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medical billing and coding manager resume example with 15+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary
I am a Senior Medical Billing Specialist with over 20 years of experience in the profession. My knowledge and experience encompass both the Medical Billing and Coding aspects of the profession. I am well versed with multiple types of Provider Specialties and Commercial and Government payers. I am always looking to add additional specialties to my knowledge base, and am self-motivated, detailed orientated, and catch on to new responsibilities, opportunities, and software systems quickly and efficiently.
WORK HISTORY AND SKILLS
Medical Billing and Coding Manager, 09/2016 - Current
Quantitech Pearl Harbor, HI,
  • Billing, Coding, and Chart Review for all Primary Care services done utilizing Practice Fusion EHR and Collaborate MD. Also utilized GMail, Word, Excel, Adobe, Chrome, and Internet Explorer.
  • Entry, scrubbing, and transmission of both primary and secondary claims both electronically and on paper when necessary.
  • Experience with ICD-10/ICD-9 codes and CPT/HCPC's codes for all insurance payers.
  • Confirm with clearinghouse through reports that electronic claims were received by insurance and processing.
  • Both auto and manual posting of insurance Eob's/payments as well as manual posting of patient copays/coinsurances/deductibles and account balances due.
  • Communicate and follow-up with insurance companies on claim denials as well as aging claims.
  • Utilize Medicare and other insurance company websites to obtain Local Coverage Determinations, Fees for Services, Global Surgery Days, etc....
  • Experience with Commercial, Government, Workers Compensation, and Motor Vehicle Accident insurance plans; Medicare, Medicaid, Tricare, United Healthcare, BCBS, Presbyterian, Humana, Molina, Aetna, NM Health Connections, GEHA, Mutual of Omaha, etc....
  • Entering of patient demographics and insurance information.
  • Run patient eligibility, check claim status, and request duplicate Eob's if needed utilizing HealthXNet, Availity, Presbyterian Provider Portal, NM Medicaid Provider Portal, and all other insurance company websites.
  • Month end reports including but not limited to spreadsheets.
Senior Billing Specialist, 07/2015 - 08/2016
Quantitech San Diego, CA,
  • Experience with billing and coding for Podiatric services in the office and inpatient and outpatient facilities, as well as DME supplies specific to the specialty.
  • Utilized Traknet and Gateway to enter patient demographics and insurance information, run eligibility, charge entry and scrubbing, transmission of claims, and auto and manual posting of insurance and patient payments.
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  • Utilized HealthXNet, Availity, and all insurance company websites to run patient eligibility, check claim status, and request duplicate eob's if needed.
  • Utilized Medicare and other insurance company websites to obtain Local Coverage Determinations, Fees for Services, Global Surgery days, etc.....
  • Experience with Commercial, Government, Workers Compensation, Motor Vehicle Accident insurance plans; Medicare, Medicaid, Tricare, United Healthcare, BCBS, Presbyterian, Humana, Molina, Aetna, NM Health Connections, GEHA, Mutual of Omaha, etc....
  • Experience with ICD-9/ICD-10 codes and CPT/HCPC's codes for multiple types of commercial and government payers. Submit charges (both primary and secondary) to insurance carriers electronically and on paper when needed.
  • Confirm with clearinghouse through reports that electronic claims were received by insurance and processing.
  • Communicate and follow-up with insurance companies on claim denials and aging claims.
  • Weekly and month end reports including but not limited to spreadsheets.
  • Experience also with Outlook Express, GMail, Word, Excel, Adobe, Internet Explorer, Chrome, FIreFox, etc.....
Senior Billing Specialist, 05/2005 - 07/2015
Mednet Medical Billing & Collection Services City, STATE,
  • Experience with billing and coding for multiple types of provider specialties in office, inpatient, and outpatient settings; Primary Care/Family Practice, Podiatry, Ear Nose and Throat, Urology, Optometry, and surgeons. ​
  • Experience with multiple billing and coding sofwares and EHR's; Lytec, MediSoft, HealthFusion, PracticeFusion, Open Practice Solutions, Office Ally, Bill Flash.
  • Experience with HealthXNet and all insurance company websites to run patient eligibility checks, check claim status, and download Eob's.
  • Experience with Outlook Express, GMail, Word, Excel, Adobe, Internet Explorer, Chrome, FIreFox, etc...
  • Experience with AAPC, Medicare, and other insurance company websites to obtain Local Coverage Determinations, Fees for Services, Global Surgery days, etc....
  • Experience with Commercial, Government, Workers Compensation, Motor Vehicle Accident insurance plans; Medicare, Medicaid, Tricare, United Healthcare, BCBS, Presbyterian, Humana, Molina, Aetna, NM Health Connections, GEHA, Mutual of Omaha, etc....
  • Entry of patient demographics, insurance information, copays, ICD-9 codes, and CPT/HCPC's codes for multiple types of provider specialties to multiple types of commercial and government payers.
  • Submit charges to insurance carriers both electronically and on paper when needed.
  • Confirm with clearinghouse through reports that charges were received by insurance and processing.
  • Apply both patient and insurance payments to charges electronically through auto post as well as manual post for paper Eob's.
  • Communicate and follow-up with insurance companies on claim denials.
  • Weekly and month end reports including but not limited to spreadsheets.
  • Scanning of information through both Drop Box systems and emails to clients as needed.
  • Meet with new clients in regards to services provided by the company.
  • Meet with existing clients to go over the existing account status and any areas tha could be improved to help increase the revenue of the practice.
Education and Training
Certificate: Medical Billing and Medical Claims Technology, Expected in 1997
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Central New Mexico Community College - Albuquerque, NM
GPA:
Status -

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Resume Overview

School Attended

  • Central New Mexico Community College

Job Titles Held:

  • Medical Billing and Coding Manager
  • Senior Billing Specialist
  • Senior Billing Specialist

Degrees

  • Certificate

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