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Billing Associate Resume Example

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BILLING ASSOCIATE
Professional Summary

A very highly organized Medical Biller with 10+ years experience who has an extraordinary eye for detail and strong customer service ethic. Manages a high-volume workload within a deadline driven environment. Passionate and motivated with drive and determination to reach company goals. Works very well under pressure and has been consistently praised by management for performance excellence.

Skills
  • Laboratory, DME, Respiratory, Home Infusion Billing knowledge
  • Proficient in Microsoft Office
  • ICD9, ICD10, HCPC Codes, CPT, Modifiers
  • Knowledge of HIPPA and patient privacy
  • Able to learn and master new skills quickly
  • Expert with common Insurance payer portals
  • Strong listening, communication and interpersonal skills
  • Great attention to detail and follow through
  • Excellent problem solving and critical thinking
  • Proficient in Xifin, Copia, Mesta Med, Zirmed, Meditech
  • Advanced organizational, time management and multitasking skills
  • Exceptional team lead and motivator
  • Medical Terminology knowledge
  • National Drug Codes knowledge
  • Staff Trainer
  • Strong data entry skills
  • Strong 10 key by touch and sight
  • Types 40+ WPM
Work History
A/R Billing Associate, 09/2015 to 05/2019
Sequenom Center for Molecular Medicine/Lab Corp – San Diego, Ca
  • Worked Primary, Secondary, Tertiary Lab claims via Xifin
  • Responsible for all f/up on insurance claims for HMOs, PPOs, EPOs, Managed Medicaid, TPAs, and LOAs for all states
  • Worked both in and out of network payers
  • Reviewed, worked and resolved denials with payment resolution
  • Worked independently with minimal supervision
  • Consistently met A/R monthly collections goals
  • Quickly identified and resolved medical billing, coding and insurance discrepancies
  • Thoroughly reviewed error processing summary, EOBs
  • Efficiently performed insurance verification via web portals and telephone
  • Reviewed, worked and monitored assigned accounts in a timely manner
  • Communicated and problem solved with insurance companies regarding denial trends for corrective action and prevention in the future
  • Communicated with Dr offices regarding missing Dx, documentation, patient insurance
  • Appealed denied claims and attached all required claims documentation including referrals treatment plans or other required correspondence
  • Obtained medical records via Copia
  • Submitted Authorization requests for genetic testing
  • Experimented different options with Payers when appealing via fax, online, e-mail, mail, spreadsheet, to determine which method will pay in a prompt manner
  • Worked high-volume claims daily, exceeded expectations
  • Maintained low percentage for aged A/R accounts
  • Referred to Provider Contracts regarding denied claims and underpayments
  • Provided Management with emails, spreadsheets regarding denial trends
  • Updated AR spreadsheet with all pertinent information for Management to view
  • Made necessary adjustments on accounts
  • Maintained confidentiality of all patient and business work information
Reimbursement Lead, 07/2011 to 09/2015
LifeCare Solutions/Preferred Homecare – San Diego, Ca
  • Managed the daily workflow for five team members
  • Trained and assisted staff
  • Motivated, educated and guided team on a daily basis
  • Created pivot tables in Excel, reports detailing balances and aging
  • Researched, corrected and resubmitted rejected and denied claims via Zirmed, online and paper
  • Worked with Manager to obtain credits to offset adjustments via Mestamed
  • Billed DME, Respiratory and Home Infusion
  • Ran credit card transactions for patient payments
  • Consistently met performance benchmarks in all areas on a monthly basis for assigned payers
  • Exceeded cash collections and reached monthly and quarterly goals
  • Collected all necessary information to prepare accurate insurance claims and reviewed Provider Contracts
  • Interpreted Explanation of Benefits, understands co pays, coinsurance and deductibles
  • Researched billing problems and proactively resolved them
  • Worked daily edits to correct any errors upfront before billing claim
  • Appealed denied claims with necessary documentation and f/up as well
  • Requested and logged approved authorizations
  • Billed patients for their responsible portions and answered patients questions regarding charges billed
  • Knowledgeable in timely filing and timely appeal restrictions
  • Knowledgeable of various insurances: HMO, PPO, Medi-Cal, Medicare, Workman Comp
  • Exceptional knowledge of HIPPA Privacy and Security Policies
  • Submitted refund requests for claims paid in error
Customer Service Representative, 03/2003 to 07/2011
LifeCare Solutions/Preferred Homecare/Coram Healthcare – San Diego, Ca
  • Responded to high volume telephone inquiries and orders from referral sources
  • Accurately entered patients demographics into MestaMed including choosing correct ICD9 Codes and insurance payers
  • Processed orders by preparing all appropriate paperwork for DME/Respiratory
  • Completed all necessary paperwork in an accurate and efficient manner
  • Coordinated the delivery, set up and pick up of equipment, supplies and services with appropriate personnel
  • Contacted patients to inform them of any patient payment requirements, determination of best delivery method and instructions for receiving delivery
  • Generated refill orders for Cpap/Bipap/Trach supplies and O2 delivery for Dispatch and Respiratory Therapy Department
  • Assisted with walk-in patients with the selection of equipment, supplies, and services
  • Collected co pays and ran credit card transactions
  • Reviewed orders and medical documentation in order to qualify patients for services for various insurances for different types of equipment
  • Submitted and obtained approved authorizations for services
  • Constantly recognized for generating most orders, answering most phone calls, collecting most co pays, etc in the CSR Department
Patient Access Representative II, 08/2002 to 03/2003
Rady Childrens Hospital – San Diego, Ca
  • Greeted patients and visitors
  • Registered both new and existing patients for Emergency Room Department
  • Assisted with registering patients for Urgent Care Department
  • Obtained and entered demographic, clinical and financial information into MediTech System
  • Verified insurance eligibility
  • Selected correct insurance Mnemonics for billing purposes
  • Answered multi-line phones
  • Explained a variety of admission, HIPPA, consent forms and policies
  • Obtained signatures and held discussions on financial responsibility
  • Collected co pays
  • Ran credit card transactions
  • Created trauma packets
Education
Certificate of Completion: CPC Certified Billing And Coding, 05/2020
National University - San Diego, CA
High School Diploma: 1997
Sweetwater High School - National City, CA
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Resume Overview

Companies Worked For:

  • Sequenom Center for Molecular Medicine/Lab Corp
  • LifeCare Solutions/Preferred Homecare
  • LifeCare Solutions/Preferred Homecare/Coram Healthcare
  • Rady Childrens Hospital

School Attended

  • National University
  • Sweetwater High School

Job Titles Held:

  • A/R Billing Associate
  • Reimbursement Lead
  • Customer Service Representative
  • Patient Access Representative II

Degrees

  • Certificate of Completion : CPC Certified Billing And Coding , 05/2020
    High School Diploma : 1997

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