Medical Billing and Follow-Up Specialist Resume Example
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MEDICAL BILLING AND FOLLOW-UP SPECIALIST
Professional Summary
Certified Medical Billing Specialist with 8 years experience in a fast-paced, multiple client medical billing company. Researched and denied claims and submitted appeals. Familiar with health billing and collections.
Skills
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Work History
Medical Billing and Follow-Up Specialist, 05/2011 to 07/2014
Pgim Global Short Duration High Yield Fund, Inc. – Myrtle Beach , SC
Pgim Global Short Duration High Yield Fund, Inc. – Myrtle Beach , SC
- Medical claim billing and Follow-up with experience billing Medicare, Medicaid and Commercial Insurance.
- Answering client inquiries and solving client problems.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
- Verified patients' eligibility and claims status with insurance agencies.
- Diligently filed and followed up on third party claims.
- Researched questions and concerns from providers and provided detailed responses.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Maintained strict patient and physician confidentiality.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
- Accurately posted and sent out all medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
- Precisely evaluated and verified benefits and eligibility.
- Responded to correspondence from insurance companies.
- Posted and adjusted payments from insurance companies.
- Confidently and adeptly handled claim denials and/or appeals.
Electrician/Field Technician, 01/2009
New Electric – City , STATE
New Electric – City , STATE
- Installation of residential and commercial wiring systems, customer service, troubleshooting and repair.
- This included high voltage wiring, Telephone, CATV and Security Systems.
- Up-to-date knowledge of current electrical codes was required.
Customer Service Representative, 01/2008 to 01/2009
Circle K Corp – City , STATE
Circle K Corp – City , STATE
- Cashier duties including but not limited toshift cash reporting and accuracy.
- Receiving, stocking of inventory and theft reporting.
Electrician/Field Technician, 01/1998 to 01/2007
RB Electric/RDB Construction – City , STATE
RB Electric/RDB Construction – City , STATE
- Installation of residential and commercial wiring systems, customer service, troubleshooting and repair.
- This included high voltage wiring Telephone, CATV and Security Systems.
- Up-to-date knowledge of current electrical codes was required.
WIN System Administrator, 01/1998 to 01/1998
Jennifer Loomis & Assoc./OSI Inc – City , STATE
Jennifer Loomis & Assoc./OSI Inc – City , STATE
- Building and maintaining medical billing system modifications as needed by the staff and management.
- This included solving and correcting problems as they arise, writing reports based on user needs, creating and implementing improvements and helping users with specific questions or needs.
- Training included 24 classroom hours as a System Administrator, using the FACS computer system.
- M Technology, MS DOS, Windows95/98 and network knowledge are essential job functions.
- Advanced working knowledge of Word, Word Perfect and Excel was also required.
Medical Biller/Team Leader, 01/1994 to 01/1998
Jennifer Loomis & Assoc./OSI Inc – City , STATE
Jennifer Loomis & Assoc./OSI Inc – City , STATE
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
- Adeptly managed a multi-line phone system and pleasantly greeted all patients.
- Verified patients' eligibility and claims status with insurance agencies.
- Diligently filed and followed up on third party claims.
- Determined prior authorizations for medication and outpatient procedures.
- Performed qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded data.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
- Accurately posted and sent out all medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Responded to correspondence from insurance companies.
- Posted and adjusted payments from insurance companies.
- Confidently and adeptly handled claim denials and/or appeals.
- Prepared billing correspondence and maintained database to organize billing information.
Education
High School Diploma: 1988
Pembroke Academy - City
Special emphasis was placed on accelerated Math and Science courses.
Pembroke Academy - City
Special emphasis was placed on accelerated Math and Science courses.
ABA General Banking Diploma: 1 1991
New Hampshire Technical Institute - City, State
New Hampshire Technical Institute - City, State
Macro and Micro Economics, The Federal Reserve System, Bank Lending and Overall banking operations.: Electrical Engineering, 1 1993
DeVry Institute of Technology - City, State
Electrical Engineering Advanced Mathematics, Circuit Logic, Circuit Troubleshooting and Repair and Structured Computer Programming. I hold a FCC Technician NC class amateur radio operator license, N1NVR (expires 12/2022). I also build, repair and upgrade computers in my spare time
DeVry Institute of Technology - City, State
Electrical Engineering Advanced Mathematics, Circuit Logic, Circuit Troubleshooting and Repair and Structured Computer Programming. I hold a FCC Technician NC class amateur radio operator license, N1NVR (expires 12/2022). I also build, repair and upgrade computers in my spare time
Skills
banking, billing, Cashier, CPT, client, customer service, customer service, Economics, ICD-9, Insurance, inventory, Logic, Math, Mathematics, medical billing, medical terminology, medical terminology, Excel, Windows95, 98, Word, MS DOS, network, Computer Programming, coding, radio, Receiving, reporting, Structured, System Administrator, Technician, Telephone, Troubleshooting, upgrade, wiring, Word Perfect
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Resume Overview
School Attended
- Pembroke Academy
- New Hampshire Technical Institute
- DeVry Institute of Technology
Job Titles Held:
- Medical Billing and Follow-Up Specialist
- Electrician/Field Technician
- Customer Service Representative
- WIN System Administrator
- Medical Biller/Team Leader
Degrees
- High School Diploma : 1988
ABA General Banking Diploma : 1 1991
Macro and Micro Economics, The Federal Reserve System, Bank Lending and Overall banking operations. : Electrical Engineering , 1 1993
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