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medical administrative assistant billing auditor resume example with 20+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Summary

Focused and empathetic professional dedicated to meeting and exceeding customer expectations by delivering industry-leading service. Skilled in creative problem-solving, multitasking and research abilities. Extensive background in healthcare roles with high-volume customer demands; including expertise in initial contact resolution. Diligent advocate with in-depth understanding of medical standards, compliance requirements and operational procedures.

Skills
  • Customer advocate
  • Creative problem solver
  • Reliable and trustworthy
  • Adaptive team player
  • Active listener
  • Medical claims billing & processing
  • Multitasking
  • Cross-functional collaboration
  • Quality control
  • Conflict mediation
  • Call Center Operations
  • Team management
  • Medical Terminology
  • Time Management
Education and Training
Smoky Hill High School Aurora, CO Expected in 05/1994 High School Diploma : - GPA :
Concord Career Institute Denver, CO, Expected in 02/1995 Medical Assistant : Healthcare - GPA :
Experience
Westminster Canterbury - Medical Administrative Assistant & Billing Auditor
Virginia Beach, VA, 09/2020 - Current
  • Communicated with patients to obtain payments on outstanding accounts or accounts requiring deductible, coinisurance or co-pay collection.
  • Verified insurance coverage, obtained preauthorizations and updated charts in eClinicalWorks.
  • Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
  • Scheduled provider appointments, surgeries and procedures.
  • Coordinate with billing company the status of rebilling and reimbursement process to ensure account resolution.
  • Monitored appeals for claim denials and minimized inaccuracies by maintaining accurate records of approvals.
  • Investigated claim denials to determine accuracy and possible solutions.
Nursecore - Medical Administrative Assistant
Brooklyn, NY, 09/2019 - 06/2020
  • Communicated with patients in person to obtain payments on outstanding accounts or accounts requiring deductibles or co-pays.
  • Scheduled patient appointments, accounting for physician availability and optimal patient loads.
  • Verified insurance coverage, obtained preauthorizations and updated charts in EMR system.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • Handled front office customer service, appointment management, billing and administration.
  • Coordinated admission processes and prepared medical records and agreement packets.
Lehigh Valley Hospital & Health - Medical Billing and Collections Specialist
Scranton, PA, 10/2018 - 10/2019
  • Corrected, completed and processed claims for payer codes.
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Posted charges, payments and adjustments.
  • Completed and submitted appeals for denied claims.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Determined customer eligibility for benefit programs and services.
First Federal Savings And Loan - Patient Services Representative
Forks, WA, 09/2017 - 09/2018
  • Accessed and documented patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Referred patients to appropriate professionals and services.
  • Checked daily doctor schedules and verified insurance.
  • Provided consultations for patients about rights and services.
  • Facilitated communication between patients, medical staff, administrative staff, and regulatory agencies.
  • Helped patients obtain health care services by setting up referrals.
  • Explained policies, procedures and services to patients.
  • Supported hospital operations using customer service skills and detailed system knowledge.
Iconma, L.L.C. - Director of Child Development & Statistic Analyst
Spring Hill, TN, 10/2012 - 09/2017

During this time I was at home raising two children. I preformed contract work with Krause & Co, for individual state Medical Group Management Annual Salary Reports.

  • Interpreted sets of data and identified tends and relationships.
  • Extracted and organized raw data.
  • Develop statistical modeling and graphic analysis software programs.
  • Managed data cleaning and quality evaluations.
  • Created graphs, charts, and tables to report on results of statistical analyses.
  • Collected, tracked and organized data to evaluate current business and salary trends.
9Round Fitness - Medical Secretary and Medical Assistant
Flower Mound, TX, 01/2007 - 09/2012
  • Maintained detailed administrative and procedural processes to improve accuracy and efficiency.
  • Composed, proofread and distributed clean and professional business correspondence and internal team communications.
  • Resolved issues quickly and escalated critical problems immediately to proper resolution.
  • Interviewed patients to obtain medical history, chief complaints and vital signs.
  • Educated patients about medications, procedures and physician's instructions.
  • Collaborated with local pharmacies to resolve and clarify issues with patient medication.
  • Efficiently performed insurance verification and pre-certification and pre-authorization functions.
  • Contributed to office operations by triaging patients by severity of medical complaint.
  • Performed, validated and reported laboratory tests for prognosis, diagnosis, treatment and research.
  • Performed diagnostic imaging procedures by operating x-ray.
Cigna - Insurance Biller & Eyewear Technician
Doral, FL, 08/2005 - 01/2007
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Composed End of Month financial reports and business correspondences for supervisors, managers and other professionals.
  • Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
  • Researched claim denials for accuracy. Submitted appeals when needed and/or forwarded additional information for review.
  • Sold and recommended eyewear products, merchandise and services in retail and clinical settings in order to drive company revenue and meet customer needs.
  • Instructed patients on insertion, removal, cleaning, care and proper handling of contact lenses.
Principal Insurance - Customer Service Specialist
City, STATE, 06/2003 - 03/2005
  • Documented conversations with customers to track requests, problems and solutions.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Exceeded company productivity standards on consistent basis.
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Reviewed documentation and accounts to gain full picture.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
  • Maintained high-volume workload within fast-paced environment and consistently met performance and quality benchmarks.
  • Assisted callers with benefit and claims to determine needs and address concerns.
Anthem - Customer Service Representative III
City, STATE, 05/2001 - 05/2003
  • Evaluated pending claims to identify and resolve problems blocking adjudication.
  • Reviewed payment or denial of medical claims upon well-established criteria for claims processing.
  • Sent request, response, explanation, and missing information letters to obtain incomplete information.
  • Complied with confidentiality regulations in handling customer information.
  • Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
  • Forwarded claims for payment or forwarded to appropriate personnel for further investigation
  • Handled claims status and detailed Explanation of Benefit advisement.
  • Served as subject matter expert for development and implementation of HIPAA policies and procedures to all call and correspondence centers in Colorado and Nevada.
  • Exceeded team goals and collaborated with staff to implement customer service initiatives.
  • Mentored junior team members.
  • Achieved top satisfaction, retention, and referral rankings on consistent basis.
  • Fielded up to 125 calls per day with 99% accuracy.
Community Health Plan Of The Rockies - Customer Service Trainer
City, STATE, 01/1998 - 04/2001
  • Maintained high-volume workload within fast-paced environment and consistently met performance benchmarks.
  • Led customer service staff in implementing strategies to propel Customer Satisfaction Index levels and achieve manufacturer service objectives.
  • Improved productivity by providing CSR performance feedback for corrective action.
  • Developed, implemented and monitored programs to maximize customer satisfaction and manage on-site customer service representatives.
  • Trained newly hired top talent to fill key positions and maximize productivity.
  • Tested trainees on materials to determine levels of understanding and areas requiring further instruction.
  • Developed and coordinated trainings to help individuals learn company policies and procedures and job tasks.
  • Developed training materials, manuals, procedures and visual aids to effectively achieve organizational goals.
  • Determined appropriate instructional plans based on personal strengths and training goals.
The Eye Center - Medical Receptionist
City, STATE, 02/1995 - 12/1997
  • Entered insurance, demographics and health history into electronic scheduling system.
  • Checked patients in and out for appointments and collected co-payments.
  • Called patients to confirm scheduled appointments and obtain additional details.
  • Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
  • Managed office phone lines.
  • Handled correspondence, managed files and performed other clerical duties for office staff.
  • Compiled physical documents, charts and reports.

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Resume Overview

School Attended

  • Smoky Hill High School
  • Concord Career Institute

Job Titles Held:

  • Medical Administrative Assistant & Billing Auditor
  • Medical Administrative Assistant
  • Medical Billing and Collections Specialist
  • Patient Services Representative
  • Director of Child Development & Statistic Analyst
  • Medical Secretary and Medical Assistant
  • Insurance Biller & Eyewear Technician
  • Customer Service Specialist
  • Customer Service Representative III
  • Customer Service Trainer
  • Medical Receptionist

Degrees

  • High School Diploma
  • Medical Assistant

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