Experience

EBMS

• United States
• Health, Wellness & Fitness
• 100 - 200 Employee

• Provider Service Representative

  • Apr 2022 - Present

  I assist provider offices with claim status, appeal status, benefits, preauth requirements based on the description of the service or procedure being done, and confirming which network the plan has. I assist all callers to the best of my ability with providing accurate information and sending claims back for review when applicable. I assist provider offices with claim status, appeal status, benefits, preauth requirements based on the description of the service or procedure being done, and confirming which network the plan has. I assist all callers to the best of my ability with providing accurate information and sending claims back for review when applicable.



Omega Medical Billing and Collections

• United States

• Billing Manager

  • Nov 2010 - Apr 2022

  I'm not a certified coder yet but I do assist with coding cardiology procedure billing and vascular surgeon billing. I research denial reasons and also will assist with researching any other valid CPT codes. I assist team members that are under me with their work and help find resolutions. I also audit their work to see if additional assistance is needed. I meet with doctors and also assist with new practices that we start doing new billing for. My experience included reconcile billing for different doctors of different specialties such as internal medicine, cardiologist, neurologist, gynecologist, and others, work A/R issues, take patient payments, apply patient payments, check for LCDs, research CPT and dx codes, research policies, call patients in regards to insurance information for either new insurance or if the insurance is requesting information, appeal denials, call and confirm denial reasons, file, work on Medisoft and some parts of ECW, pull medical records from certain portals and if they aren't there or the hospital doesn't have a portal then send a medical record request, use insurance portals to verify insurance information, check claim status, and/or submit claim reconsideration and sometimes submit appeals online when the insurance has this option, work refund request to confirm if it is valid or not Show less