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medical billing and collections specialist resume example with 6+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Skills
  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions
Experience
02/2020 to 01/2022
Medical Billing and Collections Specialist Nursecore Dumas, TX,
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Posted charges, payments and adjustments.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Completed appeals and filed and submitted claims.
  • Posted and adjusted payments from insurance companies.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Collaborated closely with other departments to resolve claims issues.
  • Submitted refund requests for claims paid in error.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Applied payments, adjustments and denials into medical manager system.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Took billing calls, questions and concerns from patients and third party carriers.
02/2019 to 12/2020
Medical Billing and Collections Specialist Nursecore Georgetown, TX,
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Took billing calls, questions and concerns from patients and third party carriers.
  • Corrected, completed and processed claims for payer codes.
  • Protected medical office operations and integrity by keeping patient information confidential.
  • Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Processed refund requests and reconciled deposit and patient collections.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Posted charges, payments and adjustments.
  • Filed and submitted insurance claims.
  • Prepared and submitted claims to insurance companies electronically and manually.
  • Completed and submitted appeals for denied claims.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Completed appeals and filed and submitted claims.
  • Posted and adjusted payments from insurance companies.
  • Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Added modifiers, coded narrative diagnosis and verified diagnoses.
  • Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
02/2015 to 02/2019
Medical Office Administrator Sas Institute Ut, UT,
  • Registered patients and scheduled appointments.
  • Assisted with referrals and prepared medical records for patients.
  • Scheduled appointments, oversaw check-ins and resolved patient concerns in high-volume Allergy and Immunology practice.
  • Provided exceptional patient experience through friendly and compassionate communications.
  • Maintained consistent patient confidentiality in alignment with HIPAA protocols by using encryption software.
  • Collected information, verified insurance and collected co-payments for patients as part of check-in process.
  • Communicated with patients regarding payments on outstanding accounts.
  • Called in prescription refills for patients.
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Took billing calls, questions and concerns from patients and third party carriers.
  • Corrected, completed and processed claims for payer codes.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Posted charges, payments and adjustments.
  • Filed and submitted insurance claims.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Confirmed patient demographics, collected copays and verified insurance.
Education and Training
Expected in 08/2014 to to
Certificate: CPC - Certified Professional Coder
Medco Consultants - St Johns University - Queens, NY,
GPA:
Expected in 2012 to to
: Healthcare Management
AIU - American Intercontinental University - Online,
GPA:
Expected in 07/2008 to to
2 Certificates: Medical Billing & Coding / Customer Service
Career Quest LTD - New York, NY,
GPA:
Expected in 2003 to to
Associate of Applied Science: Computer And Information Sciences
New York Technical College - Brooklyn, NY,
GPA:

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Resume Overview

School Attended

  • Medco Consultants - St Johns University
  • AIU - American Intercontinental University
  • Career Quest LTD
  • New York Technical College

Job Titles Held:

  • Medical Billing and Collections Specialist
  • Medical Billing and Collections Specialist
  • Medical Office Administrator

Degrees

  • Certificate
  • Some College (No Degree)
  • 2 Certificates
  • Associate of Applied Science

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