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insurance claims billing specialist resume example with 10 years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Skills
  • Documentation review
  • Prior authorization processing
  • Insurance coverage verifications
  • Excellent administrative abilities
  • Data integrity
  • Account management
  • Teambuilding
  • Attention to Detail
  • HIPAA Guidelines
  • Medical Billing and Coding
  • Appointment Scheduling
  • Medical office administration
  • Insurance claims
Work History
Insurance Claims/Billing Specialist, 03/2017 to Current
Kneaders Bakery & CafeF T Sanfords, UT,
  • Prepared insurance claims for submission to clearinghouses or insurance companies.
  • Filed and tracked insurance claims and communicated claims status to patients.
  • Achieved revenue goals by managing collections and accounts receivables, referral process and insurance billing.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Handled Medicare/Commercial Appeals - redeterminations-reconsiderations-ALJ request
  • Benefits & Insurance verifications
  • Took patient information and scanned into EMR, ensuring accurate records and patient authorizations
  • Scheduled patient appointments around availability of physician.
  • Used Opie software regularly to compile records, produce reports and create correspondences and physician forms needed
  • •Supported medical unit by answering multi-line phones and providing clerical support.
Assistant Manager, 02/2015 to 03/2017
Rockwell Automation, Inc.Minneapolis, MN,

• insurance verifications / authorizations

• Supported back office procedures, including hiring and employment processes.

• Maintained an onsite presence to ensure the operations team met all company operational standards.

• Worked on medical billing to review clinical statements and assigned standard codes using CPT, ICD-10-CM or HCPCS.

• Translated health care services into coded medical claims for submittal to insurers.

• Kept all files secure and confidential to protect the patients and comply with HIPAA requirements.

• Verified coverage with insurers, filed required forms, and submitted paperwork to obtain timely payments.

• Followed-up on claims submitted to insurance companies to mediate disputes and obtain reimbursement for services rendered during patient's treatment.

• Reviewed patient charts for completeness and accuracy and verified missing information.

• Scanned reports, patient consent forms, and chart forms into patient record.

Manager , 11/2012 to 11/2015
Espresso YourselfCity, STATE,

• Offered product selections for customers based on their stated preferences.

• Followed guidelines for merchandising and visual displays of product in the department.

• Stocked display cases and kept all bakery in merchandise in storeroom rotated to remain freshness and prevent spoilage.

• Worked cooperatively with coworkers to build a strong bakery team.

• Kept a well-organized and stocked inventory of ingredients and supplies to meet expected customer demands.

• Checked deliveries in, verified invoices, and stocked products following sanitation standards.

• Monitored and adjusted staff schedules based on business requirements.

• Brewed coffee and tea, restocked ice and changed out soda syrup containers to keep the drink station fully operational.

• Kept the cash register balanced and accurate to avoid financial errors.


Education
High School Diploma : , Expected in 12/2014 to Flagler Highschool - ,
GPA:
Medical Billing And Coding : , Expected in 07/2020 to Penn Foster - ,
GPA:

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Resume Overview

School Attended

  • Flagler Highschool
  • Penn Foster

Job Titles Held:

  • Insurance Claims/Billing Specialist
  • Assistant Manager
  • Manager

Degrees

  • High School Diploma
  • Medical Billing And Coding

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