Sade B

Prescreened to assure timely filing of claims and performed insurance verification for acute hospital accounts, specializing in MCO Medicare. Obtained benefits for urgent add-on diagnostic medical, surgical inpatient, outpatient, and advanced radiology procedures. Utilized ICD10, HCPCS, CPT, and authorization knowledge for claims processing.

Prescreened incoming MD orders via electronic fax system and performed data entry for patient demographics. Triaged fast care for high acuity patients, including wound vac, total knee replacement, and colostomy. Scheduled initial evaluations for SN or PT within the home.

Verified patient insurance and demographics, and obtained the newest fee schedules by payor for appropriate reimbursement. Utilized proper CPT codes for DME, high dollar immunosuppressants, antibiotic infusions, and injections. Gathered all clinical documentation from ordering MD necessary for approved authorizations and communicated with case managers and physicians.

Outreached to promote plant-based diets in food deserts and provided presentations to educate the public on disease prevention. Created recipes for grade school students to follow. Met with sponsors such as United Way and Houston Food Bank to organize future endeavors for the organization.

Pursuing certification as a Certified Professional Coder (CPC) from AAPC. This involves preparing for an exam scheduled for 2025.

Pursued a Bachelor of Science in Health Sciences. Focused on developing a strong foundation in health-related disciplines.