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co owner daily operations manager resume example with 18+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

Accurate Medical Biller/Coder who performs all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Brings 17 years of experience in working hand-in-hand with staff and clients to validate/bill/collect/track claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials.

Well-organized in managing over 500 insurance claims per day. Talented at analyzing and validating patient information, diagnoses and billing data. Skilled in drafting invoices and resolving billing disputes quickly. Proficient in Ethomas, Kareo, WebPT, Advanced MD and MEDEO software.

Skills
  • Workforce training
  • Policies and procedures implementation
  • Systems implementation
  • Staff training and development
  • Project management
  • Workforce Management
Experience
02/2012 to Current Co-Owner/Daily Operations Manager Billing Technology Inc. | City, STATE,

Job duties Include, but are not limited to;

  • Trained employees on additional job positions to maintain coverage of roles.
  • Filed and submitted insurance claims.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Documented and filed patient data and medical records.
  • Reviewed medical records to meet insurance company requirements.
  • Assessed medical codes on patient records for accuracy.
  • Expertly assigned charges and payments for medical procedures.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
  • Verified final claim submissions by comparing account charges with documentation.
  • Performed routine quality assurance audits to promote data integrity.
  • Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
  • Compiled and maintained logs, and statistical or research records to locate requested health data.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Assigned procedure and diagnosis codes for insurance billing using Ethomas/Genius Solutions.
  • Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Interpreted medical reports to apply appropriate ICD-10,CPT and HCPCS codes.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Verified proper coding, sequencing of diagnoses and accuracy of medical procedures.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
  • Thoroughly reviewed remittance codes from EOBS/AR's.
  • Received, organized and maintained all coding and reimbursement periodicals and updates.
  • Assigned tasks to associates to fit skill levels and maximize team performance.
  • Recruited and hired qualified candidates to fill open positions.
01/2011 to 01/2012 Billing Manager-Auto Department Medical Practice Made Perfect | City, STATE,

As the Billing Manager of the Auto Accident Department, I was responsible for a staff of 6 who only worked on client accounts that had 30% or more auto accident/WC patient volume.

This Department was created to ensure clients specific account needs were handled by a properly trained team in liability claims.

Some daily tasks included, but were not limited to;

  • Resolved billing issues by applying knowledge and completing in-depth research.
  • Developed improved standard operating procedures to increase billing accuracy and cash flow.
  • Set up and maintained Advanced MD electronic billing system.
  • Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Posted charges, payments and adjustments.
  • Completed appeals and filed and submitted claims.
  • Posted and adjusted payments from insurance companies.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
04/2003 to 01/2011 Medical Biller and Coder Billing Technology Inc | City, STATE,
  • Filed and submitted insurance claims.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Documented and filed patient data and medical records.
  • Reviewed medical records to meet insurance company requirements.
  • Assessed medical codes on patient records for accuracy.
  • Expertly assigned charges and payments for medical procedures.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
  • Verified final claim submissions by comparing account charges with documentation.
  • Performed routine quality assurance audits to promote data integrity.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Education and Training
Expected in 05/2010 to to Associate of Science | Science Schoolcraft College, Livonia, MI GPA:
  • 4.0 GPA
  • Phi Theta Kappa Member
  • Dean's List Honoree Winter 2009, Fall 2009, Winter 2010
Expected in 12/2011 to to Bachelor of Science | Science Education Schoolcraft College, Livonia, MI GPA:

Finished half of my Bachelor of Science as a pre-requisite for the MOT (Masters Of Occupational Therapy) . You complete the other half and your Masters Degree in one.

  • 4.0 GPA
  • Phi Theta Kappa Member
  • Dean's List Honoree Fall 2010, Winter 2011
  • Volunteer work-Ronald McDonald House, Detroit MI
  • Volunteer work- Karmanos Cancer Center- Radiation Therapy Department.

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Resume Overview

School Attended

  • Schoolcraft College
  • Schoolcraft College

Job Titles Held:

  • Co-Owner/Daily Operations Manager
  • Billing Manager-Auto Department
  • Medical Biller and Coder

Degrees

  • Associate of Science
  • Bachelor of Science

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