Angelique Merold Home Phone 904 342 6353 112 Colon Avenue Cell Phone by bkt20283


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									Angelique Merold                                                                Home Phone: (904)342-6353
112 Colon Avenue                                                                Cell Phone: (850) 543-4254
St. Augustine, FL 32084                                                         Email:

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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