Medical Biller Resume Example

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(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
Professional Overview

I am a self-motivated medical billing professional with over 5 years of front medical office experience. I am a multi-task-oriented individual with the ability to manage a busy medical office and provide excellent customer service to all patients. I am a dedicated person who's enthusiastic as a solid team player and a reliable associate. I am an organized, quality-focused medical biller with a successful track record in settling patient and insurance accounts. I am a resourceful employee with effective billing corresponding parties revenues, customer-relations, and decision-making skills. If your company is seeking a new member of the staff who is disciplined with strong work ethic and ensures efficient daily business operations, I am the best applicant for this establishment.

Summary of Skills
  • Medical billing
  • Insurance eligibility verification
  • Health insurance processing
  • CMS-1500 billing forms
  • Online claim submission
  • HIPAA compliance
  • Claims appeal procedures

  • Patient scheduling
  • Patient charting
  • Current Procedural Terminology (CPT)
  • HCFA Common Procedure Coding Systems (HCPCS)
  • International Classification of Diseases (ICD.9CM)
  • Attention to detail
  • Problem resolution

Ultimate Medical Academy Jacksonville, Fl Expected in 2012 State Certified : Medical Billing and Coding - GPA :

Continuing education in [Medical Billing and Coding]

[3.7] GPA

Touro College Brooklyn, NY Expected in 2001 Bachelor of Science : Business Science - GPA :

[3.3] GPA

Member of Literature Club

Work Experience
American Advanced Management, Inc - Medical Biller
Sacramento, CA, 07/2012 - 09/2012

•Diligently file 30 patients/payers claims daily, over 1,200 claims within two months.

•Examined patients’ insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.

•Verified patients’ eligibility and claims status with insurance agencies; updated patient financial information to guarantee accuracy; identified and resolved patient billing and payment issues.

•Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.

•Prepared and attached all required claims documentation including progress notes, treatment plans or other required correspondence to reduce incidence of denials.

•Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

•Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the eClinicalWorks/GatewayEDI 9.0.

•Submitted electronic/paper claims documentation for timely filing; responded to correspondence from insurance companies.

•Submitted refund requests for claims paid in error; carefully prepared, reviewed and submitted patient statements.

Concentra - Medical Office Supervisor
San Antonio, TX, 2007 - 05/2011

•Scheduled patient appointments; confirmed patient information; verified patients’ eligibility and benefits; collected and recorded copayments, deductibles, and co-insurance.

•Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Remittance Advice; thoroughly reviewed adjustment reasons and remark codes on Explanation of Benefits to research denied claims.

•Efficiently performed insurance verification and pre-certification; acquired insurance pre-authorizations for procedures and tests ordered by the referring physician.

•Professionally and courteously verified appointment times with patients; consistently informed patients of their financial responsibilities prior to services being rendered.

•Prepared new and established patient charts for pre-scheduled appointment; completed registration quickly and cordially for all new patients; prepared patient charts accurately and neatly for the clinic.

•Recorded and filed patient data (clinical studies) in medical records.

•Performed quality control of the data entry system to verify that claims and payments were posted correctly.

•Precisely completed appropriate claims paperwork, documentation and system entry.

•Adeptly managed a multi-line phone system; monitored shared email in-boxes and ensured inquiries were addressed.

•Accurately entered procedure codes, diagnosis codes and patient information into billing software; submitted electronic/paper claims documentation for timely filing.

•Submitted refund requests for claims paid in error; carefully prepared, reviewed and submitted patient statements.

•Performed full-cycle medical billing in a fast-paced medical billing company; directed patient flow during practice hours, minimizing patient wait time.

•Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.

•Communicated with DME vendors regarding back order availability, future inventory and special orders.

MMS/Medical Management Services - Demographer/Medical Biller
City, STATE, 2002 - 07/2006

•Inputted echocardiograms encounters at a rate of 130 per day.

•Updated patient financial information to guarantee accuracy; precisely evaluated and verified benefits and eligibility.

•Correctly billed medical claims for various specialties; determined prior authorizations for outpatient procedures; submitted paper claims for timely filing.

•Evaluated the accuracy of provider charges, including dates of service, procedures, locations, diagnoses, patient identification and provider signature.

•Verified claims status with insurance agencies; responded to correspondence from insurance companies; diligently filed and followed up on third party claims.

•Accurately posted and adjusted payments from insurance companies.

Pathmark Super Center - Bookkeeper/Customer Service Representative
City, STATE, 05/1994 - 07/2000

•Compiled weekly monetary reports and records for store manager; performed store evening duties, including counting overnight cash drawers and checking all register's daytime systems with printed receipts for managers’ viewing.

•Accurately balanced cash drawer after overnight shift; prepared accurate financial statements at end of the week.

•Trained new employees by providing knowledge of specific store tasks and policies.

•Ensured superior customer experience by addressing customer concerns, demonstrating empathy and resolving problems on the spot.

•Assisted customers with rain-checks on an out-of-stock item when applicable.

•Directed calls to appropriate individuals and departments.

•Answered questions regarding store and products, while maintaining knowledge of current sales and store promotions; maintained up-to-date knowledge of store policies regarding payments, returns and exchanges.

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Resume Strength

  • Length
  • Personalization
  • Target Job

Resume Overview

School Attended
  • Ultimate Medical Academy
  • Touro College
Job Titles Held:
  • Medical Biller
  • Medical Office Supervisor
  • Demographer/Medical Biller
  • Bookkeeper/Customer Service Representative
  • State Certified
  • Bachelor of Science