certified medical biller resume example with 1 years of experience
JessicaClaire
, , 100 Montgomery St. 10th Floor(555) 432-1000, resumesample@example.com
Professional Summary
I am a detail-oriented professional with over 3 years expertise in accurately and efficiently processing medical claims and billing statements for healthcare services. I have a deep understanding of medical coding systems, insurance policies, and billing regulations. I am proficient in various billing software and electronic health record systems, enabling me to quickly and accurately process claims. Additionally, I have strong communication and negotiation skills, allowing me to effectively communicate with healthcare providers, patients, and insurance companies to resolve payment disputes and ensure timely payment. I am committed to continuous learning and staying up-to-date with the latest industry developments to provide the best possible service to my clients.
Skills
ICD-10 coding
A/R Follow-up
Pre-Authorization
Medical terminology
EHR/EMR knowledge
Microsoft Office
BLS/CPR
Billing dispute resolution
Account reconciliation
Filling Appeals and Corrected claims
AdvancedMD
Worker compensation
Insurance Verification
Payment posting
Work History
08/2022 to CurrentCertified Medical Biller Icon Identity Solutions | Rolling Meadows, IL,
Facilitates the timely and accurate electronic transmission of over 1000 claims to third party payers. In cases where electronic transmission is not available, assures that the paper claim is properly completed and submitted in a timely manner.
Answer billing inquiries from patients and staff via phone and email.
Collected payments, processed receipts and informed policyholders of outstanding balances.
Processed and accurately posted over $80k in payment from various insurance companies to practice management system. Payments included but not limited live checks / credit cards, EFT deposits.
Reviews the unapplied funds report to identify cash transactions that were not able to post
Posts approved guarantor write-off batches and balances utilizing the write-off report
Facilitating Pre-authorization for Workers Compensation patients.
Coordinated with adjustor's and nurse case managers to insure Workers Compensation claims are billed accurately and in timely fashion. Insured to follow-up with adjustor's to insure reimbursement.
Coordinate with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation.
Verified proper coding, sequencing of diagnoses and procedures.
Completed and submitted appeals for denied claims.
Organized information by using spreadsheets, databases or word processing applications.
Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
Maintain strict confidentiality with regard to protected health information and understands and adheres to Sound's HIPAA Privacy & Security policies and procedures
05/2022 to 08/2022A/R Specialist Advanced Spine And Pain Centers | City, STATE,
Reading and interpreting EOB
Denials and appeals management
Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.
Identify trends, and carrier issues relating to billing and reimbursements and report findings.
Worked closely with insurance carriers for reimbursement requirements to ensure payment
Initiated reconsiderations and appeals with over 30 commercial and Federal insurances, for denied or rejected claims.
Follow-up with payers to ensure timely resolution of all outstanding claims
Ability to use various workflow systems and client host systems.
Corrected Over 2000 claims with 95% rate of reimbursement.
Document follow-up appropriately in the practice management system
01/2022 to 03/2022Medical Coding Intern Khalid Wasimmuddin MD MRCP | City, STATE,
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
Verified final claim submissions by comparing account charges with documentation.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Quickly responded to staff and client inquiries regarding CPT codes.
Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
Submitted and accurately processed insurance claims with related medical code verifications and assessments.
Assigned procedure and diagnosis codes for insurance billing using EPIC and eClinicWorks.
Education
Expected in 10/2021 to to Medical Billing And Coding Certificate | Medical Billing And Coding Specialist Institute of Health And Technology , Lorton, VA, GPA:
Completed professional and hands-on training in medical billing and coding. Acquired a variety of skills including; a vast knowledge of CPT, ICD-10, and HCPCS level 2.
using different modifiers when applicable
Receiving and reviewing patients’ charts and documents for verification and accuracy.
Complying with medical coding guidelines and policies.
Received training in Accounts receivable management including charge entry, payment posting, customer service and follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability.
Expected in 05/2015 to to High School Diploma | American Online School , Lansing, IL, GPA:
Certifications
Certified Billing and Coding Specialist (CBCS) through NHA
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