Ajee Smith

Ajee’ Smith Atlanta, Georgia •-• - Education JACKSON STATE UNIVERSITY School of Public Health, Healthcare Administration Jackson, MS August 2023-Present Experience Remote SYNERGRX City, State Medical Biller and Coder April 2023 – Present • Review and audit claims monthly for chronic care management, ensuring accuracy and compliance. • Upload patient records, close encounters, and drop claims in Athena Health, streamlining workflow progress. • Billed Chronic Care Management and Remote Patient Monitoring ICD-10 and CPT codes following allotted global periods. • Utilize Excel to organize and track workflow progress, analyze billing trends, and identify insurance payment and coding denials. MIDTOWN NEUROLOGY Atlanta, GA Medical Biller/Front Office Specialist/Administrative Assistant September 2020 – April 2023 • Analyzed claims data using Excel Spreadsheets to identify trends and provide insights for process improvements. • Completed A&R using Eclinical Works for Medicare and Medicaid Georgia claims, including submitting appeals, reconsiderations, and correcting claim errors. • Managed multiple provider schedules, scheduling appointments, check patients in/out and answered incoming patient calls. • Reconciled bank statements tracked monthly office expenses, managed employee records and onboarding, and maintained a credentialing calendar for provider certifications. • Reviewed and audited claims for chronic care management, uploaded patient records, closed encounters, and dropped claims in Athena Health, while analyzing billing trends and insurance payments. GEORGIA SURGICARE Atlanta, GA Patient Care Coordinator/Accounts Receivables July 2018 – September 2020 • Registered and scheduled new patients in Athenahealth, maintaining accurate and up-to-date information. • Verified patients' insurance benefits, specifically focusing on bariatric benefits to facilitate treatment plans. • Coordinated and managed schedules for four different providers, ensuring all appointments were confirmed. • Demonstrated excellent sales skills in scheduling self-pay plastic surgery procedures. • Collected up to $30,000 weekly in inpatient payments and assisted patients with credit applications such as GreenSky, Care Credit, and Alphaeon. • Scheduled surgeries/appointments collected deposits and payments and created care plans based on obtained insurance benefits for Bariatric procedures. Skills, Software & Insurance Experience • • • • • • • • • • Skills: Data Analysis Software: Athenahealth, eClinicalWorks, Availity, TriZetto, Encoder Pro, Accounts Receivable Find-A-Code and CoverMyMeds. Claims Management ICD-10 & CPT Coding Insurance: Medicaid Georgia, Medicare Part B Georgia, Humana, UHC, Insurance Verification Tricare, Cigna (most packages), WellCare, Ambetter, Aetna, Denial Resolution BCBS, Worker’s Compensation, AARP, Sonder Health, Oscar, Claim Auditing CareSource, and Bright Health. Payment Posting HIPPA Complaint Prior Authorization & Precertification