Renee Raleigh

Experience

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  Novant Health-Eastover Pediatrics

  Jan 2000 - Jan 2007

  Coding and posting of doctor’s chargesOffice cash managementVerified insurance benefits for pediatric careMaintaining of medical recordsScheduling of Sick & Well appointments for 9 doctors Accounts receivableSwitchboardCertifications:NC State AAPC Exam for CPC coding August 2014

  • Patient Coordinator

    Jan 2002 - Jan 2007

  • Front Desk Receptionist

    Jan 2000 - Jan 2002
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  Piedmont Plastic Surgery & Dermatology

  May 2007 - Apr 2009

  Patient Services Coordinator

  Pulling and preparing charts from medical records for upcoming appointments Verfying insurance for dermatological procedures Scheduling of surgeries, doctor visits and follow ups for 8 doctorsChecking In/Out of patients for scheduled visits.

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  Lash Group

  Oct 2009 - Feb 2010

  Health Insurance Specialist

  Contract Job- Insurance verification with commercial insurance for an injectable drug

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  BlueDot Medical

  Mar 2010 - Dec 2013

  Medical Billing Specialist

  Processed incoming Durable Medical Equipment orders:Verifying Insurance benefits for NC/SC Medicaid, Medicare, Commercial Insurance Obtaining Insurance authorizations for medical equipment through NC/SC Medicaid, Medicare, Commercial Insurance Coordinating deliveries between delivery technicians and patients. Scheduled patients for initial visits for equipment evaluations, physical therapy evaluationsObtained and reviewed chart notes, physical therapy evaluations and other medical documentation to qualify patients for medical equipment through insurance company; Front end and back end billing for NC/SC Medicaid, Medicare, Commercial Insurance Answered high volume of billing calls.Obtaining and Logging Certificate Of Medical Necessity Worked monthly denial logs from insurance companies. Collection calls Show less

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  First Care Medical Clinic

  Sept 2015 - Apr 2016

  Assistant Billing Manager

  Coded for 7 different practices at 5 different locationsServed as a liaison between the healthcare providers and billing departmentAnalyzed account charges with documentation to ensure accuracy for final claim submissionFollowed insurance policies and state law requirements for coding initiatives.Reviewed EOBs for various insurance carriers and completed necessary appeals needed for denials received.Ensured accurate use of ICD-9 and ICD-10 for diagnostic codes and documentation to support visit encounter.Maintained a 97% or above accuracy rateMaintained consistent daily production of greater than 40-60 reviews per day. Show less

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  Rotech Healthcare

  Apr 2016 - Jan 2021

  Location Manager

  Abstracted clinical information from a variety of medical records for the qualification of medical equipment.Followed correct coding initiatives per insurance policy and state law guidelinesReviewed EOBs for various insurance carriers and completed necessary appeals needed for denials received.Ensured accurate use of ICD-9 and ICD-10 for diagnostic codes and documentation to support visit encounter.Maintained a 97% or above accuracy rateServed as a liaison between the healthcare providers and billing departmentCase management between multiple hospitals to coordinate delivery of home equipment at dischargeParticipated in physician reviews of clinical documentation for appeals on healthcare coverageManaged payroll, monthly/quarterly sales reporting, reconciliation of sales commissions.Worked with logistics program to distribute equipment within assigned three-county regionPlanned equipment delivery for three locationsTeam lead for 5 employeesBonused twice in manager program based on tier and size of locationGrew location by the monthly 5% growth for 14 months straightCreated Emergency Preparedness Plan for location used for hurricanes, floods and pandemicsHandled additional locations during emergency evacuations and natural disastersMonitored Joint Commission playbook for location’s compliancePassed an internal and State Joint Commission inspection while managing locationPassed Board of Pharmacy inspection while managing locationCompleted a successful NC DHHS inspection while managing location Show less

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  Corporate Jobs with TNAA

  Sept 2021 - Apr 2023

  Quality Assurance Specialist

  TNAA is an RN staffing agency. I worked in the Quality Assurance department. This department works with credentialing departments with hospitals when an RN is staffed and fully credentialed upon start date and continued through assignment.

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  Asembia

  Oct 2023 - now

  Patient Care Coordinator