Medical Billing/Coder Specialist











OBJECTIVE:             Seeking a position within a reputable company offering potential for


PROFILE:                  Over 21 years of medical office experience. Very professional with the ability to identify customer needs
both internal and external, assess priorities, organize and fulfill
commitments. Possesses the ability to address and resolve issues independently
with diplomacy and tact.  Strengths
complemented by a professional demeanor and appearance accentuated through
punctuality and reliability.


STRENGTHS:            Excellent communication skills, both oral and written. I am an
independent, resourceful, well organized, problem solver, decisive and a team


I am experienced on most office equipment such
as fax/scanner machine, cash register, computer and adding machine. Software
includes:  Microsoft Office software,
including Word, Excel, PowerPoint and Outlook. 
 I have worked with several EMR
systems including Tiny Term, Doc-Write, QOL, Uni-Care, Office Ally
Clearinghouse and Quantum.  Very familiar
with APS care connection and knowledge base websites and HP Medicaid website as
well as working and navigating through some insurance company websites.





DEC 10- JULY13          Albany Area Community Service Board

Clerk II


Process and bill Medicare, Medicaid, State Contract,
Treatment Court from Jail and Commercial Insurance Claims weekly.  Bill all QMB secondary claims on HP website. Verify
that electronic claims are submitted correctly and correct any billing errors
and resubmit claims.  Post payments and
balance all EFT deposits.  Manually post
all payments that are not set up through EFT. Work insurance denials, correct
errors or contact appropriate staff for corrections and resubmit claims for
payment.  Post cash internal payments and
balance for 5 outlying counties at the end of each month.  Complete month end process and run necessary
billing reports for COO, CFO and to the state in a timely manner.  Works with IT director overseeing all billing
support tickets resolving any IT issues such as voiding errors and resetting
notes for correction at clinical staff level. 
Backup-fill in and train other billing staff as assigned  Input and monitor all prior authorizations
approved by the state for MR Waiver.  Works
closely with each clinician with questions or concerns they may have regarding
billing and authorizations.








JULY 09 – DEC 10     Albany Area Community
Service Board



  Process all Outpatient Treatment Request from
Clinicians to appropriate  

                                       CMO for prior authorizations typing on CMO
websites, keeping a log of all customers with CMO coverage according to timeframe,
expiration date, and units approved and services authorized.  Communicate with CMO’s and clinicians to
problem solve any discrepancies, submitting reports to clinical and support
staff providing all training to staff on completing required paperwork.  Process all commercial insurance billing
including posting payments to appropriate accounts, researching denials and
re-set claims necessary for re-billing. 
Download and process daily response files from APS and generates tag
number for files to be auto loaded into EMR system
researching any problems with the loading of the authorizations notifying the
clinician of corrections needed. Follow up on changes in customer’s payer
eligibility each month to insure that any necessary authorizations are
requested making payer changes in EMR system. 


JULY 07 – JUNE 09    Albany Area Community Service Board



  Posted and
billed Pharmacy Medicaid remittances and Cash Receipts in EMR system. Process
all refunds and adjustments weekly via the web and ran aging for Medicaid on
monthly basis submitting to Supervisor any write-offs needed.  Receive all monies from mail for 8 counties making sure posted to
appropriate accounts writing up deposits to give to Operation Analysis for
depositing into bank account.  Follow up
on any services not posted from the non-applied payment reports submitting to
supervisor within 24 hours of receiving. Assist in performing any duty in the
absence of the Billing Specialist to ensure all job duties are completed in a
timely manner and giving assistance to billing staff as needed. 



JULY 03 – JUNE 07    Albany Area Community Service Board

                                                Accountant, Paraprofessional                                     


Responsible for bookkeeping and reporting for
the Mental Retardation Programs by maintaining a cash disbursement journal.
Ensuring vouchers are processed within stated time limits, monitor check
processing, classify expenditures according to the State Chart of Accounts,
execute programs to obtain distribution journals, check registers, checks and
post to ledgers.  Maintain files with all
supporting documentation.  Receive and
record funds from State (GIA), Local governments (Counties), Federal (USDA and
SSI//SSA), Medicaid, Client Fees, Work Activity and other sources.  Post all journals at the end of each month,
assuring accuracy of posting and prepare Trial Balance Reports.  Prepare Monthly Income and Expenditure and
Budget to Actual Reports.  Prepared
Budgets and Budget Revisions for programs by date requested by the Regional
Board. Maintain accurate personnel listing, updating quarterly breaking down
internal budget figures. Assist auditors in review of the Centers
Accounts.  Prepared 1099’s prior to
January 31st.  Assist with
special projects as requested by supervisor.









JULY 94- JUNE 03     Albany
Area Community Service Board 

III (Medical Director)


Receive staff concerns regarding issues and
works with Medical Director to resolve clinical issues.  Received training’s on credentialing process
of medical staff, completing paperwork to recruit physicians on J-1 Waiver,
serving as liaison for Medical Director attending meetings to represent Medical
Director working with staff, the general public and external representatives to
address general issues or concerns.  Assist
in conducting reviews of UR/UM forms daily to ensure information flow to
managed care companies.  Worked with IT
in the implementation of the Care Management Software training all staff on the
usage providing instruction on accessing the Network, Care Management Treatment
Planning, Operation of Printer and Connection to Unicare or Citrix Server and
provide technical advice on essential components in treatment planning and
supporting documentation. Composed the training manual for all staff as well as
troubleshooting for IT Department.   


NOV 93 – JUNE 94                 Mitchell County Family and Children Services 



                                                Greet families, patients directing to
the appropriate staff.   Receive incoming
calls on 6 line multi-phone taking messages and getting to staff in timely
manner.   Data Entry into PC on
alternating basis with other DEO’s to bring up Paris display on CRT each
morning printing and distributing to appropriate staff.  Balance monthly bank statements for agency.  


MAY 92 - OCT 93       Southwestern State Hospital 



                       Received incoming call and directs
to appropriate personnel ensuring messages are given in a timely manner, Greets
families, customer’s directing to the appropriate area or staff.  Typed various documents for professional and
paraprofessional staff checking for grammatical errors, punctuation, spelling
and sentence structure.  Submits material
request and supply orders.  Files and
purges records according to established guidelines.  Maintained policy and procedure manuals for
Life Skills A and B.




EDUCATION:            Calhoun County High School-Graduated 1983


REFERENCES:         Available Upon Request 

  • ID#: 73679
  • Location: Albany, GA , 31705

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