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Elizabeth J. Ashbaugh
12090 Calle De Montana #254
El Cajon, CA 92019
H (619) 303-4929
C (612) 345-2683
 
Software Skills:
 
Officeally (Practice Mate) Medical Software, Medisoft Version 12 and 14, Medical Manager, MedFx, Eclispe, Paychex, Quick Books, Clear Connect and Zirmed Electronic Billing Software, Cerner Powerworks, DISC Level 7 and 8 (Vital Works) Computer System, IDX, MN ITS, DME Express, and SyMed Credentialing Software.
 
Work Experience:
 
Albert J. Sharf, MD, INC., National City, CA 08/10 – current (Temporary assignment)
 
Insurance Specialist/Payroll/Credentialing/Accounts Receivable
 
  • Entering charges daily for Medicare, Medi-cal, HMO’s, PPO’s, Private insurance, Personal Injury, and Workers Compensation 
  • Worked aging and set-up patient arrangements for amounts due for their deductibles and co-insurance balances 
  • Coding charges with CPT, HCPC and ICD-9 codes, filing appeals to insurance companies and Worker’s Compensation
  • Posting payments from EOB’s/EOR’s, posting patient copays and co-insurance, and working denials from the EOB/EOR’s
·         Submitting claims electronically, contacting insurance companies and Attorney's, and responsible for prior authorizations, for the follow-up of all denied claims, and the filing of claims to the patient’s secondary insurance carriers. 
·         Attaching all appropriate documentation (from EMR) to claims that are filed to Worker’s Compensation Carriers.
  • Help this practice with their contracting, credentialing, re-credentialing with HMO’s, PPO’s, IPA’s and Managed Care carriers.
  • Responsible for the Payroll for ten employees and the calculation of their accrued PTO
 
PDS, San Diego, CA 09/09 –08/10
 
Account Insurance Specialist for Orthopedics/Physical Therapy and a Neurosurgeon
 
  • Entering charges daily for Medicare, Medi-cal, HMO’s, PPO’s, Private insurance, Personal Injury, and Workers Compensation 
  • Worked aging and set-up patient arrangements for amounts due for their deductibles and co-insurance balances 
  • Coding charges with CPT, HCPC and ICD-9 codes, filing appeals to insurance companies and Worker’s Compensation
  • Posting payments from EOB’s/EOR’s, posting patient copays and co-insurance, and working denials from the EOB/EOR’s
·         Submitting claims electronically, contacting insurance companies and Attorney's, and responsible for prior authorizations, for the follow-up of all denied claims, and the filing of claims to the patient’s secondary insurance carriers. 
·         Attaching all appropriate documentation (from EMR) to claims that are filed to Auto/Personal Injury and Worker’s Compensation Carriers.
 
Water and Sports Physical Therapy, San Diego, CA 07/09 – 08/15/09 (Contracted Office position)
Central Urgent Medical Care, Montclair, CA 04/09 - 08/09 (Contracted Credentialing/Contracting position)
Robin Center Chiropractic/ Midway Healthcare Services and Physical Therapy, Robbinsdale, MN 08/07 – 07/09
 
Office Manager/ Collections/Insurance Specialist/Contracting and Credentialing
 
  • All aspects of the office, from scheduling and rescheduling appointments, answering multi-line phones, coding charges with CPT, HCPC and ICD-9 codes, entering charges daily for Medicare, Medi-cal, HMO’s, PPO’s, and Workers Compensation 
·         Submitting claims electronically, posting payments, contacting insurance companies and Attorney's and responsible for prior authorizations, for the follow-up of all denied claims, and the filing of claims to the patient’s secondary insurance carriers. 
  • Attaching all appropriate documentation to claims that are filed to Auto/Personal Injury and Worker’s Compensation Carriers.
  • Hired, trained and managed a staff of five and was responsible for all staff evaluations, payroll, accounts receivable/accounts payable and bank deposits. Helped with the training of staff to use computer software to its potential. 
  • Help these practices with their contracting, credentialing, re-credentialing with HMO’s, PPO’s, IPA’s and Managed Care carriers.
  •  Worked aging and set-up patient arrangements for amounts due for their deductibles and co-insurance balances  
 
 
 
 
 
 
 
 
Western Orthopaedic Surgery, Ltd., St. Louis Park, MN 03/05 to 08/07
 
Office Manager/Collections/Contracting and Credentialing/Project Coordinator/Insurance Specialist/Surgery Scheduler
 
  • Posting all payments from remits/EOB’s to patients accounts, working with patient’s to set-up payment arrangements, do follow-up call on accounts that haven’t been paid or not paid correctly, contact attorney’s offices in regards to payments for their legal consults and medical legal reports.
  • Pre-registering all new patients, and verifying their medical insurance, for coding of all medical, surgical and radiology charges and entering the charges with correct CPT and ICD-9 codes then transmitting them electronically thru McKesson Clearinghouse.
  • Hired, trained and managed a staff of four. I was responsible for their evaluations, all office responsibilities including payroll and human resources.
  • Responsible for Credentialing/re-credentialing process with third party payers for two physicians.
  • Took the office from paper claims to Cerner Powerworks medical software, setting up the practice in Cerner Powerworks with the physicians’ credentials, payer group ID numbers, NPI number, practice information, fee schedules, CPT, ICD-9 codes, and training staff on how to use the software.
  • Scheduling all new and existing patients in the computer along with scheduling all surgeries
  • Scheduling surgeries, scheduling legal consults and IME’s for the two physicians and sending letters out to the attorney’s to remind them of the day of the consult.
 
Allina Health System and Hospitals, Minneapolis, MN 11/25/02 to 03/05
 
Credentialing Specialist/ Collections/Insurance Specialist
 
  • Working with Medicare, Medicaid, Medica, BCBS, Health Partners, Preferred One and other Insurance carriers in regards to applications completed and the status of provider numbers.
  • Responsible for Credentialing/re-credentialing process with third party payers for all employed Allina Health System physicians (totaling 450 providers), nurse practitioners, licensed psychologists, licensed social workers, Neonatal Nurse Practitioners, Cardiologists, ER physicians, General Practice, OB/GYN, Cardiologists and Anesthesiologists. Working with Clinic Managers on getting copies of provider’s current DEA’s, MN License, CV’s and Diplomas.
  • For completing out of state Medicaid applications for providers who see patients treated from outside our 5-state region.
  • Position works very closely with medical staff Credentialing and clinic providers and the hospital and physician business office.
  • For maintaining physician master file in SyMed billing systems (for all staff physicians) and training new staff on how to use SyMed, as well as, working with our professional billing vendors related to physician provider number issues.
  • For working pending reports and Third Millennium issues by correcting any coding errors and printing off the claims and filing them to the correct payers, working closely with clinic managers to receive Credentialing applications back in a timely manner.
 
Griggs Chiropractic Care/Advanced Rehab and Physical Therapy/Community Chiropractic, Champlin,  MN 9/01 – 11/22/02
 
Office Manager/Collections /Insurance Specialist/Credentialing
 
  • Responsible for all aspects of the office, from managing a staff of seven, scheduling and rescheduling appointments.
  • Setting up all new patient accounts, and entering all demographics into the computer and for contacting all new patients’ insurance carriers prior to their appointments to get their benefit information.
  • Typing interventions to the State Of Minnesota for workers’ compensation cases that our schedule for court hearings.
  • Entering in all charges and payments daily with the correct ICD-9/CPT-4 codes, did all daily deposits.
  • Filed all claims to all insurance carriers, and making sure all-appropriate documentation was attached.
  • Worked all denied claims, and the filing of claims to the patient’s secondary insurance carriers. 
  • Typing twelve-week letters for additional treatment and physical therapy, then mailing to the insurance carriers, and responsible for all transcriptions of patient’s daily notes.
  • I maintained all medical records, and filling all requests for records on patients.
  • Took care of all the credentialing/re-Credentialing on any new Doctors or Chiropractors.
 
 
 
 
 
 
 
Sheila Merzer, MA, LP and Robbie Gunther, MA, SP, CCC, St. Louis Park, MN 3/01 to 4/12/03
Reach for Resources, INC., Hopkins, MN 11/01 to 5/24/04
 
Office Manager/Collections/Insurance Specialist/Credentialing
 
  • I was responsible for all aspects of the office, from scheduling and rescheduling appointments.
  • Entering all demographics, verifying insurance, applying the correct ICD-9 and CPT-4 codes, making sure we have a prior authorization on file prior to sending claims.
  • For billing all schools for consultations, evaluations, in-service training on students, for billing all claims to Medical Assistance through MN ITS, insurance companies for respite, strive, Case Management, oral and speech evaluations. 
  • I was responsible for all Accounts Receivable/Accounts Payable, Payroll, and all Medical Credentialing.
  • I was responsible for monthly, quarterly, and yearly taxes.
  •  I sent to parents and the schools the completed assessment letters from a child’s evaluation.
  • I also did all the billing for the assistants to the Licensed Psychologist and Speech Pathologist.
  • I worked all credit/collection reports, sent letters to insurance companies in regards to out-standing claims, claims that have authorization numbers that have not yet been paid on, for running all monthly reports and typing all patient notes and consultations.
  • I was responsible for all medical records and all medical records requests
 
Prairie Center Chiropractic and Prairie Center Physical Therapy, Eden Prairie, MN 11/2/98 to 3/01
 
Office Manager/Legal Secretary/Insurance Specialist/Collections
 
  • Hired, trained and managed a staff of four. I was responsible for their evaluations, all office responsibilities including payroll and human resources.
  • I was responsible for setting up all new patient accounts, and entering all demographics into the computer and for contacting all new patients’ insurance carriers prior to their appointments to get their benefit information.
  • Typed interventions to the State Of Minnesota for Worker’s Compensation cases that our scheduled for court hearings.
  • Printed previous day’s treatment notes and dictation to file to insurance companies and file in the patient’s charts.
  • Collected all patient portion amounts and copays at time of visit, entering in all charges and payments daily with the correct ICD-9/CPT-4 codes. 
  • Also responsible for daily deposits, for filing all claims to all insurance carriers, and making sure all-appropriate documentation is attached.
  • I was responsible for the follow-up of all denied claims, and the filing of claims to the patient’s secondary insurance carriers. 
  • Typed twelve-week letters for additional treatment and physical therapy, then mailing to the insurance carriers and also responsible for typing patient’s daily notes.
  • I was responsible for all Accounts Receivable/Accounts Payable, and Payroll.
  • Responsible for Credentialing/re-credentialing process with third party payers for all employed Allina Health System physicians (totaling 450 providers), nurse practitioners, licensed psychologists, licensed social workers, Neonatal Nurse Practitioners, ER physicians and Anesthesiologists. Working with Clinic Managers on getting copies of provider’s current DEA’s, MN License, CV’s and Diplomas.
 
University of MN Physicians Cardiology Dept and Internal Medicine/North Urology, LTD., and Dr. Steven Schwartz, Minneapolis, MN 4/98 – 11/1/98
Insurance Billing Spwcialist/Collections/Account Follow-up Specialist and Business Office Specialist
Temporary Positions
 
  • Responsible for applying correct CPT and ICD-9 codes from the doctors dictation and operative reports then submitting claims to the appropriate insurance companies along with notes.
  • I verified patients insurance, calling companies on past due accounts and setting up payment arrangements with them so we can bring their accounts current.
  • I checked accounts to see if payments have been received, and if not calling the companies to see if the check has been mailed to us.
  • I called insurance companies to check on claim status, to either find out if they received the claim or if the claim has been denied.
  • Investigated and obtained additional information requested, or needed to resolve outstanding claims, set-up accounts for pre-collect/collection status per Departmental Policy, and resolved unidentifiable or questionable payments that were posted incorrectly to a clients account.
  • I was responsible for correcting any inappropriate CPT codes and ICD-9 codes and adding any modifiers to a claim to help in the process of getting the claim paid.
  • I pulled all primary EOB’s and attached them to the appropriate HCFA 1500 claims forms and filed them to the secondary insurance carriers,
  • I applied incoming payments, discounts and reserves to the appropriate accounts; and for working the credit reports, identifying any problem, and correcting them. Filing claims to MN Medicaid thru MN-ITS.
 
 
 
 
Orthopaedic Consultants, PA., St. Louis Park, MN 10/95 – 11/98
Office Manager/Collections /Lead Insurance Specialist/Cash Applications Specialist/Surgery Scheduler
 
  • I responded to correspondence from patients, clinics, and third party payers within five business days, responded to telephone inquiries from patients, clinics and third party payers with follow-up in 48 hours.
  • I was responsible for the follow-up on claims not paid per Department Policy, investigated and obtained additional information requested, or needed to resolve outstanding claims. 
  • Reviewed EOB’s and researched denials, and/or excessive reductions in order to assure optimal payment. 
  • Worked the credit balance reports; which identify errors and accurately transfer them to the correct adjustment batch form. 
  • Applied payments, disallows, and reserve amounts to the appropriate accounts per department protocol, balanced batches to today-end totals, processed all charge, payment and transfer batches on a weekly basis. 
  • Resolved unidentifiable or questionable payments posted to the holding account.
  • Hired, trained and managed a staff of nine. I was responsible for their evaluations, all office responsibilities including payroll, human resources and assisting with scheduling surgeries.
 
 
Education:
 
Inver Hills Community College: ICD-9-CM Coding Certificate
North American Correspondence College: Medical Office Assistant Diploma
Southwestern College – Massage Therapy Training
Southwestern College: Introduction to Business
Regional Occupational Program: Word Processing Certificate
Regional Occupational Program: Computer Applications Certificate
Regional Occupational Program: Medical Office Procedures
Southwestern College: Secretarial Office Procedures
Cuyahoga Community College: Accounting Principles
Cuyahoga Community College: Data/Computer Applications/Basic Accounting Principles
 
Continuing Professional Education:
 
Additional training in Business and Office Procedures
DISC Computer Services
Personnel Motivation and Supervision
Communication Techniques
Conflict Management
Problem Solving Strategies