Crystal V Montoya

Crystal V Montoya is currently obtaining her CPC license thru AAPC. With 4 yrs of Outpatient coding and billing.

Skills:

Knowledge of Centricity Programs such as Groupcast/Flowcast. That is used for our THR Physician’s. As well as computer software such as MS Word, Excel, and PowerPoint

Experience:

• Obtain and verify eligibility information on physicians’ /work comp/Specialist benefits for private/commercial insurance for upcoming pre-arrival appt
• Analyze/edit and assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting.
• Review and obtain general outpatient information from Insurances for correct modifier usage. Edited any changes in codes and modifier’s to reflected it properly for Claim processing
• Receive and obtain any compliance and reimbursement under outpatient grouping systems, to better handle medical necessity, claims denials, bundling issues and charge capture.
• Micromanage daily work so that it is done in a timely manner, based on productions and quality compliance in our Dept
• Answered phones, faxes, and correspondence from Practice managers on clinical level, as well from management and employees I work with on a daily basis
• Receive and input data on Pt from Healthcare facilities, insert all patient information in the system CPR+ for reimbursement purposes
• Analyze, research, and collect proper codes w. ICD-9, HCPC’s and Dx codes to obtain appropriate auth’s on DME equipment
• Obtain and create documentation such as Assessments, statement, LMN’s, EOB’s, and Plan of treatments  for  authorization of duration of durable medical equipment for pt’s and physicians
• Assist discharge planner in all modes of therapy of DME such as ventilators, O2 concentrators, Bipap/Cpap, and eternal feeding
• Knowledge of Medicaid/Medicare compliance, rules and regulations on fee schedules and billing remittance
• Answered phones, faxes, and correspondence statements to Physician’s, Therapist, Insurance Rep’s, and Patience on a daily bases

Education:

In-house training programs

• EKG
• Phlebotomy
• Tech Class
• Unit Clerk Class
• Nursing Assistant Class
• CPR Certified

Computer training: WordPerfect I, Certificate