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Billing Specialist II/Commercial Follow-up Analyst Resume Example

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BILLING SPECIALIST II/COMMERCIAL FOLLOW-UP ANALYST
Summary

Detail-oriented Healthcare Administration major currently attending Southern New Hampshire University, with 10+ years of work experience. Aiming to leverage a proven knowledge of customer communications, procedure standardization, and provider relations skills to successfully fill the Provider Customer Service role at your company. Frequently praised as hard-working by my peers, I can be relied upon to help your company achieve its goals.

Skills
  • Strong understanding of HIPAA and privacy laws
  • Experience in Microsoft Office and Microsoft Excel - create / save documents and spreadsheets, formulas, Excel VLOOKUP & pivot tables
  • Experience in working with medical claims platforms
  • 9+ years of experience working in a production environment with metrics and QA standards
  • Demonstrated ability to listen skillfully
  • Customer Service Skills/Multi-line telephone skills
Experience
Billing Specialist II/Commercial Follow-up Analyst
November 2015 to May 2020
Good Shepherd Hospice - Saint James , NY
  • Solve complex problems and / or conduct moderately complex analyses
  • Provide explanations and information to others on difficult issues
  • Research, correct, and re-submit rejected and denied claims
  • Takes ownership of the total work process and provides constructive information to minimize problems and increase customer satisfaction
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes
  • Identify solutions to non-standard requests and problems
  • Liaised with patients, insurance companies and billing office personnel to effectively create and post bills, obtain payments and update system information
  • Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies
  • Assisted and provided information to patients, clerical staff and insurance companies, as well as identifed and resolved patient/physician billing complaints
  • Responsible for the collection, posting, and management of accountpayments
  • Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations
Registration Representative/Medical Billing Clerk
February 2014 to March 2015
Madison Parish Hospital - City , STATE
  • Answered questions about admissions, financial and hospital policies
  • Checked insurance benefits, received payments and provided receipts
  • Gathered, verified and processed patient paperwork
  • Gathered personal and insurance information from each patient
  • Boosted productivity by maintaining strong call control and quickly working through scripts to address diverse problems
  • Delivered fast, friendly and knowledgeable service for routine questions and service complaints
  • Documented conversations with customers to track requests, problems and solutions
  • Applied payments from customers to proper accounts, checking over all information to verify accuracy
  • Facilitated payment of invoices due by sending bill reminders and contacting clients
Medical Scheduler
December 2012 to November 2014
River Region Health System - City , STATE
  • Managed physician calendar, including scheduling patient appointments and procedures
  • Created and maintained accurate and confidential patient files
  • Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services for multiple providers
  • Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses
  • Maximized office efficiency by answering more than 100+ incoming calls per day to provide office information and transfer calls to desired personal
  • Managed medical supply inventory, insurance records, patient charts and company files using online tracking system
  • Supported administrative and healthcare staff with skilled clerical assistance such as ordering supplies and organizing office inventories
  • Updated patient financial information to ensure accuracy
Emergency Room Clerk
April 2011 to December 2012
River Region Health System - City , STATE
  • Compiled physical and digital paperwork to meet business and patient needs, including charts, reports and correspondence
  • Informed patients of financial responsibilities prior to rendering services
  • Communicated with all partners throughout the practice including physicians, nursing staff, technicians and medical assistants
  • Ensured that the phone was answered by the second ring and enthusiastically greeted all callers
  • Managed a multi-line phone system and greeted all patients
  • Observed strict HIPAA guidelines at all times according to company policy
  • Processed patient payments and scanned identification and insurance cards
  • Delivered high-quality administrative and customer service to sustain patient and work flows
  • Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to-date
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files
  • Set up appointments for physician visits and procedures using calendar software
Education and Training
Present : Health AdministrationSouthern New Hampshire University - City
High School Diploma : 2007Warren Central High School - City, State
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Resume Overview

School Attended

  • Southern New Hampshire University
  • Warren Central High School

Job Titles Held:

  • Billing Specialist II/Commercial Follow-up Analyst
  • Registration Representative/Medical Billing Clerk
  • Medical Scheduler
  • Emergency Room Clerk

Degrees

  • Present : Health Administration
    High School Diploma : 2007

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