- , , 100 Montgomery St. 10th Floor
- (555) 432-1000
- resumesample@example.com
Certified Medical Billing and Coding Specialist with experience in fast- paced, multi-client outpatient facility. Accurate Medial Biller performs all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Brings experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials. Focus on deadlines and the assurance that all medical billing is handled efficiently and without errors. Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Trained Medical Coder knowledgeable in AMA and the CMS coding rules. Organizational and Prioritization abilities for achieving financial performance goals. Interpersonal and communicational skills. A fully engaged parent, eager to return to pursuing a full time career. Gained internet and computer skills, written and verbal communication, multi-tasking, time management, ability to work under pressure, decision making, self-motivation, conflict resolution, leadership, adaptability, team work all while being a fully engaged parent and prior educations and employments.
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Amn Healthcare – Sunset Hills, MO,
Supervisor : Paul
- Contacted Patients with past due accounts to formulate payment plans and discuss options.
- Prepared and mailed invoices to patients, processed payments and documented account updates.
- Reviewed accounts on a monthly basis to assess aging and pursue collection of funds.
- Responded to inbound inquires regarding accounts and payments.
- Handled financial postings for patients and insurance companies such as Federal, Medicare, Medicaid , Private and Workman's Comp claims.
- Verified insurance coverage for patients, Processed denial claims in a timely manner.
- Operated office equipment.
- Adjusted $27,363 and 955 transactions in my first month.
- Adjusted $51,367 and 1,780 transactions in my second month.
'Ike Group – Honolulu, HI,
Supervisor: Wendy
- Printed and reviewed monthly patient/insurance aging reports and solicited overdue payments.
- Posted and adjusted payments from insurance Co.,/Patients.
- Located errors and promptly refiled rejected claims.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated with patients/insurances for unpaid claims for HMO, PPO and Private accounts and delivered friendly follow up calls for proper payments to contracts.
- Verified insurance benefits and eligibility for patients. including deductibles, co-insurance, co-pays, out of pocket expenses and not covered services.
- Data entry of insurance information and patient demographics.
- Accurately processed and sent out medical 1500 claim forms.
- Identified and resolved patient billing and payment issues.
- Spanish interpreter for Spanish speaking patients
- Collections - creative communicational skills to handle difficult patients, made arrangements to resolve payment issues before any further action. Kept track of monthly arranged payments. Submitted broken payment arrangements to a collection agency.
- Magistrate - Attended court proceedings against patients and/or insurance companies after careful review for accuracy and having all information to validate claims, this was last result and was very rare,
- Operated office equipment.
Aetna US Healthcare 610-336-1000 – City, STATE,
- Effectively communicated with patients about payment needs such as co-payments, co-insurances, out of pocket expenses, deductibles, and non- covered services.
- Followed federal and state requirements to minimize legal and financial risks. Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures. Applied mathematical abilities on a daily basis to calculate and check figures in all areas
- Verified accuracy of claims payable payments resulting in reduction of payment errors.
- Maintained a daily quota processing medical claims for various medical facilities
- Located and attached appropriate files to claims requiring replies such a s denial or approval of payments
- Efficiently and effectively processed a large volume of medical claims on a daily basis.
- Sent clinical request and missing information letters to obtain incomplete information.
- Based the payment or denials of medical claims upon well-established criteria for claims processing.
National Healthcare Association - ,
Successfully completed the requirements set forth by the NHA as a certified Billing and Coding Specialist .
Certification # F3N7M4G5
Type of exam: CBCS
Penn Foster Career School - Scranton, PA,
Graduated with an overall grade of 93%.
Program outline includes:
- Introduction to Allied Health
- Office Procedures
- Law, Ethics and Confidentiality in Allied Health
- Word and Excel
- Business English
- Body Systems/Terminology 1
- Body Systems/Terminology 2
- Basic Pharmacology
- Medical coding 1
- Medical coding 2
- Electronic Medical Records
Baltimore Medical Systems - Baltimore, MD,
HIPPA Privacy, Security and Transactions Standard Training
Aetna US Healthcare - Allentown, PA,
Medical Billing and Coding training program through Aetna US Healthcare.
Offered position after completion of training as Medical Accounts Payable Specialist .
Lehigh Carbon Community College - Allentown, PA,
Program for Office Technology
- Phone Etiquette
- Respond to inquires
- Data Entry
- Prepared reports
- Office equipments
- General Office Procedures
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School Attended
- National Healthcare Association
- Penn Foster Career School
- Baltimore Medical Systems
- Aetna US Healthcare
- Lehigh Carbon Community College
Job Titles Held:
- Accounts Receivable Specialist
- Medical Billing Specialist
- Medical Accounts Payable
Degrees
- CBCS
- Diploma
- Certificate of Completion
- Certification
- Certificate
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