LiveCareer-Resume

medical billing specialist resume example with 20+ years of experience

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

Results driven, organized Medical Biller with over 20 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.

Skills
  • Quality-Oriented team player
  • Files and records management
  • OPIE software applications proficiency
  • Microsoft office
  • Problem solving
  • Time management
  • Decision making
  • Patience
  • Reliability
  • Attention to detail
Education and Training
Plattsmouth High School Plattsmouth, NE Expected in 05/1991 High School Diploma : - GPA :
Experience
Healthpro Heritage - Medical Billing Specialist
Chicago, IL, 02/2013 - 12/2022
  • Review patient insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Determine prior authorizations for medication and outpatient procedures.
  • Evaluate accuracy of provider charges, including dates of service, procedures, level of care and diagnoses, identifying errors within timeframe.
  • Maintain current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Maintain timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
  • Perform quality control of data entry system to verify proper posting of claims and payments.
  • Apply payments, adjustments and denials into medical manager system.
  • Contact insurance providers to verify insurance information and obtain billing authorization.
  • Complete appeals and file submitted claims.
  • Accurately code diagnostics and prepare billing statements for patients.
  • Precisely complete appropriate paperwork and system entry regarding claims.
  • Meticulously track and resolve underpayments.
  • Review and verify benefits and eligibility with speed and precision.
  • Post charges, payments and adjustments.
  • Post and adjusted payments from insurance companies.
  • Submit refund requests for claims paid in error.
  • Enter procedure codes, diagnosis codes and patient information into OPIE Software.
  • Prepare billing statements for patients, ensuring correct diagnostic coding.
  • Contact patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Enter procedure codes, diagnosis codes and patient information into OPIE software.
Univar - Medical Patient Service Representative
Birmingham, AL, 2011 - 2012
  • Complete registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements.
  • Organize timely and accurate referrals to help patients obtain health care services and access available resources.
  • Access patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Schedule patient appointments and procedures.
  • Scan completed forms, identification and insurance cards, maintaining patient documents folder.
  • Obtain proper authorization and identification to release confidential medical records.
  • Compile information from patients and caregivers or family members to identify care concerns.
  • Verify patients' insurance and payment methods during admissions or check-in processes.
  • Screen patients for eligibility for state, local and federal assistance programs.
  • Run credit card batches and balanced deposits on daily basis.
  • Explain policies, procedures and services to patients.
  • Counsel patients on potential financial liabilities and payment requirements.
  • Register patients by verifying records to update computer system and patient charts.
InfoUSA - Customer Service Representative
City, STATE, 1993 - 2011
  • Provide outstanding service to new and long-standing customers by attending closely to concerns.
  • Use proven techniques to de-escalate angry customers during telephone interactions.
  • Maintain knowledge of current promotions, exchange guidelines, payment policies and security practices.
  • Mentor new employees on procedures and policies to maximize team performance.
  • Set up and activate customer accounts.
  • Consult with customers to resolve service and billing issues.
  • Answer incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
  • Escalate customer concerns, issues and requirements to supervisors for immediate rectification.
  • Promote high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Answer inbound calls, chats and emails to facilitate customer service.
  • Ask probing questions to determine service needs and accurately input information into electronic systems.
  • Develop strong customer relationships to encourage repeat business.
  • Educate customers on special pricing opportunities and company offerings.
  • De-escalate problematic customer concerns, maintaining calm, friendly demeanor.
  • Field customer complaints and queries, fast-tracking for problem resolution.
  • Remain calm and professional in stressful circumstances and effectively diffused tense situations.
  • Demonstrate excellent communication skills in resolving product and consumer complaints.

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Resume Overview

School Attended

  • Plattsmouth High School

Job Titles Held:

  • Medical Billing Specialist
  • Medical Patient Service Representative
  • Customer Service Representative

Degrees

  • High School Diploma

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