Billing Manager resume example with 11+ years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000
Cell:
resumesample@example.com
Professional Summary
To effectively use my knowledge and experience within an established organization with potential for growth and self
advancement. To successfully make a difference in the workplace with my skill and dedication.
Skill Highlights
Maintains strict confidentiality attention to detail Knowledge of HMOs, Medicare and Medi-Cal Ability to work multi-tasks with time constraints HIPAA compliance Investigative skills Medical billing software payment posting Excellent written communication great understanding of insurance denials & OR Exercises good judgment explanation of benefits Deadline-driven charge entry/demographics Team player with positive attitude excellent customer service Strong work ethic work effectively Patient-focused care Microsoft applications (Outlook, Excel,Power Point) ICD-9/ICD-10 coding Typing 50wpm
Professional Experience
Billing Manager , 2016 to 05/2016 Dayton Freight – Kent, OH,
I
oversee and managed the billing for four orthopaedic surgeons at St. Marks
hospital. My responsibilities included but not limited to coding surgery
charges/ clinic charges; enter charges
into Red Planet. Correct any EDI edits. Claim submissions, working AR. Payment
posting, EFT deposits, collections,
weekly deposits, appeals. Processing credit card payments; set up payment
plans. I also answered patient/insurance phone calls. . Carefully prepared, reviewed and submitted
patient statements. My daily responsibilties involved working an account front beginning to end.
Billing Manager, 04/2013 to 07/2013 Dayton Freight – Lowell, IN,
By far
this job was the best opportunity that has ever crossed my path. I loved every
minute of it. I had the great opportunity to step into a new role at the
Presidio Sports Medicine Clinic as the billing manager. I over saw the daily
A/R and A/P and worked closely with the business director and our billing team
located out of state. It was such a great learning experience stepping into a
new role. It was short lived as I learned very early on that the cost of living
was not substainable so I had to move back to Utah in late August 2013 and have
been working temporary jobs
Billing Specialist, 10/2010 to 04/2013 21St Century Oncology – Lake Worth, FL,
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Monitored shared email in-boxes and ensured inquiries were addressed.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Thoroughly reviewed remittance codes from EOBS/AR's.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.Submitted refund requests for claims paid in error.Carefully prepared, reviewed and submitted patient statements.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Billing & Pre-Authorization Manager, 04/2009 to 12/2010 21St Century Oncology – Lauderdale Lakes, FL,
Preauthorize surgeries for cranial-facial and cosmetic surgeries Verify benefits and eligibility Collect on cosmetic surgeries and deductibles for upcoming surgeries A/R follow up (contact insurances on outstanding balances and or appeals) Scheduled surgeries and procedures in conjunction with Surgical Coordinator.Prepared prescription refill requests on behalf of the physician.Scheduled patient appointments.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Thoroughly reviewed remittance codes from EOBS/AR's.Confirmed patient information, collected copays and verified insurance.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Efficiently performed insurance verification and pre-certification and pre-authorization functions.
Cross Billing Specialist Utah Cancer Specialist, 02/2009 to 03/2010 Medicare & Blue – City, STATE,
Oversee & manage Medicare & Blue Cross oncology patients.
A/R follow up on accounts 60-150 days aging.
Consistently ensured proper coding, sequencing of diagnoses and procedures.Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Thoroughly reviewed remittance codes from EOBS/AR's.Completed appeals and filed and submitted claims.Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
Hospice & SNF billing.
Billing Specialist, 11/2006 to 11/2008 Comprehensive Orthopaedics – City, STATE,
Oversee & managed three orthopaedic surgeons.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.Submitted refund requests for claims paid in error.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Process 835's & work 864 reports.Reviewed accounts for collections.Process weekly Dashboard Reports.Performed full-cycle medical billing in a fast-paced medical billing company.
Anesthesia Billing & Account Manager, 05/2002 to 11/2006 Professional Management Group – City, STATE,
Managed eight anesthesia's doctors accounts.Thoroughly investigated past due invoices and minimized number of unpaid accounts.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.Submitted refund requests for claims paid in error.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Meticulously tracked and resolved underpayments.Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.Performed full-cycle medical billing in a fast-paced medical billing company.Reviewed accounts for collections.
Education and Training
Ca: General Studies, Expected in Dublin High School - , GPA: General Studies
Associate of Arts: , Expected in Entrada High School - Sandy, UT GPA:
: , Expected in Salt Lake Community College - Salt Lake City, UT GPA:
Skills
anesthesia, Microsoft applications, AR, attention to detail, benefits, billing, excellent customer service, diagnosis, documentation, email, fast, financial, Hospice, ICD-9, Infectious Disease, insurance, medical billing, Medical billing, medical manager, Excel, Outlook, Power Point, oncology, pathology, prescription refill, problem-solving, coding, radiology, receiving, Team player, treatment plans, Typing 50wpm, Excellent written
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