AIMEE LIAN CAGANDE

( (856)287-0544 * - 1404 White Horse Rd. Voorhees, NJ 08043

Medical Billing Accounts Manager
Accomplished and results driven professional recognized for productive performan
ce, commitment to excellence, and demonstrated ability to communicate and workin
g with senior management, associates, and customers. Has an excellent interperso
nal skill, able to communicate and collaborate effectively with co-workers at al
l levels. Self-motivated and can work independently or in a team.
AREAS OF EXPERTISE
*
* EXCELLENT STRATEGIST - Provide solutions that boost productivity and efficien
cy across the organization. Quickly identify problem areas and implement effecti
ve solutions to meet goals.
* EXCEPTIONAL ORGANIZATIONAL SKILLS - Consistently recognized by colleagues for
exceptional talents in needs analysis and problem resolution in fast-paced envi
ronments.
* STRONG SENSE OF RESPONSIBILITY - Solid professional standards; excellent trac
k record of dependability. Maintain focus on achieving results while implementin
g business solutions to meet a diversity of needs.
* ADMINISTRATION AND MANAGEMENT - Knowledgeable of administrative and managemen
t principles involved in strategic planning, resource allocation, leadership tec
hnique, and coordination of people and resources.
* CLERICAL - Knowledge of administrative, medical and clerical procedures and s
ystems such as word processing, managing files and records, designing forms, and
other office procedures and medical terminology.
* CUSTOMER SERVICE - Consistently demonstrate responsiveness, strong customer f
ocus, and ability to build good customer relationships.
* COMPUTER SKILLS - Knowledgeable of computer programs to include Web MD, Medi
software, Medical Manager & Mysis, Allscript, People soft, PICIS, SMS, Microsoft
Windows, Outlook, Word, PowerPoint, Excel and the use of Internet.
PROFESSIONAL EXPERIENCE
Medical Billing/Coding Specialist:
Virtua Home Care Mt. Laurel, NJ 2006-Present
* Provide coverage for open/absent positions and assists in team training as we
ll as support during high volume workflows.
* Responsible for monthly end close, Revenue Cycle and MEDICARE quarterly credi
t balance report.
* Consistently adheres to and provide recommendations in maintaining best pract
ice in billing procedures.
* Proficiently investigate billing errors, via contact with Medical Records, Co
ding, Registration, and other ancillary departments, making adjustments or escal
ating issues as needed.
* Evaluate and monitor physicians' professional coding of evaluation and manage
ment (E&M) and other CPT, ICD-9, and HCPCS procedural codes for accuracy prior t
o claim submission which involves the interpretation and analysis of medical rec
ord documentation and application of correct coding principles as defined by reg
ulatory agencies (such as CMS, AMA, The Coding Clinic) and standards of ethical
coding.
* Responsible for working coding related denials such as medical necessity, bun
dling, etc. and discussing these denials and or discrepancies between documentat
ion and code selection with the provider for clarification and educational purpo
ses.
* Maintain knowledge base by reviewing coding and reimbursement newsletters, at
tending in-service training sessions and participating in continuing education w
orkshop.
 * Accurately review each record and knowledgeably utilizes ICD-9 and CPT-4 and
encoder to accurately and timely code all significant diagnoses and procedures a
ccording to AHA, AHIMA, UHDDS hospital specific guidelines and rules/conventions
. Sequence principal diagnosis and principal procedures according to documentati
on found in the medical records and UHDDS definitions.
* Accurately utilize written state and federal regulations and written guidelin
es regarding definitions and prioritization of abstract data elements to assure
uniformity of database. Verify and/or abstract required data into PC according t
o procedure.
* Extensively use ongoing knowledge and reference material regarding DRGs to va
lidate DRG assigned.
* Utilize equipment and processes appropriately, to ensure efficient coding and
abstracting; use the PC stand alone when needed.
* Maintain department level competencies and participates in performance improv
ement activities as needed.
Key Accomplishments:
* Best Top 10 Employees Award 2006-2009
* Best Departmental T.E.A.M. Award 2008
* Numerous complimentary letters from satisfied patients
* Accounts receivable average of at least $800,000 per month (Consistently the
top billing collector)
Health Care Patient Access - Part Time:
Kennedy Health System Cherry Hill, NJ 2009-Present
* Review medical records and code all appropriate diagnosis and procedures for
all applicable records.
* Consistently ensure accurate coding by following established coding principle
s and guidelines.
* Assist hospital personnel with coding inquiries; abstracts data from medical
record into computer for billing, abstracting and other data collection purposes
.
* Verify data already present on abstracting screens and monitors DNFB on a wee
kly basis.
Medical Billing/Coding Specialist - Part Time:
Continuum Health Alliance Voorhees, NJ 2007-2009
* Reviewed patient medical records and audit outpatient/inpatient coding for va
rious facilities, (ENT, Primary care, Neurology, etc.).
* Handled wide variety of Medical claims for various insurance companies.
Medical Biller, Coding, AR Coordinator, and Accounts Resolution Specialist:
Children's Health Associates Voorhees, NJ 2004-2007
* Accounted for posting payment from all insurances and self-pays.
* Utilized knowledge of insurance company's contractual constraints, as well as
federal and state regulations, to positively impact accounts receivable.
* Performed data entry of billing slips from multiple medical testing sights.
* Responsible for reports of unpaid claims from insurance carriers, transmittin
g electronic claims, dealing with third party in collection, correcting and gene
rating new medical claims electronically or hard copy claims.
* Dealt with insurance carriers/patients for unpaid claims.
* Intensively used knowledge of CPT/ICD-9, medical terminology, abbreviations,
anatomy and physiology and customer service
Medical Receptionist, Accounting & Business Office Assistant Manager:
Vernon Pediatrics Vernon, NJ 2002-2004
* Responsible for the coordination of these efforts together with site personne
l to ensure the accuracy and timeliness of registration, charge capture, charge
entry, claims submission, follow-up and account adjudication.
 * Assisted in patient scheduling, referrals, outpatient admission and discharge
* Responsible for updating patient files including insurance verification and o
ther documentation
Medical Business Office Assistant Manager - Part Time:
Doctors Office Paterson, NJ 2001-2002
* Responsible for processing clinical documentation, supports physician complet
ion of records, ensures integrity of MPI as well as physical files.
* Performed clinical pertinence reviews, assists with tracking of unbilled acco
unts.
* Ensured flow of clinical documentation to appropriate areas, responsible for
accurate input of data into departmental systems, and protects patient confident
iality.
* Indexed for optical system and performs quality checks.
* In charged of account receivables and payables.
Business Office Manager:
United Travel Agency South Pacific Region 1992-2001
* Managed a top class travel agency consistent with company standards in the ar
eas of developing new business through an active new sales program, customer ser
vice agent, productivity, profitability, and operating procedures.
Key Accomplishments:
* Top Agency in Sales - Pacific Region 1996-2000
EDUCATION
Candidate for Master of Health Administration/Informatics:
UNIVERSITY OF PHOENIX Philadelphia, PA expected date of completion: 2013
Associate Degree in Medical Billing and Coding:
PENN UNIVERSITY Philadelphia, PA 2007-2009
B.S. in Banking and Finance:
UNIVERSITY OF THE PHILIPPINES Manila, Philippines 1988-1992
CERTIFICATION
Six Sigma - Green Belt 2010
E/M Clinical Documentation Certificate
AFFILIATIONS
CAP (Change Acceleration Process) Member
AAPC (American Academy of Professional Coders)