Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,
Professional Summary

Diligent and skilled medical biller/credentialing specialist with solid experience and knowledge in the medical field. Highly ambitious motivated person seeking for a company who can offer growth for their team members. Familiar with the following software and vendors, Medisoft, Ez-Bis, Navinet, WebPT, Novitasphere,and Emdeon-Change HealthCare. I'm looking to be part of a great team where i can utiJessicae my strong work ethics and skills as a medical biller and credentialing specialist.

  • Self-motivated and great problem solver
  • In-depth knowledge of medical terminology, billing procedures, and insurance guidelines
  • Knowledge of medical coding terminology and billing standards and practices
  • Possess excellent leadership, communication, and management skills
  • Experience 10 years in field of medical billing for multi specialty physicians
  • Strong ability to analyze with deep knowledge of billing, medical terminology,Medicaid,Medicare,Commercial Insurance, Worker Compensation, PIP Claim's, etc
  • Exceptionally good at dealing customer's queries and complaints with strong power to resolve problems
  • Profound ability to demonstrate and presentation with good interpersonal skills
  • Staff development plans
  • Great communication skills both verbally and written
  • Insurance credentialing processes
  • Provider enrollment
  • Training and development
  • File and records management
  • Business Administration, Microsoft Excel,Organizational Skills
  • Medical billing and coding
  • Business operations
Work History
05/2018 to Current Medical Billing and Credentialing Specialist Aln Medical Management | Lincoln, NE,
  • Accurately posted and sent out all medical claims
  • Maintained and updated collections tracking spreadsheet to help organize payment information
  • Precisely evaluated and verified benefits and eligibility
  • Posted and adjusted payments from insurance companies
  • Printed and reviewed monthly patient aging report and solicited overdue payments
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy
  • Precisely completed appropriate claims paperwork, documentation and system entry
  • Determined prior authorizations for medication and outpatient procedures
  • Promptly sent out and posted all medical claims
  • Evaluated patients' financial status and established appropriate payment plans
  • Managed collections claims for unpaid bills against estates of debtors
  • Managed invoicing and payment processing operations
  • Executed billing tasks and recorded information in company databases
  • Obtained NPI numbers for providers and facilities and updated existing profiles
  • Received and evaluated applications to look for missing and inaccurate information
  • Enrolled providers and Medicaid, Medicare and private insurance plans
  • Received and evaluated applications to look for missing and inaccurate information.
  • Enrolled providers and Medicaid, Medicare and private insurance plans.
02/2009 to 04/2019 Medical Billing Manager Sportsmed Physical Therapy | City, STATE,
  • Worked for over 10 years directly with health insurance companies, insurance handlers, claim adjuster, supervisor's ,patients ,medical providers, hospitals, attorneys and staff to achieve best possible result's to improve company revenue
  • Handling cash and entering accurate records for billing procedures for multiple accounts
  • Handle multi provider credential's efficiently ,as well as insurance credentialing for participating and non participation providers
  • Perform responsibilities of managing and controlling department budget, cash flow, and account receivables
  • Responsible for maintaining billing procedures, electronic billing functions as well as ensuring accurate billing activities
  • Assigned responsibilities of supervising billing staff and establishing implementing standard medical billing procedures
  • Prepare and distributed customer's invoice and bills
  • Responsible for analyzing, researching and resolving customer issues
  • Conducted research and reconciliation on numerous billing issues
  • Manages reconciliation of accounts receivable on daily basis
  • Responsible for Medicaid ,Medicare, All commercial insurance's ,Workers Compensation, Medical Pip Claims billing utiJessicaing Medisoft and Ez-bis software management system
  • Responsible for interview, hire and train medical billing staff
  • Responsible for maintenance of customer bills and special reports, answer customer queries, complaints and problems on phone
  • Manage multiple accounts efficiently for multiple doctors
  • Billing and coding for ,Acupuncture,Occupational, Chiropractic, and Physical Therapy services
  • Handle multiple appeals to insurance carriers, follow ups on medical bills submitted to insurance carrier's, insurance verifications, manage patient scheduling, assisted patients with insurance problems as best possible
  • Analyze multi practice revenue and collections on monthly basis, arbitration handler, investigated new ways to improve billing production, entered new demographics to system, data entry savvy, generated multi reports for production purposes
  • Precisely evaluated and verified benefits and eligibility
  • Conducted orientation sessions and organized on-the-job training for new hires.
01/2008 to 05/2009 Point of Sale Associate Love Culture Inc. | City, STATE,
  • Checked prices for customers and processed items sold by scanning barcodes.
  • Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers.
  • Restocked, arranged and organized merchandise in front lanes to drive product sales.
  • Operated cash register for cash, check and credit card transactions with accuracy.
  • Helped guests every day by processing payments, monitoring reward accounts and resolving service concerns.
  • Assisted customers with special services, account updates and promotional options.
  • Maintained current knowledge of store promotions and highlighted sales to customers.
  • Counted cash in register drawer at beginning and end of shift.
  • Increased sales [20]% by offering advice on purchases and promoting additional products.
  • Mentored new team members on POS system operation, customer service strategies and sales goals.
Expected in 2019 Bachelor of Arts | Finance William Paterson University , Wayne, NJ, GPA:
Expected in 06/2009 Certification | Medical Billing And Coder Berdan Institute , Wayne, NJ, GPA:

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School Attended

  • William Paterson University
  • Berdan Institute

Job Titles Held:

  • Medical Billing and Credentialing Specialist
  • Medical Billing Manager
  • Point of Sale Associate


  • Bachelor of Arts
  • Certification

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