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Medical Billing Specialist Resume Example

Resume Score: 80%

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Skills
  • Medical Billing
  • Billing
  • Bill Payment
  • Insurance Knowledge
Education and Training
Some College (No Degree): Medical Billing And CodingSeacoast Career SchoolsCity, State
MEDICAL BILLING SPECIALIST
Summary

Quality-focused Medical Biller offers strong track record over more than 16 years in settling and resolving complex patient billing accounts. Thoroughly experienced in handling medical charges and invoicing. Tech-savvy approach to understanding and resolving difficult areas of dispute.

Experience
Company Name - Medical Billing SpecialistCity, State8/11/14 - 3/19/21
  • 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.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
Company Name - Medical Billing SpecialistCity, State04/2013 - 08/2014
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Prepared and attached all required claims documentation including 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.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Posted and adjusted payments from insurance companies.
  • Precisely completed appropriate paperwork and system entry regarding claims.
  • Entered procedure codes, diagnosis codes and patient information into software at the time.
  • Submitted refund requests for claims paid in error.
  • Posted charges, payments and adjustments.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Applied payments, adjustments and denials into medical manager system.
  • Collaborated closely with other departments to resolve claims issues.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Completed appeals and filed and submitted claims.
Company Name - Medical Billing SpecialistCity, State10/2007 - 04/2013
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Prepared and attached all required claims documentation including 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.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Posted and adjusted payments from insurance companies.
  • Entered procedure codes, diagnosis codes and patient information into Nextgen software.
  • Submitted refund requests for claims paid in error.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Posted charges, payments and adjustments.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Applied payments, adjustments and denials into medical manager system.
  • Collaborated closely with other departments to resolve claims issues.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Completed appeals and filed and submitted claims.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
Company Name - Medical Billing SpecialistCity, State07/2005 - 10/2007
  • Maintained current working knowledge of CPT and ICD-9 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.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Posted and adjusted payments from insurance companies.
  • Precisely completed appropriate paperwork and system entry regarding claims.
  • Entered procedure codes, diagnosis codes and patient information into software at the time.
  • Submitted refund requests for claims paid in error.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Posted charges, payments and adjustments.
  • Completed appeals and filed and submitted claims.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Accurately coded diagnostics and prepared billing statements for patients.
Additional Information

Proficent in Medicare billing

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Resume Overview

School Attended

  • Seacoast Career Schools

Job Titles Held:

  • Medical Billing Specialist

Degrees

  • Some College (No Degree) : Medical Billing And Coding

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