Antonia Z.

Hello! I am a Medical Biller and Coding Specialist who can manage the important administrative work of coding and billing to ensure healthcare providers are reimbursed for their services. You can expect me to properly code services, use valid Current Procedural Terminology and appropriate ICD-10 code. Following up with patients and/or insurance companies regarding outstanding charges. Review the reason/s behind any denied or rejected claims prior to correcting and resubmitting. Capable of creating and submitting good cause argument letter and/or formal letter of appeal for incorrectly denied claims. Track and post insurance payments. Excellent ability to communicate effectively and professionally. Proficient level of computer literacy. With Six years of experience as Customer Service Representative for one of the biggest Medical Insurance, I am knowledgeable with insurance guidelines and strictly follows HIPAA regulations. Two years of experience as an Account Receivable (AR) Specialist and a Subject Matter Expert (SME) for major payers Medicare and Medicaid Health Plans. Benefits/Services I previously worked: • All Medical Benefits (including Preventive Services) • Behavioral and Mental Health • Substance Abuse Few Major Insurances and their States I previously worked: • Medicare Health Plan (MI, IL, OH, TX, GA, CA, AZ) • Medicaid Health Plan (MI, IL, OH, TX, GA, CA, AZ) • Humana, Aetna, Anthem Inc., Illinicare, Cigna Health, Meridian/Wellcare, Molina Healthcare Inc., UnitedHealth Care Has Experience working with software • CallCare Browser • Phicure • Citrix/Trizetto *Familiar with all areas of CMS 1500 form and its guidelines. *Adaptive and can easily learn to navigate in working with a new software Can manage multiple assigned task by determining its level of urgency. Will make sure target levels are meet timely. I am willing to be trained and looking forward to working with you.