Medical Billing And Follow Up Specialist Resume Example Company Name

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

Medical terminology expert
ICD-10 (International Classification of Disease Systems)
Billing and collection procedures expert
Hospital inpatient and outpatient records
Understands insurance benefits
Office support (phones, faxing, filing)

HCPCS Coding Guidelines
Familiar with commercial and private insurance carriers
Insurance and collections procedures
DRG and PC grouping
Composed and professional demeanor
Excellent problem solver
Close attention to detail

Work History

Medical Billing and Follow-Up Specialist, 05/2011 to 07/2014
Company Name – City, State

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
Company Name – 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
Company Name – City, State

Cashier duties including but not limited to shift cash reporting and accuracy.
Receiving, stocking of inventory and theft reporting.

Electrician/Field Technician, 01/1998 to 01/2007
Company Name – 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
Company Name – 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
Company Name – 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.

ABA General Banking Diploma: 1 1991
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

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

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

Medical Billing and Follow-Up Specialist Resume Example

Resume Score: 90%

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