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medical billing specialist resume example with 20+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident and knowledgeable in data confidentiality and privacy practices when reviewing patient information. Experienced in Hospice and Home Health billing. Accurate and detail-oriented with knowledge of benefits, eligibility and appeals practices. Reliable in handling high volumes of practice billing.

Skills
  • Medicare, Medicaid and Commercial Insurance knowledge
  • Medical claims submission
  • Customer service support
  • Hospice and Home Health billing knowledge
  • Fluent with Epic, McKesson, Palmetto, Brightree Medi and Waystar software.
Work History
02/2018 to Current Medical Billing Specialist People Incorporated | Mansfield, MA,
  • Verified Insurance benefits and eligibility, deductibles, Co- Ins, Out of pocket max, Life Time max , benefit periods, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Determined/Obtained prior authorizations for Routine Hospice, Respite, GIP and Room and Board.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Performed billing of Routine Hospice, Respite, GIP and Facility Room and Board.
  • Responded to requests for additional information from various insurance agencies.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Communicated with insurance providers to resolve denied claims, locate errors and promptly refile rejected claims.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Acted as back up for Home Health Billing- as needed basis.
08/2015 to 02/2018 Patient Service Representative Bjc Healthcare | O Fallon, MO,
  • Completed incoming Medical Equipment orders, verified order was completed correctly and reviewed patient records to verify that they qualify for the equipment.
  • Communicated with Physicians and Hospital staff to resolve discrepancies in orders.
  • Answered constant flow of customer calls with minimal wait times.
  • Responded to customer requests for products, services and company information.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Communicated with vendors regarding backorder availability, future inventory and special orders.
  • Assisted customers with setting appointments, special order requests, and arranging merchandise delivery and pick up.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
12/2006 to 08/2015 Medical Receptionist Chumash Casino | Santa Ynez, CA,
  • Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
  • Checked patient insurance, demographic and health history to keep information current.
  • Coordinated patient scheduling, check-in, check-out and payments for billing.
  • Transcribed phone messages and relayed to appropriate personnel.
  • Helped patients complete necessary medical forms and documentation.
  • Kept waiting room neat and organized by stacking magazines, removing trash and cleaning glass.
  • Adhered to strict HIPAA guidelines to protect patient privacy.
  • Maintained current and accurate medical records for patients.
  • Enhanced office productivity by handling high volume of callers per day.
  • Managed multi-line phone system(over 100 calls per day) and pleasantly greeted patients.
  • Disseminated sensitive patient information and coordinated with translators to offer personalized service to individuals from diverse backgrounds.
  • Completed patient referrals to other medical specialists.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Offered ample support to team members with creative solutions to complex challenges regarding scheduling, conflict resolution and medical care.
  • Responded to correspondence from insurance companies to verify patient's coverage.
07/1997 to 12/2006 Warranty Administrator Bob Moore Auto Group | Norman, OK,
  • Oversaw logistics for incoming replacement parts and outgoing shipments of defective components.
  • Gathered paperwork and contacted customers to book appointments.
  • Monitored factory recalls and announcements to stay on top of changes.
  • Reconciled monies due, followed up on outstanding claims and worked with accounting department to obtain payments.
  • Submitted supporting documents to satisfy criteria required by manufacturer or distributor.
  • Reviewed warranty repair orders for proper completion, accuracy and legibility to reduce processing delays.
  • Resubmitted rejected claims or received write-off authorization to maintain records and proper documentation.
  • Processed claim paperwork and followed up on missing information to complete processing.
  • Maintained detailed service and customer records.
Education
Expected in 04/1989 to to High School Diploma | North Boone High School, Poplar Grove, IL, GPA:

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Resume Overview

School Attended

  • North Boone High School

Job Titles Held:

  • Medical Billing Specialist
  • Patient Service Representative
  • Medical Receptionist
  • Warranty Administrator

Degrees

  • High School Diploma

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