Cynthia Jordan

Cynthia Jordan is enterprising, hard-working and technically skilled MEDICAL BILLING & CODING SPECIALIST known for accuracy, attention to detail. She has experience billing and coding over 250 accounts a day, she can work in a faced paced environment and very multi-tasking person. She would like to utilize her coding and billing skills and learn new things.

Skills:

• ICD-9-CM & CPT Coding
• Payment Transactions
• Follow Up Insurance
• Audit Medical Records
• Post Payment Charges Correct Billing/ Coding Error
• Collect Co-payments
• Claim Denials
• Teambuilding & Staff Supervision
• Spreadsheets & Accounting Reports

Technology Summary

• MS Office ( Word, Excel, PowerPoint)
• Medisoft
• Meditech
• PICIS
• AS400
• EDI Systems
• Zerimed
• AHLTA
• CHCS
• TRITECH Billing

Experience:

• Check-in, review, research and update patient demographic information on all paramedic transport tickets.
• Research and verify patient insurance information via computer, fax, or phone to confirm eligibility, request authorization, and apply billing codes to documentation to prepare claims for submission to insurance carrier
• Generate paper and electronic claims
• F/U & Appeal  Letters
• Provide customer service to patients, hospitals or insurance companies by answering phone inquiries about paramedic transport claims.
• Set up patient payment schedules, apply notes or post denials to patient accounts
• Download payment reports, process electronic EFT transactions, manual paper checks, and credit card payments to post to patients' accounts. Apply contractual allowance and any adjustments to patients' accounts as needed.
• Run credit balance report, process and post refund checks to accounts; provide additional information to COT Delinquent Accounts and re-bill claims as requested
• Reads computer files or gathers records such as patient care records, facility “face sheets”, and Physician’s Certification Statements, to compile needed data.
• Reviews and interprets Emergency Medical Service (EMS) reports for the input of billing and complete medical information utilizing SweetSoft Emergency Information Management Software.
• Enters charges based on procedures outlined in the County Fee Schedule.
• Assigns proper medical codes defined in the ICD9 coding manual based on the medical documentation  and enters the information according to the different needs of the various insurance carriers including Medicare, Medicaid, etc.
• Verifies insurance coverage, computes benefits, and compiles itemized bills. Prepares insurance assignment form with data, such as names of insurance company and policy holder, policy number, and treatment provided.
• Compiles emergency care and census data for statistical reports on type of victims treated, treatment performed, and use of ambulance services in response to inquiries from law firms, insurance companies, and government agencies.
• Telephones, writes, or electronically communicates with insurance company to verify coverage and to obtain information concerning extent of benefits. Computes total bill showing amounts to be paid by insurance company and by user, using computerized database.
• Answers user’s questions regarding statements and insurance coverage. Telephones or writes companies with unpaid insurance claims to obtain settlement of claim. Prepares forms outlining expenses for governmental, welfare, and other agencies paying bill for specified user
• Run journal entry for “write offs”
• Responsible entering CPT-4(Current Procedural Terminology & HCPCS charges in electronic medical records and confirm accurate billable charges for the Emergency Department. Responsible for monitoring, evaluating the Emergency Department for revenue collection and clinical documentation process for the Emergency Department/Ambulance Department.
• Follow up, all medical charts and coordinate with medical staff any missing documentation, signature needed provided in Inpatient/Outpatient Medical Chart.
• Identify lost charges and coordinate charge capture with timeline standards.
• Review of (International Classification of Diseases 9th Revision) & CPT procedures documentation into EMR
• (Electronic Medical Record), post charges to the patient account for services provided into the Emergency Department. Accurate keying in data provided on encounter form, using current fee schedules, supplying valid information into CBO for fee services.
• Perform batch reconciliation at the end of each batch of charges entered and make appropriate entries to log the work performed for accurate records can be tracked for verification purpose.
• Enter all modifiers based on CPT and CMS coding guidelines and client standards for charge entry functions.
• Resolved months of backlogged work,
• Receive encounter information either electronically or hardcopy from all emergency medical services. Review each encounter for consistency, accuracy and completeness of (International Classification of Diseases 9th Revision) and HCPCS Procedures.
• Explain and answer billing issues, to patients and insurance companies. Explain options, entitlements, billing procedures and benefits rights to patients. Verify insurance coverage, amount of coverage. Determine type of policy (Medicare, Tricare, and Medicaid, NJ CHIP (Children Health Insurance Plan, Aetna, Blue Cross/Blue Shield, and Humana).
• Post checks, received from patients and/or insurance companies and other agencies to computerized ledgers. Verify amounts received against billed. Computes percentages of billed paid, close the account when less than received amount in deemed correct, and re-bill the insurance company for the difference with appeal letter. Reconcile payments received, write off