Angelique Merold Home Phone: (904)342-6353 112 Colon Avenue Cell Phone: (850) 543-4254 St. Augustine, FL 32084 Email: email@example.com Work Experience: 6/19/06 to 12/16/09 Emerald Coast Surgery Center, 995 Mar Walt Drive, Ft. Walton Beach, FL 32547 Medical Biller/Collections Entered and posted all charges for the facility, ensured accurate coding per carrier guidelines. Submission of electronic and paper claims on a daily basis. Previously held and supported insurance verification position. Verified all insurances as well as self- pay rates, advised patients of their benefits and financial responsibility prior to surgery date. Responsible for patient and payer collections; explanation of reimbursements, financial obligations and billing issues to patients to obtain any payment due. Surgical coding and reimbursement experience includes Urology and Colon and Rectal surgery (including Brachytherapy and Prostate Markers and billing of associated implants), Gastroenterology, Ophthalmology (pediatric and geriatric surgery), Pain Management, Orthopaedics, Gynecology and Obstetrics, Breast Biopsies/ Surgeries, ENT, and cosmetic procedures. Fully responsible for all Florida Medicaid issues: verification, claims and resolution. Back up for reconciliation of EOBs per contract fee schedules and posting of payments. Daily management of over the counter payments and bank deposit. Participated in hiring interviews, assisted with training of new staff as well as training of other offices on FL Medicaid online system, and back up for office supervision. Maintained continuity of information from in house Surgisource system to all online systems used which included Emdeon, Availity, Navinet, Mevsnet and FL Medicaid. Collaborated with corporate office to create and test a tool to calculate proper billing of surgical implants to obtain maximum reimbursement per contract guidelines. 2/14/06 to 4/24/06 Physician Billing Solutions, 8200 Jog Road, Boynton Beach, FL 33472-2981 A/R Representative Follow up on aged claims, claim error resolution and appeals, entering charges and adjustments, patient collections, assisting patients with billing issues. 9/9/05 to 2/14/06 All Medical Staffing, 2300 Glades Road Suite 410W, Boca Raton, FL 33431 A/R Representative (Temp-To-Hire position) Same duties & employer as above. 8/9/04 to 12/17/04 Patriot Mutual Insurance Company, 14 Maine Street, Brunswick, ME 04011 Data Entry Specialist Responsible for accurately entering client information into computer system to set up auto and homeowners insurance policies after the underwriting process is completed. This includes setting up billing plans, applying account receipts and producing rates for the policies. 12/15/03 to 8/8/04 Bonney Staffing Services, 216 Bath Road, Brunswick, ME 04011 Data Entry (Temp-to-Hire position) Same job duties & employer as listed above. Angelique Merold-Resume Page 2 7/1999 to 8/2003 Coastal Women’s Healthcare, 96 Campus Drive 3rd Floor, Scarborough, ME 04074 Obstetrical Patient Advocate Verified patient’s health insurance coverage and obtained referrals and precertifications as required; educated patients on their benefits and financial responsibilities; claims investigation and resolution; researching and writing appeals; charge and payment entry. Made and followed-up on numerous telephone calls; daily patient contact by telephone and in person; answered various questions and assisted patients with insurance issues; typed various notes and letters. Documented patients disabling conditions, which included researching medical charts, effectively communicating with nurses and physicians, completion of all necessary forms, and providing medical information and documentation to insurance carriers regarding patient status. 2/1998 to 7/1998 Anthem (formerly BC & BS of Maine), 2 Gannett Dr., South Portland, ME 04106 3/1996 to 6/1997 Claims Processor – Minnesota Transaction Processing Unit Solely responsible for accurately and efficiently adjudicating all health insurance claims for two, large specialized employer groups through Blue Cross & Blue Shield of Minnesota while consistently maintaining a 99% accuracy and quality rating. Position required a working knowledge of Medicare benefits, other carrier liability, coordination of benefits, and applications of fee schedules and pricing procedures. Also required error research and resolution, communicating with other departments, and referring problems and information to the appropriate personnel. Education and Skills: Thorough understanding and working knowledge of managed care products, Florida Medicare & Medicaid, contract language, fee schedules and reimbursement methodology Solid background in ICD-9, CPT4 and HCPCS coding Working knowledge of medical terminology, anatomy and physiology Strong knowledge of HIPAA Privacy Practices Windows XP, Vista & 7, Microsoft Office, MS Outlook, Excel & Internet Explorer Data Entry Speed of 8000 ks/hr, Typing Speed 40+ wpm Excellent analytical, mathematical, grammatical and spelling skills Intent researcher and problem solver , extremely detail oriented Excellent interpersonal and customer service skills, effective communicator both written and verbally .
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