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Medical Billing Specialist Resume Example

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DJ
MEDICAL BILLING SPECIALIST
Professional Summary

Competent patient business representative providing 3 years of experience in handling wide variety of medical billing tasks, including; billing primary, secondary and tertiary insurances. Adding and removing condition codes to medical claims and handling insurance denials in a timely maner. Determined and hardworking individual with excellent communication skills and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Confidence in being detail-oriented, focused, dedicated and skillful in billing Inpatient, Outpatient, Therapy & Miscellaneous hospital claims.

Work History
Oklahoma Mental Health Council - Medical Billing SpecialistLawton , OK01/2020 - Current
  • Responsible for billing facility claims to correct insurance within timely filing guidelines, correct any errors on claims before submitting, and add coding modifiers when needed.
  • Maintain insurance work que's work insurance correspondence, EOB's and denials in timely fashion.
  • Contact insurance to review, appeal and or check on status of claims if unable to locate in provider portals.
  • Speak with patients to advise if information is needed for their claim or to assist in updating their Coordination of Benefits.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Posted and adjusted payments from insurance companies.
  • Precisely evaluated and verified benefits and eligibility.
  • Identified and resolved patient billing and payment issues.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Communicated effectively and extensively with other departments to resolve claims issues.
Barracuda Networks - Customer Services RepresentativeTrenton , NJ03/2018 - 01/2020
  • Educated and assisted patients with inquiries on billing of their insurance, processing of their claims and balances after insurance.
  • Worked with patients in resolving coding and or billing errors for their claims.
  • Maintained WQ's in timely manner, worked patient and insurance correspondence, updated and billed primary, secondary and tertiary insurances for patient.
  • Worked spreadsheets provided by lead/supervisor in timely fashion.
  • Recorded actions taken, issues resolved and document information to effectively manage customer accounts.
  • Responded to customer requests for billing, payments and insurance information.
  • Investigated and resolved patient inquiries and complaints quickly.
  • Handled over 100 calls per shift signing assisting patients.
Rod Martin's Complete Basement Systems - General ManagerLivonia , MI03/2017 - 03/2018
  • General Manager of Naples, FL, Sanibel Island, FL, and Estero, FL locations.
  • Reduced corporate risk by managing shrink processes and controlling inventory levels.
  • Managed budget implementations, employee reviews, training, and schedules.
  • Designed modern employee training program which boosted productivity knowledge and sales.
  • Set, enforced and optimized internal policies to maintain efficiency and responsiveness to demands.
  • Held weekly meetings with sales associates to identify techniques to overcome sales obstacles.
Kroger - Assistant Store ManagerOak Lawn , IL05/2013 - 03/2015
  • Achieved recognition from senior management for contribution to store success, including managing sales, employees and operations to foster optimal performance.
  • Verified inventory counts remained within monthly tolerance levels and compiled financial data in compliance with budget.
  • Created organization systems for inventory control, merchandising, financial reports and schedules, dramatically increasing operational efficiency.
  • Offered hands-on assistance to customers, assessing needs and maintaining current knowledge of products.
  • Helped with planning schedules and delegating assignments to meet coverage and service demands.
  • Monitored cash intake and deposit records, increasing accuracy and reducing discrepancies.
Website, Portfolio, Profiles
  • https://www.linkedin.com/in/danielle-james-4317b1158/
Skills
  • ICD-10, CPT/HCPCS knowledge
  • Medical terminology
  • MS Office
  • Able to work Remotely
  • Medical Records Management
  • Insurance Knowledge
  • HIPAA Compliance
  • Invoice Processing
  • Patient Care
Education
03/2020Fort Myers Technical CollegeCity, StateCertified Professional Coding: Medical Billing & Coding
12/2016Cape Coral Technical CollegeCity, StateCertified Nursing Assistant: Nursing Assistance
05/2014Cypress Lake High SchoolCity, StateHigh School Diploma
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Resume Overview

School Attended

  • Fort Myers Technical College
  • Cape Coral Technical College
  • Cypress Lake High School

Job Titles Held:

  • Medical Billing Specialist
  • Customer Services Representative
  • General Manager
  • Assistant Store Manager

Degrees

  • Certified Professional Coding : Medical Billing & Coding
    Certified Nursing Assistant : Nursing Assistance
    High School Diploma

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