Medical Billing Specialist Resume Example Inesco Billing Services

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 / Inesco Billing Services - Houston, TX02/2020 - 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 / Fondren Orthopedic - Houston, TX11/2017 - 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 / Spinecare Consultants - Houston, TX08/2010 - 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 - Baytown, TX06/2008 - 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 - Houston, TX06/2008Medical 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.

Resume Overview

Companies Worked For:

Inesco Billing Services
Fondren Orthopedic
Spinecare Consultants
Southeast Texas Institute Of Pain Management

School Attended

Texas School of Business

Job Titles Held:

Medical Billing Specialist
Medical Billing Collector
Insurance And Coding Specialist

Degrees

Texas School of Business - Houston, TX 06/2008 Medical Office Specialist Diploma : Billing And Coding Specialist

Medical Billing Specialist Resume Example

Resume Score: 80%

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