medical biller lead resume example

High Volume Medical Practice specializing in Pain Management. Observe and manage daily functions of the practice and employee task while maintaining an efficient and effective office flow. Responsible for overall operations of the office and all special projects and implementations. Ability to multitask. Advanced time management skills and organization. Review, analyze, and collaboratively resolve operational issues including staff, patient, employer, Insurance carrier and attorney concerns. Responsible for all aspects in Billing including filing all Professional Claims for Medicare, Private Insurance, Managed Care, Medi-cal, Personal Liens and Workers Compensation. All Electronic billing and payment experience processing third party billing. Except for PI Liens and Workers Compensation. Also responsible for Surgery Billing filing Claims weekly. Coded 75+Super Bills daily for up to four healthcare providers. Manages and prioritizes staff daily work assignments necessary to ensure the timely payment of billed claims. Ensuring timely follow-up, appeals and payment on claims for assigned payors. Posting Check Payments weekly including all EFTS & ERA's. Assists in the ongoing evaluation and correction of operational actions, both systems and staff oriented, that create an increase in denials or delayed billing, working closely with Practice Management. Meets billing operational standards by contributing billing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service standards; resolving problems; identifying billing system improvements. Responsible for sending out Patient's statement on a monthly basis. Managing all Patients billing concerns. Reconcile billings with AR ledger. Utilization of metrics to improve performance and have the ability to train effectively and cater to individual training needs. MediTouch / Health Fusion System.

Mi-Med brings a new level of personalized service to patients, physicians and facilities alike and offer the highest quality of disposable medical products to meet everyone's needs. Product includes Urological, Incontinence, Ostomy and Wound Care supplies. Extensive experience billing Medicare, Medical, and private insurance. Worked aging reports for insurance and patient's outstanding balances and/or claims, followed with immediate problem solving for each case. Maintained a heavy case load and solved cases. Electronic billing experience (Brightree billing software) SOLID knowledge ofprocesses associated with full cycle billing processes. Responsible for Processing and research denials. Updating pricing tables for medical devices. Review patient statements (EOB) submitting statements. Followed up on acceptance of the claims and/or claim status. Collecting mostly from insurance companies. Implement new policies and procedures. Train and assist other employees. Create LOAs and assist contracting director Data conversion for newly acquired companies. Update, correct, and create price tables. EDI and payer enrollment. Facility billing. Assist in posting, patient intake, reordering and retention. Identified and resolved issues with patient accounts and insurances. Responsible for adjustments and write-offs. Auditing a number of client files for a Medicaid audit in order to make sure we were compliant. Reduced DSO and generated an increase in revenue in only 4 months. Creation of Ad-Hoc reports. Creation of appeal templates, patient record releases, AOBs, and other patient forms including hardship reduction. Ensure HIPAA compliance and Medicare compliance.

Responsible for supporting the smooth functioning of all aspects of operations, accounting and administration. Oversight of all schedules. Providing assistance with Meaningful Use, OHSA and other compliance requirements. Handle patient complaint in a timely and consistent manner. Tracking and payout of physician according to claims. Strong AR background and knowledge of HMO, PPO, Government payers, CPT and ICD 9/10. Responsible for ensuring the timely collections of AR from insurance payers including Medicare, Medicaid, Workers Comp, Blue Cross, Blue Shield, HMO, PPO's, and private pay patients. This position works closely with patients to resolve unpaid balances, addresses their questions/concerns, and submits accounts to outside agencies as appropriate. Responsible for case management reporting and referring policyholders that fit the criteria for case management needs. Worked closely with case managers regarding treatment plans. Works closely with the Business Office Manager and the Biller to reduce and maintain acceptable days in AR and works all unresolved accounts within timeframes specified in policy and procedure. Review system reports regularly to properly manage all aspects of AR. Identified and resolved patient billing and payment issues. Maintained and updated collection tracking spreadsheet to help organize payment information. Handled claim denials and/or appeals from insurance companies. Ability to work within the team & independently, handle multiple tasks, provision computer skills, and data entry skills, file large amounts of paper and use office equipment. Used of electronic billing systems in Vision and VMR.

Other previous Employees:

*Orange County Diagnostics Biller and Collector Lead / Orange County, CA February 2008- February 2011 *California and Imaging Biller and Coder / Orange County, CA July 2005-February 2008 *Orange Coast Oncology and Hematology Billing Representatives / Orange County, CA April 2004- July 2005