SlideShare a Scribd company logo
1 of 3
Tommye E. Braun
2931 Bomar Road
Douglasville, Georgia 30135
Home (770) 949-5880
Cell (404) 304-6302
tebraun@aol.com
Objective:To maintainapositionexpandingandutilizingmyexperience potential leadership,personal
contributionsandprofessionalgrowthinaprofessional field.
Qualifications:Experienced Practice Manager/TeamLeaderwithaversatileapproach
to applymyskillsina careeroffice setting.Excellentwrittenandverbal
communicationskills,abilitytooperate anycomputersystem.CPT,
HCPCS,ICD9,ICD10coding,HMO,PPO,Medicare A,B& D plans,Medicaid,Medical terminology,Provider
Maintenance,&ProviderCertification/credentialing,HCFA-1500& UB04 Billing,EPIC,Medstreaming,
Genix,Greenway,Nextgen,EMR
Job History:
10/15-Present Peachtree Vascular Specialist-MelissaBergman
-Maintains self pay and managed care accounts
-CustomerService
-ARreporting
-Collections
-Precertification
-Manage all Insurance balancesforsurgeriesrenderedatPiedmontHospital,Wellstar
Fayetteville/HenryHospital
-BillingappealsforOutpatient/Inpatientdenials
9/14-10/15-Georgia Hand Shoulder& Elbow-LynnWolf (404) 352-3522
Medical AR/CollectionsBilling
-Manage Self payaccounts-Contactpatientsforoutstandingbalances
-Collectpayments
-Manage all Insurance balancesforsurgeriesrenderedatPiedmontHospital
and WellstarKennestone Hospital
-CustomerService
-Appeals,ReferralsforSurgery,Occupational Therapy,&Physical Therapy
-Insurance/EligibilityVerificationforinsurancesandworkman’scomp
- BenefitCoordinatorforsurgeries
-Providercredentialing
-Schedule surgeriesandoffice appointments
-Coordinate monthlyARreportsforthe doctorsmeetings
-BillingappealsforOutpatient/Inpatientdenials
- Ambulatory Surgery Center and/or Medical Coding experience including CPT, ICD9,
& ICD10
9/07-9/14-Atlanta InfectiousDisease Group-SpringButler(404) 805-4076
Collections/BillingCoordinator
-Manage collectionsforBCBC,Cigna,UHC, One Health,Medicare,Medicaid,W
Workmen’sComp.,Genericsmall group
-Collectandcounsel debt/insurancestopatients
-Bill all insurances
-Appeal,verify, precertification’s,referralsfromall insurances
-Identifiesdelinquentaccounts,agingperiodandpaymentsources.Processes
delinquentunpaidaccountsbycontactingpatientsandthirdparty reimbursors.
-Manage Self payand Insurance AR
-EPIC,Nextgen, EMDS
-EMR/HIM Medical records
-BillingforHyperbarictreatments
8/03-9/07-Wellstar Cobb Gynecology-SharonSmith(770) 732-5400
PatientAccount Representative/Collections
-Manage collectionsforBCBS,Cigna,UHC, Medicare,& Medicaid
-Insurance verification
-CustomerService
-Counsel patientsregardingbillingissues
-Setup paymentsforSurgical/Obstetricpatient
-AccountsReceivable reportmonthly
-FrontOffice,Checkout,Scheduleappointments
-Precertification/Referral
11/02-8/03-Elite FamilyPractice
Practice Manager/BillingCoordinator
-Secretarial supporttothe Doctor
-Assistswithdevelopmentandimplementationof budgetandoperationalplans
-Developandimplementoffice proceduresrelatedtointeroffice
communications,records,system operations
-Schedule/coordinatesmeetings,appointmentsandtravel arrangements
-Ensuresthe timelinessandadequacyof patientscharge entryintobilling
System
-Collectionsfromvariousinsurance companiesandpatients
-Daily,weeklyandmonthlybudgetingforthe practice
-Ordermedical/office supplies
-FrontOffice
-Verifyinsurance coverage
-Precertification/referrals
-Payroll
-Manage all employees
09/1999-8/02-The Covenant Group/ (678) 258-8200
Home Remote ClaimsExaminer
-Processonan average of 200 claimsdaily
-Examinerforlarge groups
-Evaluate complex claimswithabilitytomake all adjustmentsandpayments
-Respondtoall Subrogationinquiriesandappeal letters
-Communicate withinsurance groupsonadailybasis
7/1996-09/1999-TPA/United Health Care
Team leader/ResearchSpecialist
-Supervisesix claimsexaminers,distribute dailyworkandreports
-Prepare weeklyworkloadsforthe work-at-home examiners
-ResearchSpecialist-Complete all medical anddental
appeals/predeterminations
-Subrogation-Prepare all documentationforsubrogationattorneys,review
accidentcases,correspondingwiththe otherpartiesattorney
-Technical support-Assistclaimsmanagerondifficultcases
-BenefitAnalyst-processedanaverage of 200 claimsdaily
06/1993-07/1996 CignaInsurance Company
ClaimsExaminer/CustomerService
-BenefitAnalyst-Processedanaverage of 300 paperlessclaimsdaily
-CustomerService-Quote benefitsandsolvesanyclaimissues
-Adjustclaimsinwhichwere processedincorrectly
07/1988-06/1993-The Principal Financial Group
ClaimsExaminer
-BenefitAnalyst-processedanaverage of 100 claimsdaily
-CustomerService
05/1984-07/1988-Servidyne Systems Incorporated
Data Entry Clerk
-Inputinformationonwork ordersforrepairingHVACequipment
-Microfilminglarge quantitiesof workorders
-Produce monthendandyearend reports
-Adjustworkordersenteredincorrectly
Education:
HIAA-Part A & B
ICA
Dean Vaughn Medical Terminology
ICD-10
References:Available UponRequest

More Related Content

Similar to Experienced Medical Billing and Collections Professional

Similar to Experienced Medical Billing and Collections Professional (20)

Devon Doll resume new (1)
Devon Doll resume new (1)Devon Doll resume new (1)
Devon Doll resume new (1)
 
Kurt Boldt Resume 2015 ARS
Kurt Boldt Resume 2015 ARSKurt Boldt Resume 2015 ARS
Kurt Boldt Resume 2015 ARS
 
BRITTANY MARTIN CPC
BRITTANY MARTIN CPCBRITTANY MARTIN CPC
BRITTANY MARTIN CPC
 
Betty Iona Koender1
Betty Iona Koender1Betty Iona Koender1
Betty Iona Koender1
 
Elizabeth A Hoyt Resume Current
Elizabeth A Hoyt Resume CurrentElizabeth A Hoyt Resume Current
Elizabeth A Hoyt Resume Current
 
DR TANVI JHA CV (1)
DR TANVI JHA CV (1)DR TANVI JHA CV (1)
DR TANVI JHA CV (1)
 
New resume
New resumeNew resume
New resume
 
Patricia Gonzalez Resume
Patricia Gonzalez ResumePatricia Gonzalez Resume
Patricia Gonzalez Resume
 
LeChon Douglas2
LeChon Douglas2LeChon Douglas2
LeChon Douglas2
 
INGRID RESUME FINAL
INGRID RESUME FINALINGRID RESUME FINAL
INGRID RESUME FINAL
 
melissa resume (1)
melissa resume (1)melissa resume (1)
melissa resume (1)
 
Resume
ResumeResume
Resume
 
George Nicoll 2015
George Nicoll 2015George Nicoll 2015
George Nicoll 2015
 
Updated Resume
Updated ResumeUpdated Resume
Updated Resume
 
Medical Billing Resume
Medical Billing ResumeMedical Billing Resume
Medical Billing Resume
 
sophia fitzgerald resume december 28th 2015
sophia fitzgerald resume december 28th 2015sophia fitzgerald resume december 28th 2015
sophia fitzgerald resume december 28th 2015
 
INGRID RESUME
INGRID RESUMEINGRID RESUME
INGRID RESUME
 
2016.5 Resume
2016.5 Resume2016.5 Resume
2016.5 Resume
 
Lutes recommend
Lutes recommendLutes recommend
Lutes recommend
 
Genise Prior
Genise PriorGenise Prior
Genise Prior
 

Experienced Medical Billing and Collections Professional

  • 1. Tommye E. Braun 2931 Bomar Road Douglasville, Georgia 30135 Home (770) 949-5880 Cell (404) 304-6302 tebraun@aol.com Objective:To maintainapositionexpandingandutilizingmyexperience potential leadership,personal contributionsandprofessionalgrowthinaprofessional field. Qualifications:Experienced Practice Manager/TeamLeaderwithaversatileapproach to applymyskillsina careeroffice setting.Excellentwrittenandverbal communicationskills,abilitytooperate anycomputersystem.CPT, HCPCS,ICD9,ICD10coding,HMO,PPO,Medicare A,B& D plans,Medicaid,Medical terminology,Provider Maintenance,&ProviderCertification/credentialing,HCFA-1500& UB04 Billing,EPIC,Medstreaming, Genix,Greenway,Nextgen,EMR Job History: 10/15-Present Peachtree Vascular Specialist-MelissaBergman -Maintains self pay and managed care accounts -CustomerService -ARreporting -Collections -Precertification -Manage all Insurance balancesforsurgeriesrenderedatPiedmontHospital,Wellstar Fayetteville/HenryHospital -BillingappealsforOutpatient/Inpatientdenials 9/14-10/15-Georgia Hand Shoulder& Elbow-LynnWolf (404) 352-3522 Medical AR/CollectionsBilling -Manage Self payaccounts-Contactpatientsforoutstandingbalances -Collectpayments -Manage all Insurance balancesforsurgeriesrenderedatPiedmontHospital and WellstarKennestone Hospital -CustomerService -Appeals,ReferralsforSurgery,Occupational Therapy,&Physical Therapy -Insurance/EligibilityVerificationforinsurancesandworkman’scomp - BenefitCoordinatorforsurgeries -Providercredentialing -Schedule surgeriesandoffice appointments -Coordinate monthlyARreportsforthe doctorsmeetings -BillingappealsforOutpatient/Inpatientdenials - Ambulatory Surgery Center and/or Medical Coding experience including CPT, ICD9, & ICD10
  • 2. 9/07-9/14-Atlanta InfectiousDisease Group-SpringButler(404) 805-4076 Collections/BillingCoordinator -Manage collectionsforBCBC,Cigna,UHC, One Health,Medicare,Medicaid,W Workmen’sComp.,Genericsmall group -Collectandcounsel debt/insurancestopatients -Bill all insurances -Appeal,verify, precertification’s,referralsfromall insurances -Identifiesdelinquentaccounts,agingperiodandpaymentsources.Processes delinquentunpaidaccountsbycontactingpatientsandthirdparty reimbursors. -Manage Self payand Insurance AR -EPIC,Nextgen, EMDS -EMR/HIM Medical records -BillingforHyperbarictreatments 8/03-9/07-Wellstar Cobb Gynecology-SharonSmith(770) 732-5400 PatientAccount Representative/Collections -Manage collectionsforBCBS,Cigna,UHC, Medicare,& Medicaid -Insurance verification -CustomerService -Counsel patientsregardingbillingissues -Setup paymentsforSurgical/Obstetricpatient -AccountsReceivable reportmonthly -FrontOffice,Checkout,Scheduleappointments -Precertification/Referral 11/02-8/03-Elite FamilyPractice Practice Manager/BillingCoordinator -Secretarial supporttothe Doctor -Assistswithdevelopmentandimplementationof budgetandoperationalplans -Developandimplementoffice proceduresrelatedtointeroffice communications,records,system operations -Schedule/coordinatesmeetings,appointmentsandtravel arrangements -Ensuresthe timelinessandadequacyof patientscharge entryintobilling System -Collectionsfromvariousinsurance companiesandpatients -Daily,weeklyandmonthlybudgetingforthe practice -Ordermedical/office supplies -FrontOffice -Verifyinsurance coverage -Precertification/referrals -Payroll -Manage all employees 09/1999-8/02-The Covenant Group/ (678) 258-8200 Home Remote ClaimsExaminer -Processonan average of 200 claimsdaily -Examinerforlarge groups -Evaluate complex claimswithabilitytomake all adjustmentsandpayments
  • 3. -Respondtoall Subrogationinquiriesandappeal letters -Communicate withinsurance groupsonadailybasis 7/1996-09/1999-TPA/United Health Care Team leader/ResearchSpecialist -Supervisesix claimsexaminers,distribute dailyworkandreports -Prepare weeklyworkloadsforthe work-at-home examiners -ResearchSpecialist-Complete all medical anddental appeals/predeterminations -Subrogation-Prepare all documentationforsubrogationattorneys,review accidentcases,correspondingwiththe otherpartiesattorney -Technical support-Assistclaimsmanagerondifficultcases -BenefitAnalyst-processedanaverage of 200 claimsdaily 06/1993-07/1996 CignaInsurance Company ClaimsExaminer/CustomerService -BenefitAnalyst-Processedanaverage of 300 paperlessclaimsdaily -CustomerService-Quote benefitsandsolvesanyclaimissues -Adjustclaimsinwhichwere processedincorrectly 07/1988-06/1993-The Principal Financial Group ClaimsExaminer -BenefitAnalyst-processedanaverage of 100 claimsdaily -CustomerService 05/1984-07/1988-Servidyne Systems Incorporated Data Entry Clerk -Inputinformationonwork ordersforrepairingHVACequipment -Microfilminglarge quantitiesof workorders -Produce monthendandyearend reports -Adjustworkordersenteredincorrectly Education: HIAA-Part A & B ICA Dean Vaughn Medical Terminology ICD-10 References:Available UponRequest