Billing Specialist Resume Example

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(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
Professional Summary

Experienced Medical Biller with over seven years of experience in Medical Billing. Excellent reputation for resolving problems, improving patient satisfaction, customer service, medical billing, medical billing collection, resolving patients claims,and driving overall operational improvements consistently saved costs while increasing profits.

  • Insurance Knowledge
  • Billing
  • Billing Systems and Software
  • Collection Practices
Columbia Southern University Orange Beach, AL Expected in 05/2022 Associate of Science : Health Science With Billing And Coding - GPA :
Bishop State Community College Mobile, AL Expected in 05/2005 GED : - GPA :
Work History
Allied Universal Security - Billing Specialist
Goodyear, AZ, 01/2013 - 04/2020
  • Private Pay Collection Specialist -Handled high volume of in-bound and out-bound calls pertaining to reconciliation of delinquent accounts.
  • Performed targeted collections on past due accounts aged over 30 days.
  • Developed team communications and information for all team meetings.
  • Resolved conflicts and negotiated mutually beneficial agreements between parties.
  • Increased customer satisfaction by resolving patient account issues.
  • Counseled patients on payment options and arranged installment agreements.
  • Processed payments on patients accounts.
  • Claims Resolution Specialist -Resolved claim problems: such as denials, overpayment, incorrect payer information, posted zero pays on patients accounts, over 10K reports, and filed appeals to improved operations of claims and provided exceptional patient support to help resolve claims.
  • Monitored claim trends and implemented edits to resolve future claim denials.
  • Contacted patients to updated correct insurance information and correct coordination of benefits.
  • Used scripted conversation prompts to convey current account information and obtain payments.
  • Medical Billing Specialist -Worked effectively with medical payers such as Medicare Medicaid, commercial insurances to obtain timely and accurate payments.
  • Identified, researched and resolved billing variances to maintain system accuracy and currency.
  • Trained and mentored new team members on accounts payable systems and policies to build cohesive groups and promote operational performance.
  • Effectively worked financial statements and reports detailing accounts receivable status.
  • Corrected billing errors on UB04 and 1500 claim before submitting to electronic files.
  • Worked Denial Management claims by correcting with claims errors and resubmitting documents or filing Appeals.
  • Reviewed authorization denials on web portals by located issues and corrected issues and resubmitting.
  • Implemented denial errors and setting up edits to review and correct to prevent future denials.
  • Corrected modifier codes by using CCI edits and fee schedule to prevent future denials.
  • Communicated effectively with staff, patients and insurance companies by email and telephone.
  • Kept accurate log of all requests for medical information and records.
  • Oversaw several month project to revamp filing system, improving department productivity.
  • Maintained accuracy, completeness and security for medical records and health information.
  • Worked strongly with various insurance companies to correct errors that were issued due to system errors created by insurance companies to correct and resolve issues that resulted in claims denials.
  • Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
Brightspring Health Services - Follow-up Specialist
Keyser, WV, 07/2012 - 01/2013
  • Insurance Follow-up Specialist -Communicated effectively with staff and insurance companies by email and telephone.
  • Contacted various insurance companies to check the status of claims.
  • Detailed effective information on patients account concerning the status of patients claims if the claims was paid, pending, denied, or no record of the claim.
  • Submitted status of the claim to the Claims Resolutions Specialist to resolve the claim.
Sears Parts Direct - Parts Specialist/Customer Care Specialist
City, STATE, 03/2006 - 07/2012
  • Parts Specialist -Met customer needs by looking up part numbers and prices for various parts, identifying correct items and placing timely orders.
  • Handled all customer service issues quickly to maintain high satisfaction levels.
  • Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
  • Worked with various customers to understand needs and provide outstanding service.
  • Developed team communications and information for all team meetings.
  • Reviewed schematics and offered related parts to help customer needs the first time.
  • Customer Care Specialist- Coordinated timely responses to online customer communication and researched complex issues.
  • Conferred with customers about concerns with products or services to resolve problems and drive sales.
  • Maintained accurate and current customer account data with manual forms processing and digital information updates.
  • Evaluated customer information to explore issues, develop potential solutions and maintain high-quality service.
  • Defused customer concerns with exceptional conflict and problem resolution skills.
  • Updated customer accounts and system database with latest details to support accuracy and efficiency in future interactions.
  • Achieved long-term business objectives by analyzing customer feedback for process improvements.
  • Eliminated inefficiencies by educating and training new employees on best practices and customer care procedures.
  • Delivered superior client services, fostering strong rapport, retention and satisfaction.
  • Logged call information and solutions provided into Pega and Coboodle database.
  • Educated customers on promotions to enhance sales.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and effective solutions.
  • Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.

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Resume Strength

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  • Strong Summary
  • Target Job

Resume Overview

School Attended
  • Columbia Southern University
  • Bishop State Community College
Job Titles Held:
  • Billing Specialist
  • Follow-up Specialist
  • Parts Specialist/Customer Care Specialist
  • Associate of Science
  • GED

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