Livecareer-Resume

Medical Billing Specialist Resume Example

Love this resume?

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

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

Smart Medical Biller adept at resolving disputes and billing inquiries. Brings organized, professional presentation in adhering to strict data confidentiality and HIPAA requirements. Detail-oriented approach, cultivated over more than 15 years, toward performing intricate billing procedures with efficiency and undeniable level of detail.

Skills
  • Files and records management
  • Bill payment
  • Quality-oriented team player
  • Generally Accepted Accounting Principles (GAAP)
Education and Training
DeVry University Columbus, Ohio, Expected in Associate of Applied Science : Health Information Technology - GPA :
DeVry University Columbus, Ohio, Expected in 12/2018 Certification : Medical Billing And Coding - GPA :
NAAC Mechanicsburg, PA, Expected in 03/2021 Certification : Certified Documentation Specialist - GPA :
Experience
Hca - Medical Billing Specialist
Cedar Hill, TX, 01/2019 - Current
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Liaised with patients, insurance companies and billing office personnel to effectively create and post bills, obtain payments and update system information.
  • Processed and sent monthly invoices to customers on standard billing cycle, including adjustments, credit memos and corrections.
  • Determined prior authorizations for medication and outpatient procedures.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • 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.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Submitted refund requests for claims paid in error.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Completed appeals and filed and submitted claims.
  • Posted charges, payments and adjustments.
  • Posted and adjusted payments from insurance companies.
Hca - Medical Billing Specialist
Daytona Beach, FL, 11/2015 - 12/2018
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Determined prior authorizations for medication and outpatient procedures.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Submitted refund requests for claims paid in error.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Accurately coded diagnostics and prepared billing statements for patients.
  • Completed appeals and filed and submitted claims.
  • Posted charges, payments and adjustments.
Hca - Medical Billing Specialist
Destin, FL, 08/2014 - 09/2015
  • Determined prior authorizations for medication and outpatient procedures.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • 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.
Hca - Medical Billing Specialist
Edmond, OK, 07/2010 - 08/2014
  • Determined prior authorizations for medication and outpatient procedures.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
  • 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.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Applied payments, adjustments and denials into medical manager system.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Submitted refund requests for claims paid in error.
  • Collaborated closely with other departments to resolve claims issues.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Accurately coded diagnostics and prepared billing statements for patients.
  • Entered procedure codes, diagnosis codes and patient information into Zoll.
  • Completed appeals and filed and submitted claims.
  • Posted charges, payments and adjustments.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Posted and adjusted payments from insurance companies.
  • Precisely completed appropriate paperwork and system entry regarding claims.
Accomplishments
  • Recognized as Employee of the Year 2020 for outstanding performance and team contributions.

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Disclaimer
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

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:

86Good

Resume Strength

  • Length
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job
  • Word Choice

Resume Overview

School Attended
  • DeVry University
  • DeVry University
  • NAAC
Job Titles Held:
  • Medical Billing Specialist
  • Medical Billing Specialist
  • Medical Billing Specialist
  • Medical Billing Specialist
Degrees
  • Associate of Applied Science
  • Certification
  • Certification