medical billing specialist collections credentialing resume example with 20+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - - : - -

To obtain employment in a field that can utilize my talents and skills in the areas of business, healthcare, and my ability to relate to people. WORK ETHIC: I approach work in an organized and systematic manner. I manage basic tasks in a timely manner using appropriate tools and systems. I maintain focus on quality in completing internal processes correctly and efficiently. I effectively prioritize work. I get advice on balancing workload to achieve or exceed expected results. I work effectively in confusing situations. I actively participate in the change process. I demonstrate strength and commitment during times of change. I revise priorities as appropriate to respond to change. I adapt project plans and/or work tasks to create alignment with overall goals. I take initiative to improve own capabilities as business change. I identify opportunities to reconfigure or redesign existing programs and process to meet emerging business needs. I effectively utilize basic functionality of standard office technology tools in day-to-day work. I integrate technology applications in day-to-day work to improve efficiency and effectiveness. I find ways to reduce cycle time and level of effort by exploiting technology options. I creatively apply and shares technology skills. Analytical Medical Biller successful at resolving disputes and billing inquiries. Detail-oriented individual with 30 plus years of experience performing intricate billing procedures with undeniable level of detail. Familiar with private and commercial insurance carriers. Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with 30 plus years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software. Logical Medical Biller proudly offers over 30 plus years of experience reviewing accounts and maintaining patient records. Driven professional with background in medical terminology and coding. Recognized task prioritization expertise in fast-paced environments. Organized Medical Biller boasts 30 plus-year career performing difficult multitasking and claims-processing tasks. Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers, and clients to handle invoicing within high-traffic office environment. Quality-focused Medical Biller offers strong track record over more than 30 plus years in settling and resolving complex patient billing accounts. Thoroughly experienced in handling medical charges and invoicing. Tech-savvy approach to understanding and resolving difficult areas of dispute. Focused Billing Clerk actively pursuing an opportunity to perpetuate the NFCU values in Member Service Representative role. Adept in building quality professional connections and managing key accounts to ensure timely payments and efficient processing. Energetic and industrious with a proven history of cultivating productivity and quality. Diligent billing professional bringing a demonstrated history of success in drafting financial reports and effectively reconciling outstanding invoices. Offering mastery of MicroMd software illustrated over 30 years in financial roles. Quick-learning and ambitious with a passion for learning and applying new skills for professional growth. Results driven Medical Biller with over 30 plus 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. Driven Billing Specialist well-versed in transforming business operations. Skilled at increasing profits and reducing operating expenditures through account reconciliations to identify errors in calculations. Expert at processing payments on outstanding invoices to minimize debt and prevent excess fees from being charged. Astute professional dedicated to verifying accuracy of information within ledger to verify accuracy of processed payments. Detailed Billing Specialist recognized for successfully batching, posting and matching over 100 invoices daily. Efficiently processes 10 checks on weekly basis and prepares checks for distribution or mailing. Reliable and professional with 30 plus years of functional experience in providing clerical, administrative and financial services. Analytical Billing Specialist professional with extensive experience saving companies money and maximizing revenue. Meticulous Billing Specialist offering 30 plus years of comprehensive experience in Finance and Healthcare. Comfortable working independently or as part of supportive team. Extensive familiarity with multiple software programs . Core competencies include good communication and listening ability. Efficient Billing Specialist with 30 plus years of experience. Experienced in reconciliation procedures, accounting principles, payment processing and report generation. Equipped with accounting background to quickly propel businesses forward and increase profit margins. Committed Billing Specialist aiming to fulfill a Billing Clerk opportunity within a results-driven team. Passionate about the NFCU mission and willing to go above and beyond to contribute to team objectives. Highly skilled in collections with an aptitude for addressing past due accounts while cultivating satisfaction. Efficient billing professional pursuing a Member Service Representative opportunity to utilize expertise in payment processing and account reconciliation. Focused and productive with a commitment to perpetuating the NFCU values through hard work and dedication. Diligent Billing Specialist skilled at independently managing filing, report writing and other ad hoc office functions. Good listening, speaking and problem-solving abilities. Looking to bring 30 plus years of related experience to challenging, growth-oriented position.


10 Key (touch)

Medical Terminology

Typing (65 wpm)

CPT& ICD-9,10&HCPC Coding

Microsoft Word 2003, 2007 & 2010

Availity Info- Source

Leadership Training

Converge CC System

Transaction 1 CC System

Medical Manager System Micro MD 10.5 Encounter Pro

Allscripts Professional Elec HR Allscripts Myway

Microsoft Outlook

Practice Insight/EDI



Microsoft Office 2007 & 2010

01/2016 to Current
Medical Billing Specialist/Collections/Credentialing Acadia Healthcare Lemont, IL,
  • Entered procedure codes, diagnosis codes and patient information into MicroMD.

  • Evaluated accuracy of provider charges, including dates of service, procedures, level of care and diagnoses, identifying over 50 errors within 3 hours.
  • Performed full-cycle medical billing for fast-paced company, reducing errors 100% within 3 hours.
  • Posted surgeries, hospital visits and payments for assigned carriers within 3 hours.
  • Thoroughly reviewed remittance codes from electronic and manual sources.

• Take calls from patients and insurance companies about billing or patient account balance to resolve any problems.

10/2013 to 01/2016
Claims Benefit Specialist (Examiner) Advocates Worcester, MA,
  • Collaborated closely with other team members to resolve large volume of claims on daily basis.
  • Analyzes and approves routine claims that cannot be auto adjudicated.
  • Applies medical necessity guidelines, determines coverage, complete eligibility verification, indentify discrepancies and applies all cost containment measures to assist in claim adjudication process.
  • Coordinates responses for routine phone inquiries and written correspondence related to claim processing issues.
  • Utilizes all applicable system functions available ensuring accurate and timely claim processing service (I.e.: claim check reasonable and customary data and other post containment tools).
  • Maintain production standards; understand medical terminology, attention to detail and accuracy.
05/2012 to 01/2013
Billing Specialist Gulf Coast Primary Care City, STATE,
Reneaindentifyrsonable support.
  • Worked with MicroMd to create and submit large numbers of client invoices each day.
  • Participated in conference calls with Management to discuss incident tracker issues.
  • Identified and implemented process improvements to increase collections by $50,000.
  • Verified $50,000 in payments received to check against billing amounts.
  • Input tracking information, evaluated trends and informed management about billing and payment concerns.
  • Take calls from patients and insurance companies about billing or patient account balance to resolve any problems.
  • 08/2000 to 12/2011
    Billing Coordinator Pensacola Pediatrics, P.A City, STATE,
    • Managed daily operations for billing department handling $500,000 per month in payments.
    • Oversaw activities of 3 staff processing 1,000 payments each week.
    • Responsible for billing to corporate clients, insurance companies, including working with account personnel to determine the monthly billing and with outside accounting firm to produce monthly billing timely and accurately.
    • Loaded charges, payments and adjustments on a daily basis for two sites and edited each account.
    • Responded to insurance companies and patients inquire regarding billing.
    • Monitored and collected on account receivable once a claim has aged beyond payment terms.
    • Prepared monthly summary report by insurance companies for all open claims.
    • Prepared monthly report, which details service fees, payments and adjustments for each month as well as year to date.
    • Trained new employees all aspect of the billing department.
    • Take calls from patients and insurance companies about billing or patient account balance to resolve any problems.
    Education and Training
    Expected in 01/2014 to to
    AAS: Health Information Management
    Pensacola State College - Pensacola, FL
    Expected in 12/1986 to to
    Certificate of training in Office Management (General Clerical:
    Pensacola Junior College - Pensacola, FL
    Expected in 05/1983 to to
    Pine Forest High School - Pensacola, FL
    Activities and Honors
    Outstanding Academic Scholastic Achievement Pensacola Junior College Academic Honors Certificate of Completion Transitioning to ICD-10 (3.0 CEU) 07/28/11 Sacred Heart Hospital AAPC (American Academy of Professional Coders) Member since 02/13
    Additional Information

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    Resume Overview

    School Attended

    • Pensacola State College
    • Pensacola Junior College
    • Pine Forest High School

    Job Titles Held:

    • Medical Billing Specialist/Collections/Credentialing
    • Claims Benefit Specialist (Examiner)
    • Billing Specialist
    • Billing Coordinator


    • AAS
    • Certificate of training in Office Management (General Clerical
    • Diploma

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