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medical billing representative resume example with 20+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Summary

Highly efficient Medical Biller with over 25 years experience in Ophthalmology. Excellent multi-tasker and demonstrated team player with positive attitude. Skills in various medical billing systems. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Skills
  • Teamwork and Collaboration
  • Claims Processing
  • HIPAA Compliance Certification
  • Information Confidentiality
  • Multitasking and Organization
  • Chart Auditing
  • Commercial and Private Insurance
  • Medical Terminology
  • Records Management
  • Verbal and Written Communication
  • Billing and Collection Procedures
  • Account Reconciliation
  • Itemized Statement Preparation
  • Equipment Monitoring and Troubleshooting
  • Account Posting
  • Charge Slips
  • Fee and Charge Computation
  • Statement Distribution
  • Customer Contact
  • Billing Data Verification
  • Error Revision
  • Relationship Building
Experience
Medical Billing Representative, 06/2022 - Current
Amita Health Chesterfield, MO,
  • Verified proper coding, sequencing of diagnoses and procedures.
  • Prepared and submitted claims to insurance companies electronically and manually.
  • Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
  • Posted surgeries, hospital visits and payments for assigned carriers on a daily basis.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Evaluated accuracy of provider charges, including dates of service, procedures, and level of care and diagnoses.
  • Applied payments, adjustments and denials into medical manager system.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
Medical Billing Manager, 02/2006 - 06/2022
Community Health System Rogers, AR,
  • Resolved billing issues by applying knowledge and completing in-depth research.
  • Managed billing calendar and scheduled claims for payments.
  • Developed improved standard operating procedures to increase billing accuracy and cash flow.
  • Helped customers to bring accounts into good standing by implementing payment plans.
  • Set up and maintained Modernizing Medicine electronic billing system.
  • Conducted insurance verification and pre-authorization, coded procedures and managed patient charts.
  • Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Completed appeals and filed and submitted claims.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Posted charges, payments and adjustments.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Entered procedure codes, diagnosis codes and patient information into medical software system.
  • Applied payments, adjustments and denials into medical manager system.
  • Collaborated closely with other departments to resolve claims issues.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Posted and adjusted payments from insurance companies.
  • Precisely completed appropriate paperwork and system entry regarding claims.
  • 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.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Submitted refund requests for claims paid in error.
  • Accurately coded diagnostics and prepared billing statements for patients.
  • Meticulously tracked and resolved underpayments.
  • Remained up-to-date details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Evaluated accuracy of provider charges, including dates of service, procedures, level of care and diagnoses.
  • Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.
  • Determined prior authorizations for medication and outpatient procedures.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
Medical Representative, 09/2003 - 06/2005
Principia Biopharma Inc. Seattle, WA,
  • Worked as a check out assistant
  • Entered medical claims
  • Collected patient's payments
  • Appointment scheduling
Front Office Supervisor, 09/1996 - 12/2002
Noble House Hotels And Resorts Gateway, CO,
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Completed appeals and filed and submitted claims.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Posted charges, payments and adjustments.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Entered procedure codes, diagnosis codes and patient information into Medical Manager software.

  • Applied payments, adjustments and denials into medical manager system.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Posted and adjusted payments from insurance companies.
  • Precisely completed appropriate paperwork and system entry regarding claims.
  • 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.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Submitted refund requests for claims paid in error.
  • Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Accurately coded diagnostics and prepared billing statements for patients.
  • Meticulously tracked and resolved underpayments.
  • Remained up-to-date details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
Education and Training
Bachelor of Arts: Physical Education, Expected in 05/1991
-
Methodist University - Fayetteville, NC
GPA:
Status -

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Resume Overview

School Attended

  • Methodist University

Job Titles Held:

  • Medical Billing Representative
  • Medical Billing Manager
  • Medical Representative
  • Front Office Supervisor

Degrees

  • Bachelor of Arts

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