prior authorizations when needed.
Processed patient payments.
Scanned and uploaded all documentation to correct accounts.
Handled all appeals needed with Medicare payor.
Worked accounts from our power mobility department as well as other rented or purchased equipment.
Requested medical documentation for any Medicare patient account as well as PMD.
Other billing duties as requested by supervisor.
JANUARY 2012 – NOVEMBER 2012
CLINICAL MEDICAL ASSISTANT/ FRONT OFFICE ASSISTANT, HME PHYSICANS GROUP
Completed 12-week unpaid externship logging 225 hours as required, Hired on permanently.
Assisted in opening two family practices.
Ordered and setup both clinics with equipment and supplies needed.
Handled daily deposits Worked as a Clinical Medical Assistant/ Front office Assistant in three Family practices, OB/GYN, and in General Surgeons office as needed.
Ordered Medications for each office and delivered as needed.
Assisted management in special projects.
Assisted the physicians in procedures such AS WELL-child check-ups, sports PHYSICALS, WELL- women check-ups, and triage of patients.
Performed CLIA waived testing as needed.
Performed EKG’S, PT-INR, hemoglobin a1c, venipuncture, urinalsyis, injections.
performed hearing acuity test using an audiometer, and visual acuity testing using snellen chart.
Completed any clerical duties as needed such as check-in, check-out of patients.
Verified Insurance, Requested Medical records, Prior authorizations.
Entered patient information into NEXTGEN system
Handled referrals on patients.
Called in medications for patients.
Answered phones and completed End of day paperwork
Collected patient co pays
Helped management in training other front and back-office staff as well
EDUCATION
MARCH 2013 TO SEPTEMBER 2013
BACHELOR’S IN BUSINESS MANAGEMENT, western governers university
Maintained 3.0 GPA, pursued in hopes of obtaining my bachelor’s degree. However due to unforeseen circumstances I had to put my degree on hold.
MAY 2012
DIPLOMA IN MEDICAL ASSISTING, lanier technical college
Graduated with a 3.2 GPA, completed with Medical Office Assistant and Healthcare Assistant Certificates.
CERTIFICATES
MEDICAL OFFICE ASSISTANT CERTIFICATE
STATE OF GEORGIA X RAY SAFETY CERTIFICATION
HEALTHCARE ASSISTANT CERTIFICATE
GA WORK READY CERTIFIED
CERTIFICATION OF COMPETENCY ON OXYGEN CONCENTRATORS, HOSPITAL BEDS, AMBULATORY AIDS, POWER MOBILITY, AND OTHER DURABLE MEDICAL EQUIPMENT AS ELL.
SKILLS
EXPERIENCED WITH MICROSOFT 360, ADOBE, ETC.
HOME CARE HOME BASE, BRIGHTREE, RYCAN
DATA ENTRY, RESEARCH AND TROUBLESHOOTING
CUSTOMER SERVICE EXPERIENCE
EXPERIENCE WITH SALESFORCE AND QUICKBOOKS
REFERENCES
1.)BETH COLLINS-LOTT- CO – WORKER/ FRIEND- PRUITT HEALTH, PH# 770-***-****
2.)CRIS COCKFIELD- BRANCH MANAGER- CARE MEDICAL, PH# 706-***-****
3.)DIANE SULLIVAN- FRIEND PH# 770-***-****
4.)CHRISTINE MANEY- FRIEND PH# 404-***-****
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