Medicaid Biller Resume Example
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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
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Experience
Avalon Health Care Group | Medford , ORMedicaid 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.
Frontline National | Rockford , MIPhlebotomist01/2018 - 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.
Eurofins Scient. | Cambridge , MARegistration 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.
Frontline National | Kalamazoo , MIPhlebotomist07/2016 - 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 | CityHigh School Diploma05/2012
Victoria College | City, StateSome College (No Degree)
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Resume Overview
School Attended
- Hope High School
- Victoria College
Job Titles Held:
- Medicaid Biller
- Phlebotomist
- Registration Clerk
Degrees
- High School Diploma
Some College (No Degree)
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