Ratanang Jacobeth Nkoana
Medical Billing Clerk
Johannesburg
Summary
Professional with strong background in medical billing and coding, adept at navigating complex billing systems and ensuring accurate claim submissions. Known for collaborative teamwork, flexibility, and results-driven approach in fast-paced environments. Possesses exceptional skills in patient account management, compliance with healthcare regulations, and problem-solving. Dependable and adaptable, consistently delivering precise and efficient billing operations.
Overview
5
5
years of professional experience
2019
2019
years of post-secondary education
Work History
Medical Billing Clerk
Cs Consulting
01.2021 - Current
- Billing and Coding: Utilize medical coding systems (such as ICD-10, CPT, and HCPCS) to accurately code diagnoses, procedures, and services provided to patients during their healthcare visits.
- Claim Submission: Prepare and submit medical insurance claims to various insurance companies, government healthcare programs (such as Medicare and Medicaid), and other third-party payers for reimbursement.
- Follow-Up on Claims: Monitor the status of submitted claims to ensure timely payment, and follow up with insurance companies on unpaid or denied claims. This may involve communicating with insurance representatives, providing additional information or documentation as needed, and appealing denied claims when necessary.
- Payment Posting: Record and reconcile payments received from insurance companies, patients, and other payers, accurately applying payments to patient accounts, and resolving any discrepancies or issues.
- Patient Billing: Generate and send patient statements for outstanding balances, answer patient inquiries regarding billing and insurance coverage, and set up payment plans, or arrange financial assistance for patients as needed.
- Insurance Verification: Verify patients' insurance coverage and eligibility, confirming benefits, coverage limits, and any pre-authorization requirements prior to services being rendered.
- Documentation and Recordkeeping: Maintain accurate and organized records of patient billing and payment transactions, including medical records, insurance information, billing statements, and correspondence with insurance companies and patients.
- Compliance: Ensure compliance with healthcare regulations, billing guidelines, and coding standards, including HIPAA regulations governing patient privacy and confidentiality.
Merchandiser
Afrika Tikkun NPC
11.2020 - 12.2020
- Merchandise Planning: Collaborate with the marketing and fundraising teams to develop merchandise plans that align with the organization's goals and campaigns.
- Product Selection: Research and select appropriate merchandise items that resonate with the organization's mission and target audience. This may involve sourcing items locally, or through partnerships with ethical suppliers.
- Inventory Management: Maintain accurate records of merchandise inventory, including tracking stock levels, conducting regular stock takes, and managing reorder processes to ensure products are always available for sale.
- Vendor Management: Build and maintain relationships with merchandise vendors, negotiating pricing, terms, and delivery schedules to ensure the best possible deals for the organization.
- Design and Branding: Work closely with the marketing and design teams to develop branding and packaging for merchandise items that effectively communicate the organization's message, and enhance brand awareness.
- Sales and Promotion: Develop strategies to promote merchandise sales, including online sales through the organization's website, as well as through events, campaigns, and other marketing channels.
- Revenue Generation: Set sales targets and develop strategies to achieve revenue goals through merchandise sales, ensuring that proceeds contribute to the organization's programs and initiatives.
- Quality Control: Ensure that merchandise items meet quality standards and comply with relevant regulations, conducting inspections and quality checks as necessary.
Education
N6 Certificate - Civil engineering
CJC Johannesburg
Accounting Sciences
University of South Africa
Skills
- Experienced in construction management practices
- Understanding of accounting principles
- Pattern recognition expertise
- Proficient in client relations
- Effective verbal and written communication
- Skilled in multitasking and organization
- Strong focus on accuracy
Claims denial management
Medical coding expertise
Proficient in ICD-10 classification
References
Further Information, detail or document will be provided with pleasure on request.
Disclaimer
Declaration: I hereby give my consent to keep my CV and contact me for any future opportunities in your organization.
ATTRIBUTES
- Excellent Communication Skills (verbal & written)
- Multitasking
- Time management
- Adaptable
- Stress Management
- Leadership Skills
- Decision Making
- Conflict Resolution
- Flexibility
- Organizing and Planning Work well under pressure
- Interpersonal Skills
- Strategist
- Willing to learn
- Team Work
- Handling Confidentiality
- Strong morals and professional ethics
- Emotional Intelligence
- People Management
Timeline
Medical Billing Clerk
Cs Consulting
01.2021 - Current
Merchandiser
Afrika Tikkun NPC
11.2020 - 12.2020
Accounting Sciences
University of South Africa
N6 Certificate - Civil engineering
CJC Johannesburg
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