Carol Sinfield-Pastor, MA CPC

Physician coding, billing, and follow up since 1983 with 100% resolution within 90 days. Family practice and mental health practices, both inpatient and out-patient services. Revenue cycle analyst since 2005 facility billing/coding analyst both in patient and out-patient, ACS services, mental health, correctional care forwarding information to supervisor, staff, and client for resolution. Assist onsite hospital billing office to increase A/R, coding audit, assist with billing, collections, medical records, patient financial services, admission, COB, verification, referrals/authorizations and denial resolution. Knowledge and experience with UB92, UB04 & HCFA/CMS1500; ICD-9, ICD-10, CPT, HCPCS, Rev Code, medical terminology, HIPAA compliance, and PHI protection. Familiar with EPIC, Allscripts PPM, Zirmed, Meditech, Eclypsis, STAR, ePremis, NEBO, NEHEN, SMS, Loxogon, and IBAX systems, easily adaptable to new software programs. Claims specialist, analysis of account denials, researching problems, submitting appeals. Specialties: Medicaid (multi state including Medi-Cal), Medicare HMO/MCO's, commercial payers, VA, Tricare, auto/workers comp. Also specialty billing with Magellan and Value Options. Experienced with Excel, Word, Outlook, Access, PowerPoint, Publisher and adaptable to software. .