hospital physician billing specialist resume example with 12+ years of experience
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.
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 |
- 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
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.
- 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
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.
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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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
- Associate of Science
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