Description
320 S. C ifrus Sf. #130 Phone (310) 809-4871 Wesr 9] 791 E-mail Ke10>@S1Jo e. org Medicare Ciaims Examiner1 To advance my career in healthcare management, expanding my knowledge and gaining personal growth. 0 Knowledge oi" CPT ICD-9 HCPCS etc. HCPCS 0 Manage (4) employees 0 Supervise charge entry of patient encounters for multiple medical practices 0 Supervise all incoming patient, capitation, and fee For service payment posting for multiple medical practices I Download all EDI reports (ERAS, Acknowledgernent, etc.) 0 Correct all data entry and eligibility errors for rejected EDI claims 0 Generate patient bilting statements for multiple medical practices 0 Perform patient accounting and collection duties 0 Perform claims follow-up and ensure proper payment per payer ° Generate writterr ciaim appeals and correspondence 0 Keep up to date with all Medicare, Medi-Cal, Commercial and Managed care policies, guidelines, and fee schedules / contracts I Supervise daily provider bank deposits and perform payment tracers when needed _ » Handle provider credentialing issues with aii insurance payers 0 Create and maintain encounter' forms for providers 0 Train physician personnel on front/ back oftice responsibilities 0 Obtain and retain new clients for medical billing 0 Meet existing and new clients for ali medical biiling issues 0 Coiiection of monthly medicai billing invoices 0 Coordinate courier pick-ups from multipie medical practices l Establish service Charges using current insurance fee scheduie data 0 Negotiate contracts, and provide claims processing feedback with tnedicai groups and lPAs For multiple medical practices 5 and Revenue codes and accurateiy research member eligibiiity dupiicate ciaims submissions out of network services out ofarea services and COB and adiudicate according to departmental procedures. Perform ciaims follow-up and ensure proper payment per payer Monitors and updates inventory reports in order to track claims in inventory and follows-up on ali claims suspended for review purposes or additional information requests untii claims are in a final status. Reviews and processes audit errors on a daiiy basis.
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