MARCUS MORRISON108-03 Flatlands 7th Street

Brooklyn, NY 11236Cell# (917) 327-7419

morrisonmarcus@gmail.com

PROFESSIONAL EXPERIENCE

Shiel Medical Laboratory, 63 Flushing Ave, Unit 336, Brooklyn, NY 11205 08/15 – PresentBillerWork with 45 nursing homes per biller using Auto billing 3.3, verifying insurances, establishing payments of copays and coinsurances. Also resubmitting claims.

Amerigroup Insurance, Inc., 815 59th Street Brooklyn, NY 11220 07/12-08/15Claims Analyst

Daily methodology consist of reviewing Medicaid claims to determine if processing takes primary or secondary resolution depending on OHI (Other Healthcare Insurance) or Medicare COB (Coordination of Benefits).

All claims processed required payment, denial or pended resolution and all effort had to be resolved in a timely manner according to State guidelines for claims received and processed as per the agreement of the healthcare plan.

Work efforts included but not limited to researching EOB data submitted through spreadsheet transmission or claim/ EOB visuals for verification of payment type. Software used was Facets, Macess and Citrix on a daily basis.

E-Z BILL Company 755 2nd Ave, New York, NY 10017 09/09–07/12Medical Biller & Coding Specialist (Radiology Medical Facility)Posted Payments, did coding, and processed Radiology claims such as Obstetric Ultrasound, Abdominal Ultrasound, 1st & 2nd Trimester Obstetric Ultrasound, Venous Doppler, Shoulder meniscus tears, L-Spine, T-Spine & Cervical spine coding for MRI and MRA exams as well as many others. knowledgeable of collections, credentialing, Workers Comp, NO-Fault, Medicaid, Medicare & Private insurances. Used software such as Medisoft, and Veztek.

CONSULTANTM4 Medical Billing Out Source Contractor 11/06-09/09Medical Biller

Medical billing and claims processing in Pediatrics, Obstetrics, Gynecology, Dentistry and Chiropractor working with Primary Care, Medicare, Medicaid and HMO’s.

Verified coverage as well as registered patients in the clinic. Well versed in Medicaid, Medicare & Commercial Insurance submissions/postings/appeals.

Contacted various insurances for eligibility status, follow-up, reviewed and negotiated payments with third party Insurances.

Processed claims using MIQS, Medical Manager, Medisoft, Veztek, and IDX systems for adjustments and billing.

• Did claims examination and determining what their status are such as ;under-payment status (and what particular line. item is of question); over paid status (and what particular adjustment is required); or if denied status (to find out why and what is needed to overturn the denial). • Did four different types of adjustment; Case Mix Adjustments – is only applied when “Medicare” is Primary and an adjustment is needed to be made; Profile Adjustments – is applied when “Commercial” insurances are involved that are participating providers and also when there is no reference to “Patient” responsibility; MSP Adjustments - Medicare is the Secondary Payer (it is used only when the “PRIMARY” is a “Commercial Payer” such as HMSA, and “Medicare” is the secondary payer, and there has to be “Co-Pay, Co-Insurance, or Deductibles” present or else it’s a write-off. And use “Medicare MSP Credit when adjusting.”) Commercial Adjustment – is when it involves a Commercial Insurance that is a Non Participating Provider with no patient responsibility, and an adjustment needs to be made. So if their was a HMO Medicare Insurance that is none participating and was billed as a commercial insurance than this adjustment is to be used.

Worked on AMISYS program examining claims for payments and denials for various reasons. Processed claims on fee pricings on Medicare claims using Winstat program Entered Patient data into HCFA & UB92’s forms. Created affiliations in AMISYS to adjudicate claims.

SAINT VINCENT MEDICAL CENTER 170 West 12th Street, New York, NY 10011 10/02–11/06Accounts Payable Specialist /Medical Biller

Input, updated and released invoices and vouchers for payment using Lawson accounting program. Created and processed Pre-Pays for special vendors. Worked on problematic invoices with no purchase orders or incorrect purchase order number. Processed insurance verification, billings, and appeals on Siemens (SMS) program. Worked with a variety of insurance plans and handled corresponding forms for self pays. Audited claims and rebilled to primary carriers.

KINGSBROOK JEWISH MEDICAL CENTER 585 Schenectady Ave, Bklyn, NY 11203 06/98 – 10/02Accounts Payable Specialist

Input, updated and released invoice and vouchers for payment using the Lawson accounting program. Examined and researched invoices and vouchers for possible fraudulent claims. Worked on purchase orders, vouchers and prepaid invoices. Printed checks for vendors.

ELDER PLAN 6323 7th Avenue, Brooklyn, NY 11220-4719 02/96–06/98Claims Examiner

Worked on UB92’s and HIPAA claim forms using Amisys billing program. Interpreted and translated Code Reviews Adjudicating claims. Examined and corrected information entered from data entry personnel when auditing claims. Entered data into HCFA & UB92’s forms.

EDUCATIONMedgar Evers College B.S. Management A.S Business Administration

SKILLSProficient in Microsoft Excel, Word, Access, Power Point, Outlook, Binder, Desktop Publishing ,Lotus SmartSuite, Lotus Notes, Paradox 9, Black Baud, Financial Edge, QuickBooks, Quicken, Lawson, and Oracle. Billing, Claims Examining, and Claims Auditing using the following programs: .Amisys, Siemens (SMS), Medical Manager 10.30, Medisoft, Viztek, Envision, Epaces, Meditech, Winstat (Medicare pricing), Used Medicare Remit EasyPrint v4.0, PacWin and an Access Database for A/R., CureMD, Navinet, EDI, IDX and MIQS. Also knowledgeable of CPT & ICD coding system.