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Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

Professional Secretary with over 10+ years of experience managing daily administrative support tasks and operations in Healthcare industry. Well-organized, quick learner committed to delivering high-quality results. Adaptable and versatile worker providing excellent customer service within dynamic environments.

Skills
  • Patient-focused quality service
  • Accounting principles knowledge
  • Hospital inpatient and outpatient records
  • Medicare and Medicaid process
  • Medical claims submission
  • Payment posting
  • Collections duties
  • A/P and A/R expertise
  • Keyboarding skills
  • Microsoft Office
  • Multi-line phone systems
  • Verbal and written communication
  • HIPAA guideline compliance
  • Organization
  • Inter-office communications
  • Cross-functional communication
Work History
06/2018 to Current
Collections Clerk Patient Accounting University Of Pennsylvania Health System Mercerville, NJ,
  • Performed targeted collections on past due accounts aged over [120] days.
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
  • Performed billing and coding procedures for inpatient and outpatient services.
  • Located errors and promptly refiled rejected claims.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Posted and adjusted payments from insurance companies.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Precisely evaluated and verified benefits and eligibility.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Accurately posted and sent out all medical claims.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Reviewed outgoing bills for eligibility and accurateness.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Transferred balances to correct payers.
  • Posted payments and collections on regular basis.
  • Reviewed patient records, identified medical codes and created invoices for billing purposes.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
  • Maintained current accounts through aged revenue reporting.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Efficiently collected payments and communicated with clients.
  • Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
  • Assisted patients by determining financial assistance available and setting up payment plans.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Verified proper ICD-10 coding on claims.
  • Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
  • Analyzed medical records to satisfy insurance company mandates.
  • Communicated with insurance providers to resolve any denied claims and resubmit.
  • Collected payments and applied to patient accounts.
  • Researched and followed up on denied insurance claims.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Set up and maintained new electronic billing system.
  • Filed and updated patient information and medical records.
  • Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Completed client requests and advised supervisors of special needs.
01/2016 to 06/2018
Medical Biller Specialist and Coding AFT MEDICAL SERVICES City, STATE,
  • Managed Health Records
  • Applied ICD-10 coding under supervision
  • Submitted Claims to Medicare, Medicaid, HMO's, and private health insurance providers
  • Experienced billing for Family Medicine, OBGYN, Dermatology, and general surgeons specialties Ensure claims are entered and submitted with 48 hours of receipt Accurately apply payments to patient accounts Post and reconcile insurance and patient payments
  • Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts Insure accuracy of insurance claims
  • Verify correct ICD-10, and CPT codes for a variety of specialties Set up new patient accounts Assign ICD-10 to physicians diagnosis and insure correct level of service and various other CPT codes
  • Set-up practice management software for submission of electronic claims to clearinghouse
  • Work with clearinghouse to resolve file compatibility issues Retrieve Electronic Remittance Advice (ERA's) Send secondary claims upon processing of primary insurance Monthly processing of Patient statements
  • Answer and resolve patient billing inquires Follow up on Insurance and patient aging
  • Re-submit insurance claims as necessary Knowledgeable in timely filing restrictions for insurance payers Insure office practices are in compliance with HIPAA regulations
12/2008 to 12/2015
Medical Biller Specialist MED-AMERICA BILLING SERVICES INC City, STATE,
  • Identify and resolve patients' billing problems and discrepancies
  • Review accounts for possible assignment and made correlating recommendations to the billing supervisor
  • Efficiently receive and sort incoming medical bills and invoices by paying particular attention to the credibility of information
  • Examine medical debts and delinquent accounts status
  • Ensure that appropriate follow up duties are efficiently carried out
  • Oversee the billing procedure to ensure timely preparing of bills and invoices
  • Create and main an efficient reporting system to provide the management with information on billing procedures and outcomes
  • Effectively managed the status of outstanding payments
  • Ensured that any discrepancies were sorted immediately
  • Processed payments from insurance companies and preparing daily deposits
  • Verified completeness and accuracy of all billing records and claims before submission
  • Periodically updated accounts receivable databases with any missed payments or new account information
  • Created and maintain effective liaison with clients to provide them with information on their debts and deadlines
  • Oversaw the issuance and posting of bills and receipts by medical billing clerks
Education
Expected in
: HEALTH INFORMATION TECHNOLOGY PROGRAM
Santa Barbara City College - Santa Barbara,
GPA:
Expected in 2004
ASSOCIATE:
Maric College - Salida, CA
GPA:
Expected in 1999
HIGH SCHOOL DIPLOMA:
Ceres High School - Ceres, CA
GPA:

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Resume Overview

School Attended

  • Santa Barbara City College
  • Maric College
  • Ceres High School

Job Titles Held:

  • Collections Clerk Patient Accounting
  • Medical Biller Specialist and Coding
  • Medical Biller Specialist

Degrees

  • Some College (No Degree)
  • ASSOCIATE
  • HIGH SCHOOL DIPLOMA

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