Medicaid Billing Specialist Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
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.
  • Advocacy and Counseling
  • Application assessment
  • Program understanding and advisement
  • Applicant support and service
  • Telephone etiquette
  • Recordkeeping and data input
  • Account Reconciliation
  • Administrative support
  • Project Organization
  • MS Office
  • Team Building
  • Eligibility Verification
  • Team Management
  • Inventory management
  • Acccounts Receivable
  • Supervision
  • Customer Service
  • Organization
  • Communications
  • Billing Adjustments
  • Insurance Billing
  • Entry management
Medicaid Billing Specialist, 09/2016 to 06/2018
Universal Health Services Clifton Heights, PA,
  • Explained eligibility details and affordability options to patients with kindness and respect.
  • Analyzed information from interviews, educational, and medical records, consultation with other professionals and diagnostic evaluations to assess clients' abilities, needs and eligibility for services.
  • Cultivated effective fact-checking and research talents from daily reviews of program eligibility requirements.
  • Reviewed criteria for different aid programs to determine eligibility for various applicants.
  • Inputted all communication with applicants into computer system to facilitate future clarification and knowledgeable support.
  • Called applicants to set up appointments and explain benefits processes.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • Logged all requests for medical records into spreadsheets.
  • Verified record copies before handing each over to check for and remove unnecessary details.
  • Entered patient insurance, demographic and health information into software and confirmed records.
  • Provided respectful assistance to all parties, including patients, staff members and insurance company representatives.
  • Pulled patient records and transferred information to appropriate parties.
  • Streamlined day-to-day office processes to meet long-term goals.
  • Set up patient charts and documented information in various company software.
  • Recognized by management for providing exceptional customer service.
  • Performed site evaluations, customer surveys and team audits.
  • Earned reputation for good attendance and hard work.
Medical Billing Representative, 09/2016 to 06/2018
Healthdrive Corporation Worcester, MA,
  • Meticulously tracked and resolved underpayments.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Confirmed patient demographics, collected copays and verified insurance.
  • 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.
  • Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
  • Verified proper coding, sequencing of diagnoses and procedures.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Prepared and submitted claims to insurance companies electronically and manually.
  • Completed appeals and filed and submitted claims.
  • Posted charges, payments and adjustments.
  • Accurately posted and sent out all medical claims.
  • Billed all lab claims with attached lab slips.
  • Determined customer eligibility for benefit programs and services.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Submitted refund requests for claims paid in error.
Medicaid/Medicare Billing Specialist, 06/2012 to 05/2014
William Backus Hospital Winsted, CT,
  • Maintained accounting ledgers by verifying and posting account transactions.
  • Charged expenses to accounts and cost centers by analyzing invoice and expense reports.
  • Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
  • Created receiving reports and updated vendor balance sheets to record accounts payable.
  • Facilitated payment of invoices due by sending bill reminders and contacting clients.
  • Maintained historical records by microfilming and filing documents.
  • Expedited payments by verifying accuracy and currency of vendor information.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Gathered information to produce accounts payable reports for review.
  • Prepared monthly and year-end closing statements, financial documents, and invoices.
  • Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
  • Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
Patient Service Representative, 10/2000 to 05/2011
Proactive Physical Therapy City, State,
  • Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Checked daily doctor schedules and verified insurance.
  • Utilized customer service skills and detailed system knowledge to support hospital and clinic operations.
  • Met with patients and their families to discuss medical procedures, medications, treatments and continuing care plans.
  • Coordinated between patients and healthcare professionals to meet patient needs.
  • Scheduled and confirmed patient appointments with patients and healthcare professionals.
  • Answered patient questions and fielded complaints.
  • Ran credit card batches and balanced deposits on a daily basis.
  • Referred patients to appropriate professionals and services.
  • Performed site evaluations, customer surveys and team audits.
  • Earned reputation for good attendance and hard work.
  • Recognized by management for providing exceptional customer service.
  • Improved operations by working with team members and customers to find workable solutions.
  • Answered [Number] calls per [Timeframe] to answer customer questions.
  • Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Attended departmental meetings, providing feedback to enhance future performance.
  • Created agendas and communication materials for team meetings.
Education and Training
High School Diploma: , Expected in 06/1997
Edwards-Knox Junior-Senior High School - Hermon, NY

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Resume Overview

School Attended
  • Edwards-Knox Junior-Senior High School
Job Titles Held:
  • Medicaid Billing Specialist
  • Medical Billing Representative
  • Medicaid/Medicare Billing Specialist
  • Patient Service Representative
  • High School Diploma