Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - - : - -
Professional Summary

Medical Biller and Coder

Work independently and fast learner; initiative; proactive in identifying and resolving problems. Good personal work ethic; Communicate effectively, written, in person.

Ability to retain and apply what have learned. Attention to detail and very organized. Excellent computer knowledge. Can work both independently or in a team.


Certified Coding Specialist

Skill Highlights

Encoder Pro software; MedLook software; MedSoft software; Microsoft Package; Internet search engines; Adobe Apps; HTML programming, all office equipments.Knowledge of HMOs, Medicare and Medi-Cal

Medical Manager Software

Electronic Medical Record (EMR) software

CPT and HCPCS coding

Strong planning skills

Strong work ethic

Team player with positive attitude

Professional Experience
11/2016 to
Medical Coder and Biller - Accounts Associate Bluegreen Resorts Petoskey, MI,
  • Manage accounts receivable.
  • Super Bills Coding.
  • Claims posting.
  • Answer calls and questions from patients and accept payments.
  • Follow up with insurance companies regarding unpaid claims, denial of payments, and initiate appeal.
  • Generate billing records when requested.
  • Generate weekly accounting reports for patient accounts.
  • Request Explanation of Benefits from insurance company for recent payments.
  • Current since 12/15/2013 Highlighted Skills: CMS-1500/CMS-1450 (UB-04) claims forms Medicare/Medicaid/Tricare Workers' Compensation EMR Meridium and Medsoft HMOs/PPOs/other health plans CPT/ICD-10/HCPCS codes Medical coding software Medical terminology * Appeals Human anatomy/physiology Professional conduct (HIPAA, Joint Commission standards) Medical ethics Electronic claims submission (clearinghouse) Medical billing clearinghouse Working with healthcare providers Disability insurance Managing patient/client accounts Electronic health records (EHR).
  • Recorded and filed patient data and medical records.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Coded outpatient encounters at a rate of 160 per day and 120 complex specialty coding.Accurately entered procedure codes, diagnosis codes and patient information into billing software.Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.Consistently ensured proper coding, sequencing of diagnoses and procedures.Thoroughly reviewed remittance codes from EOBS/AR's.Confirmed patient information, collected copays and verified insurance.Completed appeals and filed and submitted claims.Posted charges, payments and adjustments.Applied payments, adjustments and denials into medical manager system.Carefully prepared, reviewed and submitted patient statements.Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.Efficiently performed insurance verification and pre-certification and pre-authorization functions.Performed full-cycle medical billing in a fast-paced medical billing company.
Customer Service Attendant Target City, STATE,
  • Served customers by providing product and service information; resolving product and service problems and checking out in the best friendly manner.
  • This position included answering product and service questions; suggesting information about other products and services.
  • Opens customer accounts by recording account information.
  • Resolves product or service problems by clarifying the customer's complaint; determining the cause of the problem; selecting and explaining the best solution to solve the problem; expediting correction or adjustment; following up to ensure resolution.
  • Maintains financial accounts by processing customer adjustments.
  • Recommends potential products or services to management by collecting customer information and analyzing customer needs.
  • Immigrates to USA in June/2013 and bring experience in accounts management in the field of international trade business and translation of documents.
Education and Training
Expected in July 2013 to to
USCI Medical Billing and Code Specialist Certified Medical Coder and Biller California - USA - 2015 Graduate Studies in English UGF - Gama Filho University - São Paulo - Brazil :
- ,
Expected in Jan 1993 to to
Associate Degree: International Business
Eastern Illinois University - , Illinois
International Business
Expected in 2005 to to
Web design and HTML programmer - 2004 FAAP - Brazil: Computer Science
Monitor Institute - ,
Computer Science
Expected in 1996 to to
BA: Business and Marketing
PUC - SP - Pontifical Catholic University of São Paulo - ,
Business and Marketing
Portuguese and English.
Volunteer as Translator to Missionaries working with Baptist Church of São Paulo / Brazil Volunteer at Senior Center - Pleasanton, CA Professional references: upon request
Professional Affiliations
Currently pursuing the CPC certification Member of AAPC Certified Translator

accounting, accounts receivable, Adobe, anatomy, Benefits, billing, CMS, CPT, client, Electronic health records, English, financial, forms, HTML, HTML programming, ICD-10, insurance, Managing, Medical Billing, Medical coding, Medical Coder, Medical terminology, office, Internet search engines, physiology, Portuguese, product and service information, Coding, programmer, recording, translation, Web design

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Resume Overview

School Attended

  • Eastern Illinois University
  • Monitor Institute
  • PUC - SP - Pontifical Catholic University of São Paulo

Job Titles Held:

  • Medical Coder and Biller - Accounts Associate
  • Customer Service Attendant


  • USCI Medical Billing and Code Specialist Certified Medical Coder and Biller California - USA - 2015 Graduate Studies in English UGF - Gama Filho University - São Paulo - Brazil
  • Associate Degree
  • Web design and HTML programmer - 2004 FAAP - Brazil
  • BA

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