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medical coding and billing specialist resume example with 13+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Medical Billing and Coding Specialist with 6 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes.

Skills
  • Records management
  • Coding error resolution
  • Insurance claims analysis
  • Patient data compilation
  • Medical claims coding
  • Medical billing code accuracy
Work History
Medical Coding and Billing Specialist, 07/2017 - Current
Pacific Dental Services Sterling, VA,

Applied charges and updated patient records by using WRS and PHICURE.
Used WRS to assign procedure and diagnostic codes to patient records for billing purposes.
Managed master calendar and scheduled appointments for four providers based on optimal patient loads and clinician availability.

  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Maintained current and accurate medical records for 1000’s of patients.
  • Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
  • Completed and filed financial documentation for accounting purposes.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Remained aware of provider schedules and scope of practice on evolving basis to organize and schedule appropriate care.
  • Scheduled appointments for doctor visits and procedures using desktop calendar software.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
  • Generated and submitted invoices based upon established accounts receivable schedules and terms.
  • Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
  • Identified, researched and resolved billing variances to maintain system accuracy and currency.
  • Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
  • Generated accounts payable reports for management review to aid in financial and business decision making.
Pharmacy Technician, 09/2013 - 06/2017
Baptist Healthcare System, Inc. Shelbyville, KY,
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
  • Resolved non-routine issues like third party billing, computer system and customer service issues.
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
  • Provided consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects and specified use.
  • Liaised with other pharmacies to eliminate issues related to product expiration.
  • Stocked, labeled and inventoried medication to keep accurate records.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items.
  • Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency and service quality.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Assisted patients in minimizing medical expenses by recommending generic alternative prescription medications.
  • Verified patient data and billing information to discover and resolve erroneous bills due to system errors.
  • Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
  • Entered and processed patients' prescriptions into internal system.
  • Processed incoming drug orders.
Medical Coding and Billing Specialist, 02/2012 - 09/2013
Pacific Dental Services Surprise, AZ,

Applied charges and updated patient records by using WIsdom.
Used Wisdom to assign procedure and diagnostic codes to patient records for billing purposes.
Managed master calendar and scheduled appointments for four providers based on optimal patient loads and clinician availability.

  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Maintained current and accurate medical records for 1000’s of patients.
  • Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
  • Completed and filed financial documentation for accounting purposes.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Remained aware of provider schedules and scope of practice on evolving basis to organize and schedule appropriate care.
  • Scheduled appointments for doctor visits and procedures using desktop calendar software.
  • Obtained payments from patients and scanned identification and insurance cards.
Lead Pharmacy Technician, 05/2007 - 02/2012
Truepill San Francisco, CA,
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems and locating items.
  • Stocked, labeled and inventoried medication to keep accurate records.
  • Reviewed and verified customer information and insurance provider information.
  • Collected co-payments or full payments from customers.
  • Counted, measured, and compounded medications following standard procedures.
  • Resolved non-routine issues like third-party billing, computer system and customer service issues.
  • Maintained proper drug storage procedures, registries, and records for controlled drugs.
  • Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
  • Restocked automated medication dispensing equipment.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Prepared intravenous solutions, admixtures, respiratory drugs and other solutions using aseptic techniques.
  • Performed various pharmacy operational activities with strong commitment to accuracy, efficiency and service quality.
  • Verified patient data and billing information to discover and resolve erroneous bills due to system errors.
  • Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
  • Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
  • Assisted patients in minimizing medical expenses by recommending generic alternative prescription medications.
  • Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
  • Liaised with other pharmacies to eliminate issues related to product expiration.
  • Resolved non-routine issues like third party billing, computer system and customer service issues.
  • Provided consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects and specified use.
  • Processed incoming drug orders.
  • Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
  • Communicated instructions to patients or caregivers.
Education
Associate Of General Studies: Pharmacy Technology, Expected in 05/2008
-
Chattanooga State Community College - Chattanooga, TN
GPA:
Status -

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Resume Overview

School Attended

  • Chattanooga State Community College

Job Titles Held:

  • Medical Coding and Billing Specialist
  • Pharmacy Technician
  • Medical Coding and Billing Specialist
  • Lead Pharmacy Technician

Degrees

  • Associate Of General Studies

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