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Hospital & Physician Billing Specialist Resume Example

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HOSPITAL & PHYSICIAN BILLING SPECIALIST
Professional Summary

HIGHLY-ORGANIZED PROFESSIONAL WHO EXCELS AT ASSISTING HEALTHCARE PROVIDERS WITH BILLING MANAGEMENT & CODING SUPPORT. WELL-ROUNDED TEAM PLAYER WITH A STRONG TRACK RECORD OF WORKING IN COLLABORATIVE ENVIRONMENTS, AND DRIVING BOTTOM LINE GROWTH THROUGH REDUCING OUTSTANDING RECEIVABLES. EXCELLENT COMMUNICATOR AND FREELANCE HEALTHCARE MARKETING CONSULTANT WHO EXCELS AT ESTABLISHING A RAPPORT WITH CLIENTS FROM DIVERSE BACKGROUNDS. PROBLEM SOLVER WHO EXERCISES CRITICAL THINKING, AND PERFORMS WORK AHEAD OF SCHEDULE. SEEKS TO TRANSITION INTO A MANAGEMENT ROLE WITH A PHYSICIAN'S OFFICE THAT WILL UTILIZE THE TALENTS/SKILLS OF AN EXPERIENCED MEDICAL BILLING SPECIALIST, AND ASPIRING OFFICE MANAGER.

Licenses
Skill Highlights
  • Collections & Receivables
  • Patient Advocacy
  • ICD-9 & ICD-10 Standards
  • Medical Billing & Coding
  • Administrative Support
  • Electronic Medical Records
  • Insurance Verification
  • Marketing & Design
  • HIPPA Compliance
  • FACS
  • Athena
  • Centricity
  • Medical Manager
  • MediTech
  • MediSoft
  • TruCode
  • NueMD
  • Microsoft Office Suite (Word, Excel, Access, Outlook, PowerPoint) ● QuickBooks

Knowledge of HMOs, Medicare and Medi-Cal

Medical Manager Software

Managed care contract knowledge

Electronic Medical Record (EMR) software

ICD-9 coding

Trained in ASC Coding

CPT and HCPCS coding

Internal medicine billing

HHM and Medisoft billing systems

HIPAA compliance

Medical billing software

Strong planning skills

Technical expertise

Patient-focused care

Strong work ethic

Team player with positive attitude

Deadline-driven

Good written communication

Exercises good judgment


Professional Experience
Hospital & Physician Billing Specialist
December 2013 to Current
Children's Hospital Boston - Boston , MA
  • Responsible for managing and resolving insurance denials for medical, Workers Compensation and Personal Injury claims. Works with a team of Billing Specialists to interact with major insurance carriers, as well as government payers, including Medicare. Accountable for ensuring all new insurance claims are filed in a timely manner to prevent future reimbursement issues.
  • Key Achievements & Bottom Line Growth
  • Reduced receivables for a major North Carolina medical center from $4M to $520K in an 8-month period by reversing denials for patients via the insurance firms' appeal process, and by providing documentation confirming procedures were necessary
  • Created and implemented new processes to facilitate the timely filing of new insurance claims
Healthcare Marketing Consultant / Freelancer
January 2009 to Current
Self Employed - City , STATE

Provides ongoing marketing support to Scripps Memorial Hospital and Scripps Mercy Hospital in San Diego. Assists with projects including graphic design, marketing materials, industry trade shows, and implementing marketing to promote fundraising events.

Physician Billing Specialist
March 2012 to January 2013
Unified Physicians Management - City , STATE
  • Served in a frontline role, and was tasked with managing 40 accounts on a daily basis as well as assisting with medical billing and collections software. Provided daily updates to physicians' office managers on the Athena billing software packages via teleconference.
  • Key Achievements & Bottom Line Growth
  • Slashed accounts receivables for 40 Florida-based member physician offices from $6M to $2M in a 10-month period
  • Consulted with senior management to expand Unified Physician Management's membership operations into the Northeast region, adding 52 new practices in a 7 month period, and increasing reimbursement rates via group membership
Hospital and Physician Billing Specialist
June 2009 to May 2010
Scripps Memorial Hospital - City , STATE

Joined as an Insurance Verifier and was quickly promoted to a Billing Specialist. Responsible for auditing patient accounts for production of clean claims, which resulted in 15% fewer rejected claims, and reimbursement received from the carriers within an average of 45 days or less.

Education and Training
Bachelor of Science : Business ManagementCanisius College - City, State, USBachelor of Science in Business Management with a Marketing Minor, Canisius College | Buffalo, NY
Associate of Science : Medical Billing and CodingSan Diego City College - City, State, USAssociate of Science in Medical Billing and Coding, San Diego City College | San Diego, CA
Accomplishments

Skills

Marketing, Fundraising, Graphic Design, Healthcare, Billing, Claims, Receivables, Accountable For, Auto Insurance, Compensation, Documentation, Filing, Insurance Claims, Medicare, Workers Compensation, Medical Billing, Medical Invoicing, Accounts For, Auditing, Accounts Receivables, Basis, Collections, Credit, Operations, Access, Administrative Support, Excel, Hippa, Icd, Icd-9, Medical Billing & Coding, Medical Records, Medisoft, Meditech, Microsoft Office, Ms Office, Outlook, Powerpoint, Quickbooks, Word, Associate, Business Management, Coding

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Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

70Average
Resume Strength
  • Completeness
  • Formatting
  • Word choice
  • Length
  • Measurable results
  • Strong summary
  • Typos

Resume Overview

School Attended

  • Canisius College
  • San Diego City College

Job Titles Held:

  • Hospital & Physician Billing Specialist
  • Healthcare Marketing Consultant / Freelancer
  • Physician Billing Specialist
  • Hospital and Physician Billing Specialist

Degrees

  • Bachelor of Science : Business Management
    Associate of Science : Medical Billing and Coding

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