Medical Billing Specialist resume example with 13+ years of experience

Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,

Highly trained HIM coder with strong clinical abilities and a successful career in both hospital and private practice facilities. Proactive and organized with passionate commitment to first-rate patient care. Licensed with AHIMA since 2006. Authorized to work in the US for any employer

  • Cost control
  • Database management
  • Diagnosis
  • Electrocardiogram (EKG)
  • Forms
  • Government
  • Inventory
  • Laboratory tests
  • Materials
  • Office
  • Neat
  • Personnel
  • Research
  • Statistics
  • Word processing
  • Files and records management
  • Quality-oriented team player
  • Data entry
  • Understands medical procedures
  • Charting expertise
  • Medical billing
  • Advanced anatomy knowledge
10/2018 to Current Medical Billing Specialist Kabafusion | Elizabethtown, NY,
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • 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.
  • Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
  • Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Thoroughly reviewed remittance codes from [Type] and [Type] sources.
  • Collaborated closely with other departments to resolve claims issues.
  • Completed appeals and filed and submitted claims.
  • Precisely completed appropriate paperwork and system entry regarding claims.
  • Meticulously tracked and resolved underpayments.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Submitted refund requests for claims paid in error.
07/2018 to 10/2018 Medical Coder Cape Cod Healthcare Inc. | Plymouth, MA,
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Reviewed medical record information to identify all appropriate coding based on [Type] and [Type] categories.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Assigned procedure and diagnosis codes for insurance billing using [Software].
  • Sought clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Received, organized and maintained all coding and reimbursement periodicals and updates.
  • Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Categorized health services and assigned a specific [Type] code to each one.
  • Consistently ensured proper coding, sequencing of diagnoses and procedures.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Coded medical observations and professional services delivered for each patient.
  • Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
  • Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
06/2005 to 04/2010 Medical records Dependable Health Services | Henderson, NV,
  • Use computers for various applications, such as database management or word processing.
  • Protect the security of medical records to ensure that confidentiality is maintained.
  • Review records for completeness, accuracy, and compliance with regulations.
  • Retrieve patient medical records for physicians, technicians, or other medical personnel.
  • Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment in computer.
  • Release information to persons or agencies according to regulations.
  • Complete and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
  • Process and Prepare businesses or government forms.
  • Process patient admissions and discharge documents.
  • Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.
  • Identify, compile, abstract, and code patient data, using standard classification system.
05/1999 to 06/2005 Medical assistant Beacon Health System | Mishawaka, IN,
  • Record patients' medical history, vital statistics, or information such as test results in medical records.
  • Prepare treatment rooms for patient examinations, keeping the rooms neat and clean.
  • Authorize drug refills and provide prescription information to pharmacies.
  • Explain treatment, procedures, medications, diets, or physicians examine and test patients, handing them instruments or materials.
  • Perform routine laboratory tests and sample analyses.
  • Contact medical facilities or departments to schedule patients for test or admissions.
  • Operate electrocardiogram (EKG).
  • Inventory and order medical, lab, or office supplies.
Education and Training
Expected in 2001 Associate of science | Medical Trinidad State Junior College, Alamosa, CO GPA:
Expected in 1995 | Cochise College, Douglas, AZ GPA:
Activities and Honors

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Resume Overview

School Attended

  • Trinidad State Junior College
  • Cochise College

Job Titles Held:

  • Medical Billing Specialist
  • Medical Coder
  • Medical records
  • Medical assistant


  • Associate of science

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