Billing Specialist with over 10 years of experience, committed to assisting others and able to work well in a high pressure environment. Skilled to work well in teams or independently. Skilled to direct and lead others to produce desired results. Knowledge of accounts receivable. Knowledge of office administrators and procedures. Proficient in relevant computer applications. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Skilled to efficiently handle high case volumes with accuracy and care.
Skills
Communications
Organization
Team building
Team management
Customer service
Supervision
Substance Abuse billing and coding
Provider billing and coding
Telemedicine modifiers
ICD 10 coding
CPT coding
Microsoft Office, including Word and Excel
Insurance billing, proficient with Maryland Medicaid and Multiple Commerical Insurance's.
Proficient in Incedo, Medical Mastermind, and Office Ally
Education and Training
Frederick High SchoolFrederick, MDExpected in 06/1999 – –High School Diploma: - GPA:
Experience
Goodwill Seattle - Insurance and Claims Manager Alderwood, WA, 03/2019 - Current
Submitted clean claims to reduce denial rates, following payer reimbursement policies and procedures.
Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records.
Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Determined prior authorizations for outpatient procedures.
Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
Reviewed and verified benefits and eligibility with speed and precision.
Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
Prepared billing statements for patients, ensuring correct diagnostic coding.
Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
Consistently informed patients of financial responsibilities prior to services being rendered.
Entered procedure codes, diagnosis codes and patient information into Office Ally.
Posted charges, payments and adjustments.
Obtained state of Maryland grants for those in need of funding.
Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
Docgo Inc. - Key Holder Supervisor- Part Time Position Gadsden, SC, 12/2017 - 02/2019
Stocked, replenished and organized inventory.
Provided customer service
Processed payments and maintained accurate drawers.
Made sure each register balanced out at the close of business.
Prepared bank deposit.
Greeted customers with a positive attitude and helped with locating items.
Processed returns and exchanges.
Operated cash register, collected payments and provided accurate change.
Dr Ernesto Torres - Medical Secretary/Billing Specialist City, STATE, 09/2009 - 02/2019
Addressed, documented, and responded to incoming correspondences to address client queries.
Updated patient financial information to promote accurate record keeping.
Managed medical practice administrative needs to provide patient satisfaction.
Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
Managed physician calendar, including scheduling patient appointments and procedures.
Maintained office supplies inventory by checking stock and ordering new supplies as needed.
Processed invoice payments and recorded information in account database.
Medical billing and coding.
Collected co-payment and deductible balances.
Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
Proficient and familiar with ICD 10 coding and the use of modifiers when necessary.
Filed and submitted insurance claims.
Maintained knowledge of new or revised codes and industry regulations to complete accurate coding services, including local coverage determinations.
Reviewed all claims for accuracy and appropriateness.
Submitted claims to insurance companies.
Amber Hill Physical Therapy - Administrative Assistant City, STATE, 09/2007 - 09/2009
Scheduled and confirmed appointments.
Maintained several therapists schedules to be accurate and efficient.
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