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Medical Biller Insurance Verification Specialist Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary
  • A high-energy, enthusiastic and dependable individual who excels in challenging and competitive environments.
  • Successful track record with high responsibility positions.
  • Fast learner; quickly incorporate and implement new procedures.
  • A solid work ethic in delivering high-quality service to customers.
  • Effective organizational skills
  • Well-developed communication skills demonstrated through extensive customer service, answering multi-phones, preparing reports and paperwork, and positive interaction with individuals at all levels
  • Expertise in business administration, record keeping, planning, policies, procedure, researching, scheduling, and related responsibilities to ensure productive operations.

Collaborative Insurance Verification Specialist with proven success building patient rapport and preserving data integrity. Smart, reliable and possessing extensive Medicaid and non-Medicaid benefits knowledge.

Pragmatic Insurance Verification Specialist touting [Number] years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and the ability to work with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.

Skills
  • Prior authorization processing
  • Patient contact
  • Understanding of medical terms
  • Proficient in [Software]
  • Insurance coverage verification
  • Data integrity
  • Multitasking abilities
  • Customer Service
  • Detail-oriented
  • Good listening skills
  • Critical thinking
  • Verbal and written communication
  • Research and due diligence
  • Month-end closing procedures
  • Physical Therapy billing experience
  • Collection Practices
  • Invoice Processing
  • Billing
  • Insurance Knowledge
  • Spreadsheets
  • Billing Inquiries
  • Payment processing
  • Accounting remittances
Work History
Medical Biller/Insurance Verification Specialist, 08/2018 to Current
Vibra Healthcare Inc.Bowling Green, KY,
  • Prepared accounts with past due balances of more than [Number] days and transferred those cases to collection agency.
  • Posted payments and collections on regular basis.
  • Liaised between patients, insurance companies and billing office.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Assisted patients by determining financial assistance available and setting up payment plans.
  • Efficiently collected payments and communicated with clients.
  • Delivered timely and accurate charge submissions utilizing [Software].
  • Transferred balances to correct payers.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Applied charges and updated patient records by using [Software] and [Software].
  • Reviewed outgoing bills for eligibility and accurateness.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Researched and followed up on denied insurance claims.
  • Collected payments and applied to patient accounts.
  • Maintained current accounts through aged revenue reporting.
  • Reviewed services rendered and completed to reconcile codes.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Reviewed [Number] patient cases per week and verified insurance coverage information.
  • Posted payments to accounts and maintained records.
  • Managed financial documentations such as expense reports and invoices.
Medical Biller, 05/2017 to 08/2018
Behavior Health NetworkSan Juan, TX,
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Maintained current accounts through aged revenue reporting.
  • Collected payments and applied to patient accounts.
  • Communicated with insurance providers to resolve any denied claims and resubmit.
  • Delivered timely and accurate charge submissions utilizing [Software].
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Researched and followed up on denied insurance claims.
  • Prepared accounts with past due balances of more than [Number] days and transferred those cases to collection agency.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Reviewed outgoing bills for eligibility and accurateness.
  • Oversaw all billing for Medicaid PCA, waiver and skilled claims, commercial insurance and private pay clients.
  • Efficiently collected payments and communicated with clients.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Posted payments and collections on regular basis.
  • Transferred balances to correct payers.
  • Verified proper ICD-9 coding on claims.
Receptionist, 01/2010 to Current
SMC Rural Health ClinicCity, STATE,
  • Greet all patients, registering and scheduling patients, taking payments, phone services, and provided office support such as filing, coding, and customer service.
Cashier/Office Manager, 01/2005 to 01/2010
Brookshire BrothersCity, STATE,
  • Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers.
  • Reviewed and resolved differences between accounting information and cash drawer.
  • Restocked, arranged and organized merchandise in front lanes to drive product sales.
  • Checked identification for proof-of-age and refusing alcohol and tobacco sales to underage customers.
  • Processed POS transactions, including checks, cash and credit purchases or refunds.
  • Increased sales by offering advice on purchases and promoting additional products.
  • Checked prices for customers and processed items sold by scanning barcodes.
  • Worked with managers to complete daily counts and maintain funds security to minimize theft and mismanagement risks.
  • Used cash registers and POS systems to request and record customer orders and compute bills.
  • Operated cash register for cash, check and credit card transactions with 100% accuracy.
  • Served needs of more than 100 customers in busy environment.
  • Assisted customers by answering questions and fulfilling requests.
  • Answered questions about store policies and concerns to support positive customer experiences.
  • Counted cash in register drawer at beginning and end of shift.
  • Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies.
  • Replenished sales floor merchandise and organized shelves, racks and bins for optimal appearance.
  • Checked EDI invoices to resolve outstanding invoices.
  • Processed daily and weekly DSD tickets to file invoices.
  • Resolved vendor errors with receiving policies to eliminate excessive inventory.
Education
Diploma: Business, Expected in
Louisiana Technical College – Sabine Valley Campus - Many, LA,
GPA:
High School Diploma: , Expected in 2004
Many High School - Many, LA
GPA:

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Resume Overview

School Attended
  • Louisiana Technical College – Sabine Valley Campus
  • Many High School
Job Titles Held:
  • Medical Biller/Insurance Verification Specialist
  • Medical Biller
  • Receptionist
  • Cashier/Office Manager
Degrees
  • Diploma
  • High School Diploma