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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
  • Recordkeeping
  • Account follow-up
  • Reimbursements
  • Submission of medical claims
  • Data entry
  • Information inputting
  • Claim review
  • AR/AP
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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How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

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Resume Strength
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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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