Rachel Garner Email and Phone Number

• Educate and provide guidance to Medicare beneficiaries on the Medicare program, health plan options and benefits so they can choose the best coverage for their specific healthcare and financial needs.• Service clients on policy questions, network and claim issues.

Lead Medical Coder *• Responsible for coding to the highest level of specificity and in accordance with AMA and CMS coverage guidelines and compliance.• Provided guidance to providers and clinical staff on coding, documentation guidelines and CMS compliance. • Audited claims for correct coding. • Prepared high-level claim appeals. Credentialing Coordinator * • Maintained provider databases, licensing and insurance plan participation. • Performed Medicare, Medicaid, Tricare Military and contracted commercial health plan credentialing for all incoming providers, and re-credentialing as required. • Performed initial hospital appointment requests and re-appointments. • Practice contact for insurance provider representatives for claims, credentialing and communications.

• Verified receipt of proper reimbursement on submitted insurance claims in accordance with contractual agreements. • Communicated to medical practices current CMS policies and updates to coding and billing guidelines. • Provided administrative reports as requested by the physicians.

Employee Benefits Manager *• Conducted interviews with health insurance carriers for annual open-enrollment employee benefit selections. • Administered employee benefit plans for group health, life, and dental insurance.Patient Accounts Manager *• Prepared monthly patient billing for residential rehabilitation facility. • Processed all accounts receivables.• Produced weekly cash-flow report and compiled information for revenue reports for CEO review.

• Processed physician and hospital claims for group health plans. • Researched plan coverage and exclusions, member eligibility, protocols and provider contracts for benefit determination.• Performed pre-existing condition investigations in accordance with plan guidelines.• Investigated for coordination of benefits, third-party liability and subrogation.