Addie Robinson
10351 Tristan Dr. Downey, Ca. 90241, 629.203.3829
ajrobinson35@gmail.com
Dependable, friendly, honest, and experienced healthcare billing professional working toward the certification in Medical Coding. Having a full understanding of ICD 9 and the opportunity to train others in ICD 10 and CPT coding I am dedicated to achieve the highest quality of service. Also enjoy participating in provider and staff education and keeping up with ever changing rules and regulations. Understanding the importance of bringing a high value of standards is my motivation. I am a self-starter that possesses great skill, enthusiasm, care, and leadership ability. Amongst other characteristics I am detail-oriented and self-motivated, with a strong sense of work ethic.
CORE COMPETENCIES
· Medical Terminology · Microsoft Office · Government Payers
· ICD-9 & 10, CPT, and HCPCS · eClinical Works (eCW) · Team oriented
· Athena, Meditech, Nextgen · Organizational & leadership Skills · Analytical Skills
PROFESSIONAL EXPERIENCE
Straight Talk Counseling August 2019 – current Health Information Management Specialist
Contract position- credentialing, medical billing, denial follow up, employee payroll, keeping medical records in compliance, billing/credentialing procedure implementation.
PH Dental January 2019- June 2019 Revenue Specialist
Handle certain aspects of the revenue cycle for 20+ dentist. Billed dental surgery procedures to the medical insurance plans. Help set up and maintain billing software program. Train offices on billing procedures.
Fannie Battle June 2018 – December 2018
Pre School Co-Teacher
Became familiar with frog street curriculum
Document and preform assessments of students
Develop lesson plans
Maintain supply list
Lead small group learning
ESS Feb 2018 – May 2018
Substitute Teacher
Classroom management
Implement lessons for the day
Provide tutoring
Afternoon Bus duty
Also developed personal substitute teaching plans if the main teacher did not leave lessons or instructions
State of TN. Jan 2017 – Jan 2018
Managed Care Specialist
Process Medicaid cases
Knowledge of procedural provisions associated with TennCare, Medicaid, CHIP, or commercial insurance and managed care related services within a hospital, healthcare center, insurance and/or managed care organization.
Resolved TennCare eligibility appeals
Assisted long-term care facilities with claims processing issues and getting clients approved for Medicaid.
Helped individuals qualify for Choices program.
Professionally managed several counties Medicaid applications for nursing facilities, hospice, or home health care.
Med Solutions May 2016 – Jan 2017
Medical Coder
Review/ interpretation of medical records to assign appropriate codes
Utilize knowledge of ICD 9 and ICD 10
Obtained medical records for Medicare and Medicaid payers
PQRS reporting and assigning codes
MIPS reporting (Merit-Based Incentive Payment System)
Tennessee Women’s Care (TWC) Nov 2015 – May 2016
Medical Coder
Review/ interpretation of medical records to assign appropriate codes
Utilize knowledge of ICD 9 and ICD 10
Charge Entry
Claim Submissions
Utilized knowledge of OB-GYN and Medical terminology.
Provided corrections and research of other improperly coded charts.
Tru Health, Inc (Tennessee Health Management) July 2015 – Jan 2016
Medical Billing Specialist (contract position)
Provider Education for ICD 9 and ICD 10
Coding ICD 9 and ICD 10
Credentialing
Payment Posting
Research and resolve denial issues
Reviewed clearinghouse, and revenue cycle management reports
Worked independently and oversaw 8+ Providers revenue cycle
Tennessee Orthopaedic Alliance (TOA) July2014 –July 2015
AR Specialist, Insurance Collector
Resolve all denial issues.
Follow up with insurance payers regarding appeals, re-determinations and re-considerations.
Work with coders and posting team to resolve balances on claims and have them posted correctly.
Effectively communicate with the offices for provider medical necessity letters, authorizations, and pre-certifications.
Reviewed and resolved worker’s comp claims.
Work with providers to improve their AR.
Completed appeal letters, re-determination, and reconsideration forms.
Trained fellow co-workers on Medicare and Medicaid policies.
Managed revenue cycle for providers.
Decreased outstanding AR.
Organized work-flow to help the process of billing claims become smoother.
Community Health Systems (CHS) December 2013- July 2014
Accounts Receivable Analyst
Handle all Accounts Receivable functions including: billing system maintenance and allocation of payments.
Monitor and reconcile all over age accounts.
Identify all collection issues and assist in the appropriate resolution.
Maintain and prepare reports for ledger accounts and analyze variance according to Account Receivable policies.
Led weekly phone calls with practice leadership, directors, and CFOs.
Assist with training in regards with certain programs.
Worked directly with billing staff and providers to improve problems within their AR.
Off-site management for practices in regards to billing or accounts receivables process.
Trained practices on new billing processes or implementing new work-flows.
Review records for completeness, accuracy, and compliance with regulations.
Develop and present health education and promotion programs, such as training workshops and conferences.
Develop and maintain cooperative working relationships with all positions in office.
Tri-Star Medical Group, (HCA) Jan 2011- Nov 2013
Charge Entry/ Billing Specialist
Billed and entered charges.
Reviewed records to assign appropriate codes per guidelines.
Analyzed and resolved coding and denial issues.
Interview patients to complete documents, case histories, or forms, such as intake or insurance forms.
Obtained prior authorizations and pre-certification.
Completed referrals
Maintain medical records, technical library, or correspondence files.
Balance end of day monies.
Called in prescriptions, gave lab results, verified insurance
Worked directly with doctors and nurse practitioners to resolve AR issues and maximize reimbursement.
Checked Vitals, explained health screenings to employees, Assisted and led in educational training material for patients in regards to nutrition and work outs, and day to day work-flow and processes for employees.
Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations.
Operate office equipment, such as voice mail messaging systems, and use word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
Perform bookkeeping duties, such as credits or collections, preparing and sending financial statements or bills, and keeping financial records.
EDUCATIONAL BACKGROUND
Middle Tennessee State University May 2016
Bachelors of Science in Healthcare Administration
American Academy of Professional Coders Currently working towards Exam
Certificate in Medical Billing and Coding
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