Medical Biller Resume Example Tucson Shared Services Center

MEDICAL BILLER

Summary

Prepared to leverage 13 years of experience to take on a new professional challenge. Well-qualified professional, familiar with the medical revenue cycle and offering strong multi-tasking, detail oriented and teamwork abilities.

Skills

Medical front office reception
Verification of insurance eligibility
Verification of prior authorization and claim status
Appointment scheduling
Medical office & hospital billing
Collections
ICD-9, CPT, HCPCS coding
Health insurance contractual language (AHCCCS, Commercial, PPO, HMO, Medicare)
Explanation of benefits and basic fee schedule review

Preparation and submission of paper and electronic insurance CMS-1500 and UB 04 claim form
Preparation of Accounts Receivable report
Medical terminology
Microsoft Word, Excel, PowerPoint, Outlook
Medical office systems: Medisoft, Telecom, MDrythm, Meditech, Cerner, Epic, PACS Philips, Synapse, HMS, Artiva, Hyland, SSI, DDE
Bilingual- fluent in Spanish
Data entry of 40 wpm
Ten key by touch

Experience

Tucson Shared Services Center | Tucson, AZMedical Biller04/2017 - 09/2019

Handle all payers secondary billing for California hospitals
Handle part B only Medicare billing for California hospitals
Assist in secondary billing for Arizona, Nevada and New Mexico hospitals
Ensure UB-04 clean claims are submitted in a timely manner
Handle Rebill, Insbill and rejected pools
Work KFI File accounts
Mail clean UB-04 claims forms via paper
Clear Share of Cost amounts from Medi-Cal website

Tucson Shared Services Center | Tucson, AZReimbursement Specialist11/2015 - 04/2017

Process all payments and adjustments received in an accurate and timely manner
Post all payments received through the lockbox or mailroom and adjustments as identified by insurance explanation of benefits
Write up all payments on cash receipts log for payments that need to be uploaded
Write up all adjustments that need to be uploaded on an adjustment log and submit for approval
Balance posted payments before leaving each day
Submit required paperwork (journal, batch out, batch cover sheets) daily
Identify and resolve payment posting issues
Call payers to obtain information on unidentified payments

Coventry/ Aetna | Tucson, AZIntegrated Service Specialist03/2015 - 08/2015

Handle Workers Compensation orders for DME Items
Input ICD-9 codes in system
Verify orders for proper HCPCS codes
Follow up on order to ensure patient received items
Negotiate with providers to obtain lowest cost on the items when ordering for patients

University of Arizona Medical Center South Campus | Tucson, AZPatient Service Specialist02/2011 - 03/2015

Assist patients and medical staff in making appointments for radiology exams
Answer phone calls and transfer to appropriate individual(s)
Verify orders for proper exams according to protocol
Assist technologist with correction of image errors
Burn radiology images for requests of outside facilities
Register ER patients into system
Transport patients to and from the Emergency Room

Carondelet Health Network | Tucson, AZPatient Access Representative02/2009 - 02/2011

Register scheduled and walk-in patients
Check insurance eligibility and any co-pay or deductible responsible by patient
Prepare monetary bag for delivery to bank and prepare graph of daily totals
Pull and scrub orders for next day patients for radiology exams

Carondelet Health Network | Tucson, AZCash ID Representative02/2008 - 02/2009

Post all incoming money for radiology services to patients accounts
Prepare monetary bag with correct total for checks and cash received daily for delivery to bank
Call insurance companies to check status on claims

Advanced Open MRI | Tucson, AZFront Office Receptionist04/2007 - 01/2008

Verify insurance eligibility
Verify prior authorization for CT Scans and MRIs
Answer calls and obtain proper information for appointments

Tucson Clinica Medica Familiar | Tucson, AZMedical Billing Specialist06/2006 - 03/2007

Handle collections and denials
Perform daily billing and posting for all insurances
Prepare patient statements
Submit paper and electronic clean claims
Produce month end and Accounts Receivable reports using advanced Excel spreadsheet functions

Education and Training

Tucson College | Tucson, AZCertification in Medical Billing and Coding

Medical terminology - Covered the major body systems, such as the skeletal, reproductive, and endocrine systems, as well as the correct terms used when working with each
Office practices - Learned valuable skills required to keep an office running smoothly. Learned medical coding, accounting principles, how insurance claim cycles work, receptionist duties, and
documentation skills
Regulatory and legal requirements - Learned about HIPAA laws, as well as various legal issues commonly faced by medical practices

PPEP Tec - Celestino Fernandez Learning Center | Tucson, AZHigh School Diploma

Resume Overview

Companies Worked For:

Tucson Shared Services Center
Coventry/ Aetna
University of Arizona Medical Center South Campus
Carondelet Health Network
Advanced Open MRI
Tucson Clinica Medica Familiar

School Attended

Tucson College
PPEP Tec - Celestino Fernandez Learning Center

Job Titles Held:

Medical Biller
Reimbursement Specialist
Integrated Service Specialist
Patient Service Specialist
Patient Access Representative
Cash ID Representative
Front Office Receptionist
Medical Billing Specialist

Degrees

Certification in Medical Billing and Coding
High School Diploma

Medical Biller Resume Example

Resume Score: 80%

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