Medicaid Biller Resume Example Memorial Medical Center

MEDICAID BILLER

Summary

Multitasking Medical Biller with a career spent submitting claims quickly and efficiently to insurance companies. Hardworking individual with a can-do demeanor and a positive attitude. Ready to tackle new challenges in an office-based environment.

Skills

Recordkeeping
Account follow-up
Reimbursements
Submission of medical claims

Data entry
Information inputting
Claim review
AR/AP

Experience

Memorial Medical Center | Port Lavaca, TXMedicaid Biller07/2019 - Current

Assessed medical codes on patient records for accuracy.
Reviewed medical records to meet insurance company requirements.
Interpreted medical terminology and pharmacological information to translate information into coding system.
Addressed and responded to staff and client inquiries regarding CPT and diagnosis codes.
Researched and rectified account discrepancies.
Completed and submitted appeals.
Filed and submitted insurance claims.
Verified final claim submissions by comparing account charges with documentation.
Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts.
Reviewed received payments for accuracy and applied to intended patient accounts.
Maintained knowledge of new or revised codes and industry regulations to complete accurate coding services, including local coverage determinations.
Added modifiers, coded narrative diagnosis and verified diagnoses.
Reviewed all claims for accurateness and appropriateness.
Handled Medicaid billing, waivers and claims for private and commercial clients.
Flagged return claims and dealt with insufficient payments.
Kept accounts current by utilizing A/R reporting and analysis strategies.
Assigned CPT procedure and evaluation and management (E&M) codes for services to assure appropriate billing and reimbursement.
Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
Effectively coordinated all communications between patients, billing personnel and insurance carriers.
Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
Expertly assigned charges and payments for medical procedures.
Reviewed account information to confirm patient and insurance information is accurate and complete.

Port Lavaca Clinic | Port Lavaca, TXPhlebotomist01/2018 - 07/2019

Labeled blood vials with critical information like time of collection, date and patient name.
Obtained variety of blood samples through venipuncture or capillary puncture using syringes, butterfly needles and straight needles.
Prepared patients for examination by properly draping patients, obtaining vital signs, verifying referrals and taking detailed health history.
Prepared blood-collecting equipment to draw blood and safely store and transport samples.
Interviewed patients and analyzed and documented medical records to update and file documents.
Conducted bleeding time tests and updated results into paper or electronic charts.
Maintained fully-stocked phlebotomy cart, carrier and station.
Obtained blood samples for medical testing and transfusion through venipuncture or capillary puncture.
Verified collection orders and communicated discrepancies to nurses.
Counseled patients to ease fears, explain procedures and enhance cooperation during blood draws.
Enforced infection control and sharps disposal procedures to protect patients, co-workers and self.

Memorial Medical Center | Port Lavaca, TXRegistration Clerk08/2017 - 01/2018

Scanned important documents, including insurance cards to include in patient charts.
Welcomed patients to facility and assisted with registration sign-in process.
Carefully checked insurance information for benefits coverage and input pre-authorization documents into system.
Thoroughly explained facility policies, prepared and distributed patient identification bands and arranged for transportation to assigned rooms.
Assessed methods of payment for services, initiated processing and made referrals to specialists for financial options.
Processed cash, debit and credit card payments for services rendered and printed receipts detailing services.
Responded to incoming department phone calls and directed callers to appropriate team members based on need.
Politely and personably welcomed incoming clients and offered seats prior to beginning registration process.
Registered patients for outpatient procedures and emergency services.
Asked various questions from clients to obtain the information necessary for paperwork.
Maintained confidentiality of all patient information by adhering to HIPAA procedures.
Maintained HIPAA compliance and integrity of hospital policies and procedures.
Contacted insurance carriers to verify coverage, copays and deductible information for patients.
Explained forms and documents to patients, guardians and family members, distributing copies as needed and confirming comprehension.
Advised patients of monies required to be paid prior to services.
Kept processes moving along smoothly so that wait times were minimized to five minutes.

Clinical Pathology Laboratories | Victoria, TXPhlebotomist07/2016 - 08/2017

Enforced infection control and sharps disposal procedures to protect patients, co-workers and self.
Counseled patients to ease fears, explain procedures and enhance cooperation during blood draws.
Traveled to over two nursing facilities per morning to collect blood and other specimens.
Obtained variety of blood samples through venipuncture or capillary puncture using syringes, butterfly needles and straight needles.
Labeled blood vials with critical information like time of collection, date and patient name.
Coordinated workflow based on stat, schedule, or outpatient needs.
Prepared blood-collecting equipment to draw blood and safely store and transport samples.
Verified collection orders and communicated discrepancies to nurses.
Interviewed patients and analyzed and documented medical records to update and file documents.
Conducted bleeding time tests and updated results into paper or electronic charts.
Maintained fully-stocked phlebotomy cart, carrier and station.
Obtained blood samples for medical testing and transfusion through venipuncture or capillary puncture.

Education and Training

Hope High School | Port LavacaHigh School Diploma05/2012

Victoria College | Victoria, TXSome College (No Degree)

Resume Overview

Companies Worked For:

Memorial Medical Center
Port Lavaca Clinic
Clinical Pathology Laboratories

School Attended

Hope High School
Victoria College

Job Titles Held:

Medicaid Biller
Phlebotomist
Registration Clerk

Degrees

High School Diploma
Some College (No Degree)

Medicaid Biller Resume Example

Resume Score: 80%

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