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Medical Billing Specialist Resume Example

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AR
MEDICAL BILLING SPECIALIST
Objective

To obtain employment with a company that allows me to utilize my acquired skills as well as to develop new ones through training and experience, while also giving me the opportunity for growth and advancement.

Skills
  • Claim review
  • Data entry
  • Anesthesia and Pain management claims expertise
  • Self-motivated
  • Excellent time management
  • Proficient with Microsoft Excel and Microsoft Word
  • Knowledgeable in Medisoft, Centricity, MD Logic
  • Submission of medical claims
  • Medical coding understanding
Experience
Medical Billing Specialist / 22Nd Century Technologies - Burkeville , VA02/2020 - 06/2020
  • Applied payments, adjustments and denials into medical manager system
  • Reviewed received payments and applied to the appropriate patient accounts.
  • Applied mathematical skills to calculate total, check figures and correct problems with physical and digital files
  • Assisted with month end closings to support accounting system accuracy
  • Review denied explanation of benefits to appeal or dispute underpayments denied in error
  • Submit appeals with appropriate paperwork to dispute their denials
  • Provide any documentation for pending claims per insurance request
  • Maintain a clean AR with Medicare and any commercial insurance company's
  • Offer negotiations as needed per settlement with insurance carriers
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Submitted refund requests for claims paid in error.
  • Assesses accuracy of demographic and policy information within patients accounts as additional information is provided
Medical Billing Specialist / 22Nd Century Technologies - Columbia , MO11/2017 - 02/2020
  • Entered procedure codes, diagnosis codes and anesthesia minutes into patients accounts for billing reimbursement from insurance carriers
  • Ensured timely and accurate charge submission through EDI submission management
  • Filed and submitted insurance claims
  • Analyzed patients' encounter forms diagnosis codes to validate accuracy, completeness and specificity
  • Accurately entered procedure codes, diagnosis codes and patient information into billing software
  • Reviewed medical records to meet insurance company requirements
  • Audited medical records and diagnosis codes for accuracy and completion
  • Entered patient information including insurance and demographic into the system to ensure that all records were up-to-date
  • Processed patient and insurance credit card payments
  • Observed strict HIPAA guidelines at all times according to company policy
  • Assisted with month-end and year-end closings to support accounting system accuracy
  • Reviewed bank account statements to reconcile accounts by documenting correct financial information in microsoft excel spreadsheet
  • Applied mathematical skills to calculate totals, check figures and correct problems with physical and digital files
  • Reviewed received payments and applied to the appropriate patient accounts
  • Applied payments, adjustments and denials into medical manager system
Medical Billing Collector / Lincare - Naples , FL08/2010 - 11/2017
  • Review denied explanation of benefits to appeal or dispute underpayments, denied in error procedures or office visits
  • Submit appeals with appropriate paperwork to dispute their denials
  • Maintain collections for patients accounts, collect balances, make payment plans or forward past due accounts to the credit bureau
  • Maintain a clean AR, Aetna, BCBS, Cigna, UMR, Unicare, Medicare, Workers Comp, any other commercial insurance or HMO's
  • Provide any documentation for pending claims per insurance request
  • Submit corrected claims as necessary when incorrect diagnosis codes, cpt codes, or patient demographics have been billed in error
  • Assesses accuracy of demographic and policy information within patients accounts as additional information is provided
  • Provide assistance with precertification when necessary for office visits and or procedures
  • Verify insurance coverage and investigate pre-existing clauses on patients policy
Insurance And Coding Specialist / Southeast Texas Institute Of Pain Management - City , STATE06/2008 - 08/2010
  • On a daily basis I complete data entry, charge entry, review EOB's, posting payments or adjustments, follow up on unpaid or denied claims, filing appeals, verifying insurance, and updates on ICD-9, CPT, and HCPCS codes on all medically necessary medical software program
  • Scheduler for appointments, hospital procedures, and medication delivery and pick-up
  • Reviews provider schedules and screens financial/demographic information for accuracy
  • Solely responsible for processing all pre-authorizations for insurance coverage, pending hospital procedures, and all prescriptions
  • Responsible for maintaining and/or creating patients accounts within medical software program
  • Coordinates with as well as serving as back-up to the front desk staff and all associated responsibilities in that position
  • Perform medical assisting duties as necessary
Education and Training
Texas School of Business - City, State06/2008Medical Office Specialist Diploma : Billing And Coding Specialist

National Certified Insurance Coding Specialist

Identification number: 638941

Renewal in Process

Summary of Qualifications

Able to take direction but also work under little or no supervision.

Ability to multi-task and prioritize while being capable of trouble-shooting uncommon circumstances with research and relatively to similar occurrences.

Self-motivated and disciplined which enable me to continuously look for ways to improve processes that in turn become more efficient for functionally in the office.

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How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

83Good
Resume Strength
  • Word choice
  • Measurable results
  • Strong summary
  • Typos

Resume Overview

School Attended

  • Texas School of Business

Job Titles Held:

  • Medical Billing Specialist
  • Medical Billing Collector
  • Insurance And Coding Specialist

Degrees

  • Texas School of Business - City, State 06/2008 Medical Office Specialist Diploma : Billing And Coding Specialist

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